Guest Post: Hearing Loss Basics

This article was submitted to me by new blogger John O'Connor from Blogging With John O.  Like me, John has a desire to spread the word about hearing loss and related issues.  We hope you learn something new from it!

In the United States, two to three children in every 1000 suffer hearing loss or are completely deaf. Unfortunately, some hearing loss in small children is not recognized until the child is already behind in language.  Early intervention is necessary to help parents take the necessary steps to prevent delays in language development.

What Precautions Can Be Taken to Prevent Hearing Loss In Children?  

All 50 states offer a newborn hearing screening, Early detection is crucial, and along with early intervention, children can learn to listen and speak without getting behind in language skills.

What are the Causes of Childhood Hearing Loss?

 
Otitis Media

  This condition can lead to permanent hearing loss if left untreated. Otitis media is a middle ear infection that often occurs in underdeveloped Eustachian tubes common in developing children. With this type of infection, the fluid builds behind the eardrum and becomes infected. If the fluid remains there for a prolonged period of time, it can impair hearing.

Acquired Hearing Loss

Certain illnesses can cause hearing loss in children. These conditions include: encephalitis, meningitis, measles, influenza, head injuries, chickenpox, genetic hearing loss, very loud noises and certain medications.

 Congenital Factors

Some children who are afflicted with hearing loss from childbirth may experience loss because of genetics or because of prenatal complications. More than half of children’s congenital hearing problems are due to genetics. Children’s hearing loss can also occur when the mother has diabetes or toxemia during pregnancy. Hearing loss is also more common in children born prematurely.

How to Notice Hearing Loss in Children

•           Children Do Not React to Loud Noises
•           Children Do Not Respond to a Mother’s Voice
•           Children Pull or Rub Ears
•           Children Are Irritable for No Apparent Reason
•           Children Do Not Understand/Follow Directions
•           Child is not reaching early language milestones 
•           Child Has Ear Pain accompanied by a Fever

How to Treat Childhood Hearing Loss

Medications

A pediatrician may prescribe antibiotics to alleviate the symptoms associated with ear infections and hearing loss.

Hearing Aids

Children with hearing loss can begin wearing hearing aids as early as one month old.

 Ear Tubes

A child may need ear tubes to drain the fluid from the eardrum and prevent infection. Children may require an ear, nose and throat (ENT) specialist for this procedure.

Implants

Children may require cochlear implants or electronic devices to help with hearing. These devices should be used only after hearing aids have been found ineffective.

Language Labels

I remember asking the question in grad school, "What is the difference between a language delay and a language disorder?"  My professor did not give us a clear answer.  In the end I was led to believe that they were the same.  Then I kept encountering more labels!  It gets very confusing.  What is acceptable?  What is used?  What are the differences?  What do they mean?  I'm hopeful that this post will help to clear up some of that confusion.

Language Delay -This term is used by many SLPs but should probably be avoided because it tends to imply that the child is simply 'a little behind' and will catch up soon without any intervention.  It's probably a good idea not to use it unless you have really examined the child and feel strongly that it truly describes the child.  This term would only seem logical to use for a child who is 2 or 3 years old.  An older child who is still struggling with language is less likely to 'outgrow' it.

Language Deviance -This term doesn't seem to be used very often, but it implies that the child's language development is different somehow. If you use this term you need to know what is different and if that difference is a disorder or not.  Which brings us to the next term:

Language Difference - This term is often used and is acceptable as long as it is used correctly.  This means that the child has obvious differences in their use of language but they do not have a disorder.  It is usually used to describe children who are learning English as a second language.


Language Disability/Language Disorder/Language Impairment -  These three are used interchangeably and are considered to be the most acceptable terms used when describing a child who is definitely having difficulty learning language.  Their language scores on tests are below the acceptable range and others notice that they have difficulty following directions or expressing themselves.  


Specific Language Impairment (SLI) - First introduced by Kamhi (1998), specific language impairment is used to describe a child who has no other difficulties such as lower IQs or syndromes or birth defects.  It is considered a 'pure' language impairment and these children tend to be quite rare.  It is very difficult to separate language and cognition.  Which is a totally different post.  SLI is the term I saw used most frequently in the school system, and it was used regardless of whether or not the child had other challenges going on.

Developmental Language Disorder - Is the best term to use when describing a child who has low language abilities as well as other problems such as low IQ's or syndromes such as Down's Syndrome or Autism.  When I worked in the schools, I didn't see it used very often but I like the idea of having a name for a language disorder that is coexistent with other cognitive problems.  

5 Ways to Provide a good language foundation for your baby

1) Sit down and have a conversation. -  Our lives have become so busy and so full of gadgets and to-do lists and errands to run.  I'm afraid that it has caused us to reduce the attention we give to our babies.  They have no choice but to lay where we lay them and to look at whatever is in the direction their head is facing.  My advice is to put down the ipad or the TV remote or the laptop and put your baby on your lap.  Look at each other in the eyes.  Practice eye contact.  Try to get your baby's attention by making noises and having her turn her head.  Then smile.  This is also establishing turn-taking skills.  Did you know that when you are making noises at your baby that you are teaching them the skill of turn-taking?  They make a noise - then you make a noise, then they make a noise, then you make a noise.  It should sound just like a conversation with different noises and different intonation, except that it's just gibberish.  Gibberish or not - it's still very important!
2) Respond to their vocalizations - More specifically, if you and your baby are in the same room but you're cooking dinner or working on the computer and your baby makes a loud noise, you can probably tell that they are trying to get your attention.  Reward it!  You want to reinforce the concept that they can initiate conversation and that by making noise they are causing you to turn your head and give them attention.  Just take a few second to turn your head towards them.  Smile.  Make a noise back.  Then go back to what you were doing.  Not only is it good for language - it reminds the child that you are there for them and that they are the more important than whatever else you're doing at that moment.
3) Tell them what you're going to do, then do it - Talk to your baby all the time.  Don't worry if they don't understand everything you say.  There is no need to simplify your language at all.  Most of what babies learn is 'incidental' meaning as it happens around them and in an unstructured setting.  You want your child to be able to associate what you are saying with what is going on.  So if you pick up your child and say, "It's time for your bath!" then you get distracted and start folding laundry, they won't learn the association between what you say and what you do.  A great example of this is when parents say, "Night-night" as part of the bedtime routine.  The baby has learned to associate sleep with the words 'Night Night'.  These are the babies who might get very upset if you say 'night-night' to them and they're not tired! :)
4) Nursery Rhymes and Finger Plays - There's a good reason why nursery rhymes have been around for so long.  They are a great way to establish language basics in babies.  Some of the skills you are reinforcing include: turn-taking, joint attention, eye contact, intonation, and vocabulary. It doesn't even matter what you're singing.  Pick a song and sing it to your child.  Help them do actions such as clapping hands and raising them high into the air.  They'll soak it up.  
5) Read to your baby -  It's never too soon to start reading to your baby!  I've mentioned before some of the great benefits of reading.  Big thick board books are great for those chubby little hands to hold and feel.  They will associate reading a book with you and the physical closeness and comfort which will help them enjoy reading as they get older.  Check out this video of my 3 month old niece!  Her daddy is reading to her in Spanish and she is just soaking it up.