Did you know it is estimated that three out of every 1,000 babies1 have a significant hearing problem at birth? According to The Centers for Disease Control2, this means that 5,000 infants are born with hearing loss each year. Although children of any age can be tested for hearing loss, it’s vital that parents and caregivers test their newborns immediately and then remain tuned into any hearing disorder as the infant grows. It’s a hidden problem because infants (obviously) cannot articulate the fact that they are having trouble hearing.
How is hearing loss in infants detected?
Hearing loss in infants is initially detected by parental observation and subsequently through advanced hearing tests. The majority of states require hearing screening tests for infants when they are born. That creates a baseline of information.
Hearing Test and Hearing Loss Guidelines for Parents
However, hearing loss may occur at any point after birth. The American Academy of Audiology3 has published a list of standard guidelines that indicate what a child with normal hearing should be able to do at certain ages. Parents can use these guidelines as milestones by which to judge any detectable hearing loss in their children:
At approximately two months, your child should:
- Be startled by loud sounds
- Be quieted by familiar voices
- Make vowel sounds like “ohhh”
At approximately four months, your child should:
- Look for the sources of sound
- Start babbling
- Make squeals and chuckle sounds
At approximately six months, your child should:
- Turn his or her head toward loud sounds
- Begin to imitate speech sounds
- Babble sounds such as “ba-ba”
At approximately nine months, your child should:
- Imitate speech sounds of others
- Understand “no-no” or “bye-bye”
- Turn his/her head toward soft sounds
At approximately 12 months, your child should:
- Correctly use “ma-ma” or “da-da”
- Give back a toy when asked
- Respond to singing or music
To determine whether an infant or young child is experiencing hearing loss, two main types of hearing tests are conducted:
- Objective hearing tests are used for children who cannot reliably respond to the test. They are tests that don’t require a response, interaction or any sort of cooperation from your child which is why they are conducted on infants.There are two types of objective hearing tests: Auditory Brainstem Response (ABR) and Otoacoustic Emissions (OAE). Both of these tests use equipment, such as electrodes, that test the brain’s response to sounds without the need for the child to respond. When conducting these tests, the audiologist cannot determine exactly what the child hears; rather, the test can determine the level of hearing that is present.
- Behavioral tests are used for children aged six months and older and do require a response from your child. Sounds of music, speech, some at specific frequencies, are emitted while the audiologist records the response(s).There are three different types of behavioral hearing tests:
- Visual reinforcement audiometry: the child turns toward something that “rewards” their response to the sound, like a puppet or a video
- Conditioned play audiometry: children between the ages of two to five (toddlers and preschoolers) are taught to play a fun game that asks the child to indicates a response after listening to a sound, i.e., putting a block in a bucket when they hear a sound
- Conventional audiometry: a test used for children aged five and older that will determine the frequencies at which your child can hear, from the faintest lows to the highest highs. When they hear a sound, they either raise their hand or push a button or say “I hear it.”
- Behavioral tests are used for children aged six months and older and do require a response from your child. Sounds of music, speech, some at specific frequencies, are emitted while the audiologist records the response(s).There are three different types of behavioral hearing tests:
It’s important to keep an eye on a child’s natural response to sound. Reporting hearing deficiencies immediately to a physician or audiologist is vital to avoiding delays in your child’s natural development.
References
1: Centers for Disease Control and Prevention (CDC). Identifying infants with hearing loss – United States, 1999-2007. MMWR Morb Mortal Wkly Rep. 59(8): 220-223.
2: Centers for Disease Control and Prevention https://www.cdc.gov/ncbddd/hearingloss/2009-data/2009-EHDI_HSFS_Summary_508_OK.pdf
3: https://www.audiology.org/publications-resources/consumer-information/fact-sheets (Hearing Loss and Infant Screening)