Little Ears: Hearing Milestones and Loss in Infants

Testing for hearing loss even in very young infants can significantly improve your child’s ability to succeed when learning speech and language, as well as improve social, emotional, and educational development.

Have you ever wondered if your infant or child is hearing properly? Many parents of children with a hearing loss are all too familiar with the scenario in the film Mr. Holland’s Opus: The mother suspects a hearing loss in her infant son because he doesn’t seem to respond appropriately to the sounds around him. The father is stunned to hear his wife’s suspicions, and the couple visits the doctor only to have their worst fears confirmed.

Fortunately for the Hollands, their son’s hearing loss was identified in infancy. All too often, one parent (or the doctor) tells the other parent that the baby is just fine, or to wait and see since the time period for normal language development can vary. As a result, nothing is done to test the child’s hearing, and the parents find out months or years later that the initial instinct was correct.

Should you be concerned about whether your infant is hearing normally? Approximately three in every 1,000 babies are born with a loss that is considered to be significant. Many more are born with more mild forms of hearing loss. In even mild cases of hearing loss in infants and children, speech and language development can be delayed along with the child’s academic and social/emotional development.

If you suspect your child is having difficulty hearing, acting promptly is crucial. In studies conducted by the National Institutes of Health (NIH), children identified before age six months as having a hearing loss develop language significantly better than those children who are not identified until age six months or older. Studies show that in some children who are diagnosed with a hearing loss before six months of age, normal language development compared to that of typically developing, hearing peers, can occur. Unfortunately, the average age that most children are identified in the United States is two years.

Another reason to act promptly is that a child’s brain is designed to learn a language by the time he or she is six years old. The first three years of this development are the most crucial. After age six, learning a language and speech to produce the language becomes increasingly difficult.

What can you do to have your infant or child’s hearing tested if you suspect a hearing loss? Consult your pediatrician or family doctor right away, and make an appointment with a professional who is trained in testing young children for hearing loss. This may be an ear, nose, and throat specialist or an audiologist.

Milestones of Infant Hearing

Birth to Three Months

Loud sounds are startling to these young babies. Infants are soothed by familiar voices. Most babies begin to gurgle, babble, or coo.

Three to Six Months

Infants turn in the direction of sound. Babies of this age like toys that make noise or rattle. Infants react to familiar voices and, around six months, may babble in response.

Seven to Ten Months

Babies understand common first words such as mama, dada, and no.Infants turn to familiar sounds even when the source of the sound cannot be seen (telephone, footsteps, dog barking). Infants make sounds other than gurgles and coos.Babies recognize their own names.

Eleven to Fifteen Months

Babies attempt to match sounds with their own speech, usually in reaction to human voices or loud noises.Babies are able to point to objects when asked. Most babies understand simple questions and respond appropriately (Where’s the cat? Where’s mommy?)

Testing for Hearing Loss

There is no need to worry if your child does need a hearing test. There are several methods available to test newborns and young children, none of which will hurt or harm your child.

ABR (Automated Brain Stem Response):

ABR is a simple test in which sounds are presented to the child through earphones while the child sleeps or rests. The baby’s brainstem response is measured by small electrodes taped to the baby’s head.

OAE (Otoacoustic Emissions): 

This test measures the function of the inner ear by insertion of a small probe tip into the baby’s ear canal.

Behavioral Testing: 

Your child must be able to turn his or her head in response to a sound or be able to play a game for this test to be done. A measurement will be taken to determine the softest sound your child can hear, his or her ability to understand words, and to determine if there is any obstruction in the middle ear.

If your child is found to have a hearing loss, the audiologist will help you determine the best way to help your child hear better. There are many options available from hearing aids to surgical devices. Children as young as four weeks can be fitted with a hearing-aid device.

The most important aspect to remember in dealing with a child whom you suspect has a hearing loss is to act immediately. Even if you are first told everything is fine or to “wait and see” and you are uncomfortable with this response, seek out another trained professional.

When considering the many areas in which a child’s life can be affected by even a mild hearing loss, acting early and being persistent can make a great difference. Early intervention can significantly improve your child’s ability to succeed when learning speech and language, as well as improve his or her social, emotional, and educational development.

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