Hearing Screenings

The Importance of Early Intervention

By Frankie Huang


May is Better Hearing and Speech month and Hearing Health Foundation (HHF) would like to take this opportunity to raise awareness on the importance of early intervention for hearing loss in children, and the significant impact it can have on language development.

Hearing Health Foundation was instrumental in advocating for the Universal Newborn Hearing Screening legislation, as today 97% of babies are screened before they leave the hospital. In 1993, that number was 5%. Approximately 3 out of every 1,000 children in the United States are born deaf or hard of hearing. More than 90 percent are born to parents with typical hearing. Fortunately, early identification allows children with hearing loss to receive help they need during the first two years of life, a critical period for the development of speech and language skills. The earlier a child’s hearing loss is detected, the sooner the family can gather as much information as possible to make the best decision for their child’s language and communication approach.

With early intervention, children with hearing loss are able to develop language skills to help them communicate freely and actively learn. There are many services available to support children. For example, the Individuals with Disabilities Education Act (IDEA) ensures all children with disabilities have access to services they need for a good education. In addition, Head Start and Early Head Start are federally funded programs to help young children of low-income families become better equipped to succeed in school.

However, if the child’s hearing loss is left undetected or untreated, hearing loss can negatively impact a child’s language development. Delayed intervention can also adversely impact a child’s language development. One study had found that children who received earlier amplification or cochlear implantation had better language outcomes. Maternal education and communication modes used during early intervention can also improve language skills over time. A longitudinal study concluded that children with permanent hearing loss enrolled in an early intervention program before the 6 months of age developed on par with age-appropriate language skills than those who were enrolled after 6 months of age.

Similarly, another study had suggested that early enrollment in intervention programs were linked to higher language scores. It concluded that children enrolled before 11 months of age showed better vocabulary and verbal reasoning scores at 5 years of age compared with those enrolled later. Children that were enrolled later may experience delays that can interfere with academic development and comprehension in the classroom.

In the same study, the results suggest that family involvement was a contributing factor for the best outcomes of early intervention. Positive language outcomes were correlated with families that were highly motivated and active with their child’s intervention, while limited family support was associated with poor language outcomes. Also, families who were actively involved with early intervention were more likely to communicate better with their children, which contributes toward their overall growth. However, it is also important to consider the contrary; a lack of family involvement poses the largest challenge to early intervention. Specifically, a systematic review on the follow-up rate in newborn hearing screenings found that, on average, 20% of babies who failed the initial screening did not return for follow-up testing. The high loss to follow-up is believed to be attributed to a lack of adequate knowledge of the risks of hearing loss. This is the largest threat to the success of the newborn hearing screening program, as it becomes the family’s responsibility to follow-up on care beyond the initial hearing screening prior to discharge.

It is important to remember that hearing loss can occur at any time of life. Some forms of hearing loss do not appear until a child is a toddler or enters school, or even later. In addition, illness, ear infections, head injury, certain medications, and exposure to loud noise are all potential causes of hearing loss. In particular, recurring ear infections may negatively affect language development because of the resultant fluctuating hearing loss’ lack of steady auditory input necessary for speech and language development.

Even if your child or a child of a loved one does not have hearing loss today, Hearing Health Foundation strongly encourages regular checkups and annual hearing tests performed by audiologists, ENTs, pediatricians, or other health providers to monitor potential changes in hearing. These professionals are also excellent resources for intervention services to help overcome barriers to communication.

Receive updates on life-changing hearing research and resources by subscribing to HHF's free quarterly magazine and e-newsletter.

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Educators Must Address Diabetes-Related Hearing Loss

By Susan Weiner, MS, RDN, CDE, CDN and Joanne Rinker, MS, RD, CDE, LDN

Hearing loss may not be commonly thought of as a complication of diabetes. How did you become interested in the condition?

As a diabetes educator, when I think of diabetes complications, I think of kidney, eye, heart and nerve damage. What I don’t think about is hearing loss. In 2012, a colleague asked me what screenings I do for my patients to determine if they have hearing loss. I realized I did nothing because hearing loss really was never on my radar. Then she asked me to think about how a patient who has diabetes might feel if they also had trouble hearing. I started to think about how hearing loss can not only make life more difficult, but could also lead to depression. For a diabetes patient who is already dealing with the pressures of a complicated disease, adding hearing impairment to the list of stressors would be devastating. So, I decided that this was something worth discussing with other diabetes educators.

