As many of three babies out of every thousand born each day in the United States are born with significant hearing loss. Mom and writer Lisa Beamer takes a look at why and how your infant's hearing may be tested.
Lisa Beamer

Early detection
Hospitals routinely screen thousands of newborn babies each day for a variety of disorders, as early detection allow for appropriate treatment and gives children a better chance for a normal, healthy life. Hearing screening, however, has never been a routine procedure in most hospitals. According to statistics from the American Speech-Language-Hearing Association (ASHA), approximately one to three babies out of every thousand born in the United States daily are born with significant hearing loss, making hearing loss more prevalent than phenlyketonuria, a disorder for which all babies are currently screened.

As of last year, less than 20% of all US-born babies were delivered in hospitals where newborn hearing screening programs were in place. Only 22 states have their own universal newborn hearing screening legislation, but that could soon change since Congress passed the Newborn and Infant Hearing Screening and Intervention Act in November, 1999. This legislation opens the door for more states to mandate routine infant hearing screening by providing funds for such programs.

Legislation offers hope
The potential for a greater number of newborns to receive hearing screening should decrease the occurrence of developmental delays that result when hearing losses go undetected through early childhood. "Hearing loss can cause children to be delayed in speech and language skills by the time they enter kindergarten," says Dr Donna Geffner, past president of ASHA. With early detection and intervention -- before 6 months of age -- Geffner states, "Children can experience speech and language development by 18 months commensurate with their hearing peers."

Whereas hearing loss can be caused by a wide range of factors such as genetics, viral infections, and instrument deliveries, babies who are considered at high risk for hearing deficits include those who are born prematurely, are of low birth weight or who have been affected by disease. Geffner points out, however, that when routine screening is implemented, just as many instances of hearing loss are detected in babies who fall into high risk categories as those who don't.

Testing methods
There are two common methods used to screen infants' hearing. Otoacoustic emissions testing (OAE) involves the detection of emissions that are produced by a normal ear in response to incoming sounds. A small plug housing a microphone is placed in the baby's ear and sound is then projected into the ear via the plug. In the case of a child who cannot hear, no emissions will be detected.

The other type of testing involves auditory brainstem responses (ABR), which are measured by placing electrodes on the baby's head. While he sleeps, sounds are introduced to the baby through tiny earphones. The electrodes then measure if the brain is detecting the sounds.

Both of these tests are painless to the child and, according to Dr Geffner, both should be done while the infant is sleeping so that results are more accurate.

When detection is delayed
Karrie Moore's son James was three years old before he was diagnosed with a mild to moderate hearing loss of 40 decibels. Moore expressed concern about her son's speech to their pediatrician who then sent him for a hearing and speech evaluation. Moore assumed the hearing screening was a mere formality, never suspecting that a hearing problem was to blame for his delayed speech.

Once his problem was diagnosed, James was fitted with hearing aids and received in-home speech therapy as well as auditory/verbal therapy. He currently receives speech therapy once a week. He also goes for hearing testing on a semi-annual basis, which has thus far confirmed that his hearing loss has not changed from its originally diagnosed level.

Says Moore, "Now, at seven, he has overcome most of the articulation problems, but had he been fitted with hearing aids sooner, he would have heard sounds that he couldn't hear without them. Because he couldn't hear them, he never learned to produce them at a young age and had to learn some of them as recently as last year."

Social implications
Since James is homeschooled -- a decision the Moores made prior to learning of their son's hearing loss -- he has not had to face any problems that his hearing loss and subsequent speech delays may have produced in a classroom situation, either academically or socially. Such is not the case with all children.

Jamie Berke has been profoundly deaf since birth, though her deficit was not detected until eighteen months of age. Through hearing aids and speech therapy, which Berke received soon after diagnosis, she was able to learn to speak and lip read. She was also mainstreamed into a regular classroom in her elementary and high school years.



Says Berke, "Fortunately [my deafness] did not negatively impact my ability to learn, as I did well as a student through my academic career. During the years of attending "hearing" schools, though, I had to cope with missing out on a lot, both socially and academically." In "Growing Up Deaf in the Seventies," a series that she's written at her "Deafness/Hard of Hearing" site on About.com, Berke shares many stories of how her life was different from her peers due to her hearing loss. She recalls going off to a corner by herself while her classroom teachers read stories to the rest of the children. Also, because she did not have an interpreter in school with her, she often didn't even know her classmates names. "Today," says Berke, "it is normal for deaf students to have interpreters in the classroom as early as kindergarten."

Today Berke is able to communicate with others through sign language as well as the methods she learned as a child, but due to the fact that her hearing loss has considerably worsened over time, she no longer wears her hearing aids. "At my last hearing test a few years ago, I was found to have total loss in my right ear and a little left in the left ear," explains Berke. "Presently, I am not using hearing aids and have not since 1995 when the last pair I had stopped helping me. The cost was too great, and they are not covered by insurance." Despite her deafness, Berke is married and works successfully at her job in web development where she has the benefit of using technologies such as instant messaging to communicate with her coworkers.

Social Implications
Since James is homeschooled - a decision the Moores made prior to learning of their son's hearing loss - he has not had to face any problems that his hearing loss and subsequent speech delays may have produced in a classroom situation, either academically or socially. Such is not the case with all children.

Jamie Berke has been profoundly deaf since birth, though her deficit was not detected until eighteen months of age. Through hearing aids and speech therapy, which Berke received soon after diagnosis, she was able to learn to speak and lip read. She was also mainstreamed into a regular classroom in her elementary and high school years.

Says Berke, "Fortunately [my deafness] did not negatively impact my ability to learn, as I did well as a student through my academic career. During the years of attending "hearing" schools, though, I had to cope with missing out on a lot, both socially and academically." In "Growing Up Deaf in the Seventies," a series she's written at her "Deafness/Hard of Hearing" site on About.com, Berke shares many stories of how her life was different from her peers due to her hearing loss. She recalls going off to a corner by herself while her classroom teachers read stories to the rest of the children. Also, because she did not have an interpreter in school with her, she often didn't even know her classmates names. "Today," says Berke, "it is normal for deaf students to have interpreters in the classroom as early as kindergarten."

Today Berke is able to communicate with others through sign language as well as the methods she learned as a child, but due to the fact that her hearing loss has considerably worsened over time, she no longer wears her hearing aids. "At my last hearing test a few years ago, I was found to have total loss in my right ear and a little left in the left ear," explains Berke. "Presently, I am not using hearing aids and have not since 1995 when the last pair I had stopped helping me. The cost was too great, and they are not covered by insurance." Despite her deafness, Berke is married and works successfully at her job in web development where she has the benefit of using technologies such as instant messaging to communicate with her coworkers.PregnancyAndBaby.com

Tags: hearing screening


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