Why Hearing is Important in Children

Question 1

Are approximately 10% of newborns at risk for medical problems and developmental disability?

Answer 1

Yes

Question 2

How much more prevalent is hearing loss in infants in the NICU?

Answer 2

20x more likely than those without complications in a normal nursey

Question 3

Is hearing loss a silent disability?

Answer 3

Yes, you cannot see hearing loss
It can go unnoticed for a long time

Question 4

How many babies are identified with hearing loss each year?

Answer 4

12,000

Question 5

How many children pass their newborn hearing screening and then develop late-onset hearing loss between birth and 3 years old?

Answer 5

4,000 to 6,000

Question 6

What are some risk factors for hearing loss?

Answer 6

Family history of hearing loss
Genetic disorders or syndromes
Problematic pregnancy
Drugs or alcohol use during pregnancy
Maternal infections during pregnancy such as rubella, sexually transmitted diseases, cytomegalovirus, and numerous others
Trauma during pregnancy
Trauma during birth
Anoxia at birth
Apgar scores below 5 at 1 min or less than 6 at 5 min
Postnatal infections
Hyperbilirubenemia
Ototoxic medications including aminoglycosides alone or in combination with loop diuretics
Patients undergoing chemotherapy or radiation for cancer treatment
Craniofacial anomalies
Recurrent otitis media with or without ventilation tubes
Mumps, measles
Noise exposure, particularly excessive use of personal listening devices

Question 7

Why is hearing so important?

Answer 7

Speech and language development is critical and is considered as a prerequisite for cognitive development

Question 8

What happens to a Deaf child in a hearing family that doesn’t receive intervention?

Answer 8

Does not learn to interpret sound patterns
Does not learn to produce sounds of spoken language around him/her
Unable to hear speech
Unable to acquire spontaneous language

Question 9

What are the roles of a pediatric audiologist?

Answer 9

Prevent
Evaluate
Intervene

Question 10

What are some challenges in pediatric audiology?

Answer 10

Identifying hearing loss early
Understanding the impact of minimal or unilateral hearing loss
Accurately assessing hearing thresholds
Providing effective counseling to caregivers
Minimizing the effects of auditory handicap
Ensuring proper follow-up for hearing-impaired patients

Question 11

Can any undetected hearing loss of any degree have an impact on speech, language, cognitive, and psychosocial development?

Answer 11

Yes

Question 12

What is the overall impact of mild hearing loss?

Answer 12

Communication, language learning, and educational achievement are affected

Question 13

What is the perception of speech sounds for mild hearing loss?

Answer 13

Vowel sounds are heard clearly but voiceless consonants may be missed. The louder voiced speech sounds are only heard. The short unstressed words and less intense speech sounds (such as voiceless stops and fricatives) are inaudible

Question 14

What are the educational and behavioral impacts of mild hearing loss?

Answer 14

In children with this degree of hearing loss auditory learning dysfunction may result in inattention, classroom behavior problems and possible mild language delay and speech problems

Question 15

What is the speech perception of moderate loss?

Answer 15

Miss most conversational speech sounds; vowels are heard better than consonants. Short unstressed words and word endings (-s, -ed) are particularly difficult to hear

Question 16

What is the communication confusion that comes with moderate loss?

Answer 16

Reduced auditory cues can lead to confusion in distinguishing speech sounds and word meanings

Question 17

How is the speech articulation for a moderate loss?

Answer 17

Speech articulation often characterized by omission and distortion of consonants. Strangers may have difficulty understanding their speech

Question 18

What are the behavioral and learning impacts of a moderate loss?

Answer 18

May demonstrate behavioral problems, inattention, language delay, speech problems, and learning problems

Question 19

How is the speech and language development in children with a severe loss?

Answer 19

Language and speech do not develop spontaneously without intervention. With early intervention, properly fitted hearing aids, and specialized education, children can achieve significant functional improvement

Question 20

How is a child’s auditory perception without amplification with a severe loss?

Answer 20

Cannot hear typical sounds or normal conversation; can hear distorted self-vocalization, very loud environmental sounds, and only the most intense speech at close range

Question 21

What are some more challenges that come along with severe hearing loss?

Answer 21

Significant language problems speech problems and associated educational problems

Question 22

What are the speech and language delays that come with profound loss?

