Most children hear and listen from the moment they are born. They learn to speak by imitating the sounds around them and the voices of their parents and caregivers. But not all children; about 2-3 out of every 1,000 children in the U.S. are born deaf or hard-of-hearing, and more lose their hearing later during childhood. Hearing loss is among the most common birth defects, affecting approximately 6 babies out of every thousand born. Prior to the introduction of newborn hearing screening regulations, the identification of congenital hearing loss occurred at approximately age 2 to 3 years, well past the age of initial language development. Babies who are identified with hearing loss that late in life are known to experience speech and language delays, learning deficits, and even behavior problems that are avoidable when hearing loss is identified early.
All babies born in New York State have a hearing screening before discharge from the hospital. If your child has hearing loss, it is important to consider the use of hearing devices and other communication options by age 6 months, because children start learning speech and language long before they begin to speak. Unfortunately, we have found many, many cases of children who passed their newborn hearing screenings, only to develop hearing loss during the first months or years of life. A passed newborn hearing screening does not ensure that hearing remains normal.
Typically, a child will undergo their next hearing screening at their pediatrician s office at age 5 or 6, as required by a school medical form. Hearing loss that remains undetected until that time can have long lasting and pervasive effects on a child's development.
What are the signs of a hearing problem in a young child
Hearing problems may not become obvious until children are 12 to 18 months of age, when they should begin saying their first words. Signs of hearing loss in very young children may not be easy to notice. Children who can’t hear well often respond to their environment by using their senses of sight and touch, which can hide their hearing problems.
Below are some hearing milestones your child should reach in the first year of life:
Most newborn infants startle or “jump” to sudden loud noises.
By 3 months, a baby usually recognizes and quiets to a parent’s voice.
By 6 months, an infant can usually turn his or her eyes or head toward a sound, may be scared by a loud sound, and enjoys rattles or toys that make sounds.
By 12 months, a child can usually imitate some sounds and produce a few words, such as “Mama” or “bye-bye,” and enjoys games like peek-a-boo and pat-a-cake. He may look at familiar objects or people when asked to do so.
As your baby grows into a toddler, signs of a hearing loss may include:
limited, poor, or no speech
inconsistent responses to auditory stimuli
difficulty learning new words or information
preference for increased volume on the TV
failure to respond to conversation-level speech, or answering inappropriately to speech
preferring to look at your face when you speak
The most common reason for hearing loss in young children is middle ear infection or a build-up of fluid behind the eardrum. These problems may be persistent, and are known to cause temporary, even fluctuating hearing loss. Problems of this nature are medically treatable, usually by a Pediatric Otolaryngologist, following a comprehensive pediatric audiological evaluation conducted by an experienced Pediatric Audiologist. This type of treatable hearing loss, called conductive hearing loss, may interfere with normal speech and language development. If you have a concern about your child's hearing, attention, or responsiveness to his/her environment, consider having a hearing test done as soon as possible.
Permanent hearing loss, known as sensorineural hearing loss, can also be difficult to detect simply by observing a child's behavior. In fact, mild to even moderate levels of hearing loss, partial hearing loss, or unilateral (one ear) hearing loss can all affect a child's speech, language, attention, focusing and behavior. But all these types of hearing loss can be detected by a routine pediatric audiological evaluation. Particularly when observing infants, toddlers, and preschool age children, the behaviors that result from such hearing losses are often misinterpreted as attention, focusing, or behavior issues rather than the true culprit, which is hearing loss.
If you have questions about your child's hearing, please feel free to call Dr. Shirley Pollak at 718-421-2782. Dr. Pollak has been practicing as a Pediatric Audiologist for over 19 years. She is Board Certified in Audiology, Certified by the American Speech-Language-Hearing Association, and a Fellow of the American Academy of Audiology. Dr. Pollak is in private practice at 1263 Ocean Parkway in Brooklyn, NY and at 115-14 Beach Channel Drive in Rockaway Park, NY.