Deaf/ Hearing Impaired
About 2 – 3 infants out of every 1000 live births will have some degree of hearing loss at birth. Hearing loss can also develop in children who had normal hearing as infants. The loss can occur in one or both ears, and may be mild, moderate, severe, or profound. Profound hearing loss is what most people call deafness.
Sensorineural Hearing Loss
Sensorineural hearing loss is permanent and there is currently no cure. Hearing aids may help. Sensorineural hearing loss is the most common type of hearing loss. 90 percent of all hearing aid wearers have sensorineural hearing loss. When the problem is in the inner ear, a sensorineural hearing loss occurs.
- Exposure to certain toxic chemicals or medications while in the womb or after birth
- Genetic changes or conditions, such as Down syndrome
- Infection before birth, including cytomegalovirus infection, or infection with German measles during the early stages of pregnancy
- Infections after birth, such as bacterial meningitis
- Problems with the structure of the inner ear
Conductive Hearing Loss
Conductive hearing loss occurs when sound is not conducted efficiently through the ear canal, eardrum or the bones of the middle ear. This results in a reduction of loudness of sound reaching the inner ear. Conductive hearing loss may result from earwax blocking the ear canal, fluid in the middle ear, middle ear infection, obstructions in the ear canal, perforations in the eardrum or disease of any of the three middle ear bones. People with conductive hearing loss may notice their ears seem to be full or plugged.
- Abnormalities in the structure of the ear canal or middle ear
- Buildup of ear wax
- Ear infections (especially repeated infections)
- Foreign objects in the ear
- Rupture of the eardrum
Mixed Hearing Loss-
Mix of both a sensorineural and conductive hearing loss.
Central Hearing Loss
Central hearing loss results from damage to the auditory nerve itself, or the brain pathways that lead to the nerve. Central hearing loss is rare in infants and children.
- Diseases that affect the protective coating (myelin sheath) around nerve cells
High Risk Factors
Birth – 28 days:
- Malformations of the ear, nose or throat
- Rubella during pregnancy
- Rh incompatibility
- Family history of hearing loss
- Apgar score from 0 – 3
- Severe neonatal infections
- low birth weight (under 3.3 lbs.)
- Ototoxic medications
- Severe respiratory distress and/or prolonged mechanical ventilation (10 days or more)
29 days – 2 years
- Presence of neonatal risk factors
- Head trauma
- Ototoxic medications
- Neurodegenerative disorders
- Childhood infectious diseases associated with hearing loss (e.g. mumps, measles)
A child who has had one or more of these conditions is considered “at risk” for a hearing impairment and should have a comprehensive audiologic evaluation by a pediatric audiologist.
Milestones of Normal Development
Some babies have a significant hearing loss due to unknown factors. Use these developmental guidelines to watch for hearing and speech milestones.
0 – 4 months: Stops movement or quiets in response to speech. Startles to loud sounds. Moves eyes toward sound source. Arouses from light sleep to sudden loud noises.
4 – 7 months: Begins head turn toward sounds and voices out of sight (4 months) and turns head directly toward the sound source (7 months). Smiles in response to speech. Looks in response to own name. Babbling begins.
7 – 9 months: Turns to find a sound source out of sight. Gurgles or coos to sounds out of sight. Intonation patterns heard in speech. Comprehends “no.” Babbles in multiple syllables.
9 – 12 months: Acquires first true word. Imitates sounds. Looks at a common object when named. Responds to music. Understands simple commands.
13 – 18 months: Uses sentence-like intonation. Perceives emotions of others. Uses 3 – 20 words. Uses all vowels and consonants in jargon.
19 – 24 months: Uses more words than jargon. Asks question by rising intonation at end of phrase. Comprehends about 300 words. Uses about 50 words. Produces animal sounds. Combines 2 words into phrases. Listens to simple stories.
(from http://www.hsdc.org )
Treatment depends on the overall health and cause of hearing loss. Treatment may include:
- Speech therapy
- Sign Language
- Picture Exchange Communication
- Hearing Aids
- Cochlear implant (for those with profound sensorineural hearing loss)