Better screening now available for children's hearing loss
By Betsy C. McElfresh CONTRIBUTING WRITER

Page Dowdy/Chesterfield Observer Lori Proffitt holds her son, 3-year-old Kilby, while his hearing is tested by Jean Couchman at Hearing Solutions.

Hearing loss isn't just limited to older adults.

"We're seeing a lot more children, partly because of the required newborn hearing screening," observes Valerie Moore, audiologist with Virginia Ear, Nose and Throat Associates (VENTA). "We're able to identify children faster and start the intervention earlier than before. Many children may have been missed in the past."

An estimated 33 babies per day are born with serious to profound hearing loss, according to the Better Hearing Institute.

State law requires that newborns have a hearing evaluation before they leave the hospital or within one month of birth. Infants who fail the hearing test are referred to an ear, nose and throat specialist (ENT) or audiologist for a medical evaluation and hearing test.

Hearing specialists often see an uptick in the number of school-age children they see during this time of the year, as kids undergo physical exams to enter school or play sports. If physicians detect signs of hearing loss, they refer the child for more testing.

Early diagnosis of hearing loss is critical to prevent delayed speech, language, cognitive and social abilities, according to the American Academy of Otolaryngology. If diagnosed with hearing loss, children under age 3 should have their hearing tested every three months, while children ages 3 and older should be assessed every six months, explains Moore.

"By age 12 or 13, children's ears are about the size they will be as an adult," she says.

Detecting hearing loss in infants and toddlers can be tricky. "It's hard for a parent to know, especially when children haven't developed speech," notes Dr. Nick Tarasidis, an otolaryngologist and partner with VENTA.

It is important that a physician rule out temporary hearing loss caused mainly by ear infections and ear wax. "Luckily, it is easily corrected," he adds.

Sometimes tubes are placed in the ears to help drain the fluid buildup caused by frequent ear infections. "It's amazing when parents bring their child in for a follow-up visit, they will tell me how much their child's speech and language has accelerated," Tarasidis remarks.

Assistive listening devices

Hearing aids come in all different shapes and sizes. "Most manufacturers sell pediatric lines. They're usually smaller and come in fun colors," notes Jean Couchman, audiologist/ hearing aid specialist and owner of Hearing Solutions.

For growing children who wear hearing aids, ear molds are made from an impression, and the ear molds are replaced as they grow. The softer ear mold fits in the ear and attaches to the hearing aid, which sits behind the ear.

Certain environments, such as a classroom, call for additional amplification. "Hearing aids are only good to about 15 feet," says Couchman.

FM systems can be paired with a child's hearing aids to enhance listening in large settings.

"If your child has a documented hearing loss, your audiologist or doctor would recommend to the school's speech therapist that the child use an FM system," explains Couchman.

An FM system has three parts. The teacher wears a transmitter, similar to a large iPod, and speaks into the attached microphone. The teacher's voice is sent through a radio signal directly to the receiver on the child's hearing aid, which helps to reduce background noise and echoing effects, Moore describes. The transmitter allows the teacher to be anywhere in the classroom - up to 100 feet away - and the volume in the child's ears stays the same.

FM systems also work without hearing aids.

Resources

Several organizations provide new hearing aids to children based on financial need, including the HIKE Fund (Hearing Impaired Kids Endowment), Starkey Hearing Foundation and Medicaid.

Most audiologists can help families in need apply for new hearing aids, monitor the process and place the order.

"I like it because you can fit children with hearing aids that are appropriate for them," says Couchman.

The Lion's Club and Virginia Hearing Aid Loan Bank offer loaner hearing aids; however, they are usually refurbished, analog devices, she notes.

Types of hearing testing for children

 

• Otoacoustic Emissions (OAE) uses a small microphone placed in the infant's ear to measure the echo response from the inner ear when sound passes through.

• Auditory Brainstem Response (ABR) testing measures how the brain responds to sound at different levels. One or both of these measures (OAE and ABR) are done during the newborn screening.

• Visual Reinforcement Audiometry is performed on children under age 3, focusing on the child's behavioral response. Sound is presented through speakers or earphones, and when children turn toward the sound source, an animated toy is activated as a reward.

• Conditioned Play Audiometry is designed for older children. It uses a game activity every time a sound is heard, such as dropping a block in a bucket or placing a peg on a board.