Answer 22

Severe language delays, speech problems, and potential learning dysfunction without intervention. Intensive special education with powerful hearing aids or cochlear implants is essential for language and speech development

Question 23

What are the auditory perceptions of children with profound loss and no intervention?

Answer 23

Cannot hear or understand sounds; amplification is critical. Early detection and treatment significantly improve outcomes

Question 24

What are the speech characteristics of children with profound hearing loss?

Answer 24

Speech often includes issues with voice, articulation, resonance, and prosody. Vocal pitch may be higher, with a monotone quality due to lack of intonation and stress

Question 25

What are some characteristics of mild loss?

Answer 25

Understand conversation at 1 – 1.5m May have delayed speech development May miss up to 50% class discussion if speaker not visible May need hearing aid Will need special education attention

Question 26

What are some characteristics of moderate loss?

Answer 26

Understand conversation at 0.5m Will have difficulty at school Likely to have language delay Will have poor speech clarity Will need hearing aid Will need special education assistance and probably special training for listening

Question 27

What are some characteristics of severe loss?

Answer 27

May understand speech at <15cm Hears loud environmental sounds Will have delayed speech/language Will need hearing aid Requires auditory training Uses vision for additional cues Speech/language will not develop spontaneously if loss present before 1 year old

Question 28

What are some characteristics of profound loss?

Answer 28

May only be aware of very loud sounds Speech and language will be defective Visual and gestured cues essential for learning Needs full time special education assistance Does not rely on hearing as primary avenue of communication Hearing aids are intended to allow the user to maintain contact with environment and to allow the utilization of any auditory clues that might be presented

Question 29

What aspects of communication will be impacted by hearing loss?

Answer 29

Vocabulary Sentence structure Speaking

Question 30

Do children with hearing loss have difficulty with all areas of academics?

Answer 30

Yes, especially reading and math

Question 31

Do children with mil to moderate loss, on average, achieve one to four grades levels lower than their peers?

Answer 31

Yes, they may have to repeat grades because they are missing information

Question 32

Do children with a severe to profound hearing loss usually achieve skills no higher than the 3rd to 4th grade level unless there is appropriate early educational intervention?

Answer 32

Yes

Question 33

Does the gap in academic achievement between children with normal hearing and those with hearing loss widen as they progress through school?

Answer 33

Yes

Question 34

Do children with severe to profound hearing loss often report feeling isolated, without friends, and unhappy in school?

Answer 34

Yes Particularly when their socialization with other children with hearing loss is limited

Question 35

Are social problems more frequent in those with mild to moderate loss than severe to profound?

Answer 35

Yes They feel like they are more like the normal hearing peers than the severe to profound They can see themselves in them, but there is still distance

Question 36

What are economic burdens that come with a child with hearing loss?

Answer 36

Medical and audiological expenses Education and training expenses Special living expenses Lifetime loss of income considerations

Question 37

Do many Deaf children have difficulties in large social settings?

Answer 37

Yes They cannot attend to multiple simultaneous conversations, especially when there is background noise

Question 38

Do Deaf children often have an inadequate concept of how others think and feel?

Answer 38

Yes Theory of mind

Question 39

How do we typically define minimal and mild hearing loss?

Answer 39

The category of minimal hearing loss is broad, severity and configuration are also important May be different for children than adults Normal for kids is typically 15 dB HL

Question 40

Why does the prevalence of minimal hearing loss increase at school age?

Answer 40

School screenings are done every few years

Question 41

Is identifying minimal hearing loss in newborns problematic?

Answer 41

Yes Current OAEs and ABRs cannot distinguish between normal and mild

Question 42

Do hearing screening programs target minimal and mild losses?

Answer 42

No, these children are not likely to be referred for diagnostic evaluations

Question 43

Does minimal hearing loss have an educational impact?

Answer 43

Yes 50% of children either repeat a grade or need resource support in school Increased behavioral and linguistic problems compared to hearing controls

Question 44

Are parents of children with mild losses uncertain of the amplification recommendations?

Answer 44

Yes

Question 45

Is there usually a considerable delay between the confirmation of hearing loss and the fitting?

Answer 45

Yes There can also be inconsistencies between audiologists on if they would recommend amplification to children with mild loss

Question 46

Could a child with minimal loss experience a speech delay?

Answer 46

Yes The unvoiced consonants /s, p, t, k, th, f, sh/ contain so little speech energy that they often fall below even normal hearing thresholds in an average rapid conversation