Children who are deaf or hard of hearing face a potential developmental emergency, according to the American Academy of Pediatrics. Hearing provides a clear pathway for sound to travel through the ears to the brain.
Sound is the important auditory information that becomes knowledge for your baby. Hearing is a key part of her learning. This auditory information helps grow connections in the brain that will allow your baby to begin learning to listen, talk, and read just like her hearing friends.
A complete hearing evaluation
Almost all babies have their hearing screened at birth, which is a pass-fail test. If your baby fails, she'll need more in-depth testing to confirm her hearing status.
Children's diagnostic testing for hearing is known as a hearing evaluation, and it will be completed by a pediatric audiologist. You'll want a thorough hearing evaluation as soon as possible so your baby won't miss the sounds and spoken language that surround her.
Your baby’s hearing evaluation is made up of several different tests to measure how much your baby can hear in each ear and whether the hearing loss can be corrected by surgery or managed by devices, such as hearing aids.
Be prepared
Bring someone with you to the scheduled hearing evaluation appointment. A family member or close friend can support you when the results are shared and if a treatment plan is explained.
If your baby is diagnosed with hearing loss, the news can be a surprise or shock, and this may be an emotional time. It can help to have another person with you to offer support.
How do you test a baby's hearing?
You won't be able to test your baby's hearing at home. You'll need a pediatric audiologist to run a set of tests using specialized equipment. Your audiologist will explain the purpose of each test and what it means for your baby's hearing. These tests include auditory brainstem response (ABR) and otoacoustic emissions (OAE). They're gentle and safe, and won't cause your baby any discomfort or pain.
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Depending on the age of your baby, she may be tested using behavioral audiometry. For this testing, you and your baby will most likely go into a soundproof booth together and your pediatric audiologist will present sounds and observe your baby's responses. Since you'll be with your baby throughout the testing, you can observe the responses as well.
Find an audiologist
There are several ways you can find an audiologist. Try using a directory from the American Academy of Audiology (AAA) or the American Speech-Language-Hearing Association (ASHA).
What the test results mean
Your pediatric audiologist will talk to you about the results of your baby's hearing evaluation. They'll be able to clearly explain what the testing does and doesn't tell them about your baby's hearing.
Diagnosing hearing loss takes more than just one testing session. Depending on a number of factors, your audiologist may ask you to schedule another appointment for further testing. If your baby's hearing is in the normal range, they'll provide information about future hearing screenings if needed.
If your baby is diagnosed with hearing loss, a lot of information will be shared with you. Your audiologist will discuss what type of hearing loss your baby has, how severe it is, and how to get started with the right devices so your baby can hear.
Audiogram
An audiogram is a visual picture that shows what speech sounds your child can hear at the time of testing. You'll learn about your child's audiogram which will help you better understand her hearing loss.
Range of hearing loss
You'll learn if your baby's hearing loss level is mild, moderate, severe or profound. With advances in hearing technology, even babies with profound hearing loss, often identified as deaf, are learning to listen and talk.
Types of hearing loss
There are two basic types of hearing loss — conductive and sensorineural.
- Conductive hearing loss is caused by problems in the outer or middle ear, such as an ear infection, wax buildup, or a problem with how the ear is formed. This may be corrected with medical treatment or surgery.
- Sensorineural hearing loss means the problem is in the inner ear or cochlea — the part of the ear that receives, organizes and transfers sound through nerves to the brain. This type of hearing loss is permanent, which means that it can't be corrected with surgery, but listening and talking are still possible with hearing devices, such as hearing aids or cochlear implants.
Location of hearing loss
Your baby may have hearing loss in only one ear (unilateral) or both ears (bilateral).
Causes of hearing loss
In many cases, the cause of your baby's hearing loss may be unknown. If possible, your pediatric audiologist and ear-nose-throat doctor (ENT) will help determine a cause.
Generally, there are two types of causes. Hearing loss can be caused by hereditary or genetic factors that have different likelihoods of occurrence. Hearing loss can also be caused by environmental events such as lack of oxygen at birth, infections, head trauma or medications. Sometimes, it's both genetic and environmental factors that cause hearing loss.
Timing of hearing loss
The timing can vary. If the hearing loss is present at birth or shortly thereafter, it's known as congenital hearing loss. Hearing losses that happen after the child has started to learn to talk are known as acquired hearing losses.
Other professionals you may need
Typically, your baby is referred to a medical doctor who specializes in childhood ear and hearing problems — like an ear-nose-throat (ENT) doctor or an otologist. They'll examine your baby to see if there's a medical solution to her hearing loss. Your baby may be referred for other diagnostic tests, such as X-rays or MRI scans, to further define the type and source of the hearing loss.
What to do if hearing loss is confirmed
After a confirmed hearing loss, you might be asking yourself, “What’s next?” Watch this video to walk you through the top three most important things you need to do so your baby can listen and talk just like kids with typical hearing.
Want to know more you can do right away to put you and your baby on the path toward learning to listen and talk? Here is what you can do:
- Get your baby fitted with the right hearing devices as soon as possible so she can hear all the sounds or information around her, especially your voice. You'll learn about the hearing device and audiological services your baby needs. Your audiologist will:
- Recommend hearing device options so your baby's brain can get complete and clear auditory information
- Discuss costs and services for the hearing devices
- Customize your baby's hearing devices so they fit well
- Teach you how to care for the devices
- Discuss enrolling immediately in early intervention based on the goals you have for your baby
- Make a plan to manage and monitor your baby's hearing so you can catch any further hearing loss as early as possible
- Enroll in early intervention services with a professional who is experienced in the communication outcome you want for your baby, like Listening and Spoken Language (LSL). They'll guide you to achieve the future you want for your baby. There's a lot to consider, but you can learn more about how to build your support team.
- Find support from other families like yours in the Hearing First Family Support Community.
Ongoing audiology services
After diagnosis and hearing device fitting, you’ll return often for audiology services. At first, these appointments may be more frequent to make sure your baby or child has access to all the sounds of speech through her devices. These frequent appointments are important for your pediatric audiologist to assess your child's hearing and her devices so that any change or drop in hearing can be detected quickly.
Seeing the pediatric audiologist on a regular basis is key to creating the best listening and spoken language outcomes for your baby. As she grows, the visits will usually become less frequent. Your audiologist will guide you on how often you and your baby need to return for appointments based on her hearing devices and health.
You’ll return often in the first year for new earmolds. Earmold fittings are critical to your baby’s success with her hearing aids.
If you ever suspect a problem with the hearing device or a change in your baby’s hearing, contact your audiologist quickly. It’s not unusual for hearing loss to progress, but there are still hearing technology options for your baby to hear.
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