Children’s audiology is advancing at a fantastic pace, as today’s technologies combined with regular rehabilitation provide more opportunities for children with hearing problems.
Nowadays, neonatal screening is performed at birth and with this, a programme for rehabilitation can be implemented in the shortest possible time, which makes improvement possible.
The paediatric audiologist specialises in providing children with hearing loss with all the resources for diagnosis, assessment, auditory stimulation and prosthetic rehabilitation.
Language enhancement and development in a child with hearing impairment
The hearing-impaired child develops the ability to talk about what he hears from himself and from those around him.
In the case of hearing-impaired children, their linguistic characteristics change according to hearing loss, adaptation to hearing aids or implants, age and rehabilitation.
In the case of profound hearing loss, the ability to speak spontaneously and develop a language will be linked to compensation with appropriate rehabilitation and amplification.
First months
In a baby’s first months, there are hardly any differences in speech, with a normal hearing child, both developing proprioceptive play and babbling.
It is at around 8 months of age that hearing begins to play an important role and development begins to lag behind that of a normal listener.
When a child with hearing loss is diagnosed early, fitted with an appropriate hearing aid and rehabilitated with current therapies focused on enhancing the auditory (and not the visual) channel, he or she can develop excellent oral language.
Newborn screening, audiological assessment and early diagnosis.
Hearing loss is the most common hearing impairment in humans in developed countries. Three out of every 1,000 babies are born with significant hearing problems. However, mild to moderate losses are even higher, occurring in one in one hundred children.
Early diagnosis is undoubtedly the first link to more effective treatment. There is a clear relationship between hearing, language and learning for newborn children with hearing loss.
If done early, it will determine the child’s inclusion, and the educational prognosis will improve.
Incidimos en la importancia de los cuatro primeros años de vida, en que será necesario disponer de un buen asesoramiento y ayuda para el desarrollo y para adquirir el lenguaje oral.
Oral language
The need for oral language is not only justified by communication, but also by the role it plays in the development of more complex cognitive processes.
Moreover, it should not be forgotten that more than 95% of parents of children with hearing loss are normal hearing, and that almost half of all babies with hearing loss have no known risk factors.
This underpins the need for universal screening with a protocol for application in the population at risk.
Only 20% are identified by paediatricians or otolaryngologists.
The CODEPEH (Commission for the Early Detection of Hearing Loss in Children, formed in 1995) created in 2003 the “White Paper on Hearing Loss. Early detection of hearing loss in newborns”.
Its implementation and subsequent revisions make it possible to state today that the implications of deafness have changed, thanks to early care and technology.
One of the main objectives of universal screening is that definitive diagnosis and intervention is established before six months of age (CODEPEH 2003; Trinidad and Jáudenes, 2011).
Tests and protocol for child assessment
Objective tests
These are the objective tests that are performed, those that provide direct and clear information about the physiological function of the auditory system.
Some of the main objective tests are
- Otoacoustic emissions
- Brainstem and steady-state auditory evoked potentials
- Impedanciometry
Details of the objective tests:
- Otoemissions
They have the great advantage of being easy to obtain, non-invasive and very fast.
It makes the work much easier, not having to count on the child’s collaboration, since in order to measure them, it is necessary for the middle ear to be functioning normally.
- Auditory potentials
Auditory evoked auditory brainstem potentials are not a hearing test per se, they represent the synchrony of auditory nerve and brainstem.
If the response is normal bilaterally, it can be inferred that the child’s peripheral hearing is also normal.
Conversely, if the response is abnormal, the interpretation is ambiguous.
- Impedanciometry
Impedance impedance testing is an evaluation of the middle ear.
A child can have normal results with significant sensorineural hearing loss.
In the presence of otitis media, middle ear function may be unstable.
Subjective evidence
These provide important information on hearing status, and we recommend supplementing them with behavioural tests.
- Anamnesis.
- Initial observation
- Previous reports from the family
This is a critical phase, the immediacy of reaching a professional diagnosis plays an essential role in the child’s development, so it is important to plan ahead.
Conclusions
It usually requires the expertise of the audiologist to interpret the sometimes somewhat contradictory results.
If the applied tests give results to establish diagnosis and treatment with hearing aids, it is not necessary to wait for exact thresholds to be completed.
Hearing aid treatment shall always accompany the audiological examination on an ongoing basis.
Family counselling and guidance
Babies undergo neonatal screening and hearing loss is detected and this is unexpected for the parents, who have not been able to observe auditory responses.
The news to the family
On receiving the news of the child’s hearing loss, the family is faced with an uncertain world, full of worry about the extent of the problem.
The slightest discordance of professional opinion is a reason for parents to hesitate and to continue consultations, not always in the hands of expert audiologists.
The result is often an unfortunate loss of valuable time for the initiation of prosthetic treatment and auditory stimulation.
The emotional state
Guiding parents in aspects they should be aware of and deciding on options for child development, orienting them…, are perhaps the most important functions of the audiologist.
It is often difficult and bewildering for parents to begin the journey of hearing loss for a child.
In our Hearing Centres in Alicante, Calpe and Torrevieja, we specialise in children’s audiology and we are happy to help you in any way we can.
Cai Salud, Hearing Centre in Alicante, Calpe and Torrevieja
We will help you in our Hearing Centres, we specialise in diagnostic tests focused on the early detection of childhood hearing loss in Alicante.
More than 20 years of experience guarantee our trajectory, during which we have helped hundreds of families, with the satisfaction of having contributed to the improvement of the lives of all these children.
Our children’s audiologists will be delighted to welcome you at Cai Salud’s Hearing Centres in Alicante, Calpe and Torrevieja. Make an appointment here.
