Breaking The Silence

Newborn Hearing And Screening
Silence isnt golden for children with hearing loss. Thats why there is a
worldwide movement to screen all newborns, now that technology can identify hearing loss in the first few weeks or months of life. Many newborns are screened before they leave the hospital, but not all provinces have newborn hearing testing available in every hospital. In Ontario, screening is well established and shows that approximately four in every 1,000 babies are identified as born deaf or hard of hearing.

    “Ideally, all babies should have a hearing screening at birth, before leaving the hospital”, says Chantal Lalonde, an audiologist with the Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA). Its important to get the screening done before the baby is one-month-old.

Where To Get Screening
Parents can ask the nursery staff or physician at the hospital where hearing screening can be done, or ask their family physician to help them find an audiologist with pediatric testing experience. Not all audiologists are set up to test babies as it takes specialized procedures and equipment. If theres a childrens hospital in the area, try calling that hospital. Hospitals dont usually charge for this test when its done prior to discharge.

Whats Involved In The Hearing Test?
Hearing screenings are painless and very quick, generally taking three to 10 minutes. There are two types of screening tests used for newborns: automated otoacoustic emissions (OAE) and automated auditory brain stem response (AABR) testing. Automated (pass/fail) versions are used for screening because the initial screening is often done by a nurse or technician in the hospital rather than by an audiologist. OAE testing involves placing a soft probe in the ear canal. Sound is sent into the ear and a small microphone within the probe mea-
sures sounds or emissions coming back out the ear. AABR testing also involves placing a soft probe in the ear to send sound into the ear. Small electrodes, usually three (sticky circles like round band-
aids) are applied to the head and base of neck or behind the ears; a computer records the response to the sound.

    The baby can sleep through the test, which is preferable since testing is easier while the baby is quiet. If a baby doesnt pass the first hearing screening, it doesnt mean theres a problem. Many newborns still have res- idual birthing debris in the ears (vernix) which can affect the test. If a newborn didnt pass the first screening, the baby should be re-screened before leaving the hospital or soon afterwards. If the screening is still not a pass, a diagnostic test should be done, preferably before the baby is three months of age.

    Only a diagnostic hearing test can confirm hearing loss, including the severity of loss. If a baby is diagnosed with hearing loss, treatment (hearing aids (if appropriate) and early intervention services) should not be delayed.

Early Intervention Is Key
Children whose hearing loss is treated in the first months of life gain critical time and skills. Studies have shown that children who were diagnosed by six-months-old and had early intervention services did significantly better in language and communication skills than children identified later.

    “It wasnt that long ago that the average age of children identified with hearing loss was well over two or three-years-old”, says Chantal. By then, much of the critical period of language learning was missed.

    According to the Ontario Infant Hearing Program, when babies are identified very early as being deaf or hard of hearing, and given the specialized help they need to develop language, those children can develop language and learn to communicate just as well as hearing children. PC

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