How common is hearing loss among people with diabetes?

I did some research, and it turns out that nearly 26 million people in the United States have diabetes, and an estimated 36 million people have some type of hearing loss (17%). NIH has found that hearing loss is twice as common among people with diabetes as among those who don’t have the disease. Also, of the 79 million adults thought to have prediabetes, the rate of hearing loss is 30% higher than in those with normal blood sugar levels.

Research suggests that diabetes may lead to hearing loss by damaging the nerves and blood vessels of the inner ear. Autopsy studies of patients with diabetes have shown evidence of such damage.

A recent study from Handzo and colleagues found that women between the ages of 60 and 75 years with well-controlled diabetes had better hearing than women with poorly controlled diabetes, with hearing levels similar to those of women of the same age without diabetes. The study also showed significantly worse hearing in all women younger than 60 years with diabetes, even when the disease is well controlled.

Additionally, a study by Bainbridge and colleagues showed that 54% of people with diabetes had at least mild hearing loss in their ability to hear high-frequency tones, compared with 32% of those with no history of diabetes. And 21% of participants with diabetes had at least mild hearing loss in their ability to hear low- to mid-frequency tones, compared with 9% of those without diabetes.

People with diabetes are 2.3 times more likely to have mild hearing loss, defined as having trouble hearing words spoken in a normal voice from more than 3 feet away. But the effects of hearing loss go beyond the ability to detect sound. Hearing loss is shown to lead to sadness and depression increasing with severity of hearing loss; worry and anxiety, including periods of a month or longer when the patient reports feeling worried, tense or anxious; paranoia (“people get angry at me for no reason”); less social activity; and emotional turmoil and insecurity.

What can diabetes educators do to help patients with hearing loss?

Encourage diabetes patients to be screened routinely for hearing loss, just as they are for eye and kidney problems. Those with mild to severe impairment should be referred to an audiologist for more intense screening and treatment.

Treatment for hearing loss will typically start with a hearing aid. Often this will alleviate the problem. In about 10% of the population, medication may also be necessary, but most hearing loss is corrected with the introduction of a hearing aid. With improved hearing, patients will also likely experience increased alertness; improved job performance, memory and mood; less loneliness, fatigue, tension, stress, negativism and anger; better relationships and feelings about themselves; and greater independence and security — improved overall quality of life.

The bottom line is that diabetes educators must remember to add this to their diabetes education curriculum. They should know the resources in their area and have a process for referring patients to an audiologist who can do more extensive screenings as well as order and fit patients for hearing aids. Lastly, they should follow up with patients with hearing loss about overall quality of life. I am sure they will surprised how much adding this one aspect of care can benefit the lives of their patients.


  • Bainbridge KE, et al. Ann Intern Med. 2008;149(1):1-10.

  • Handzo D, et al. Effect of diabetes on hearing loss. Presented at: Triological Society 2012 Combined Sections Meeting. Miami Beach, Fla.; Jan. 26-28, 2012.

  • National Academy on an Aging Society. Hearing loss: a growing problem that affects quality of life. 1999. Available at: http://ihcrp.georgetown.edu/agingsociety/pdfs/hearing.pdf

This blog post orginally appeared on Healio.com on March 1, 2016. 

Joanne Rinker, MS, RD, CDE, LDN, is Senior Director for Community Health Improvement at Population Health Improvement Partners and the 2013 American Association of Diabetes Educators (AADE) Diabetes Educator of the Year. She has been elected to the AADE Board of Directors 2015-2018. She can be reached at jorinker@gmail.com.

Susan Weiner, MS, RDN, CDE, CDN, is the 2015 AADE Diabetes Educator of the Year and author of The Complete Diabetes Organizer and Diabetes 365 Tips For Living Well. She is the owner of Susan Weiner Nutrition PLLC and is the Endocrine Today Diabetes in Real Life column editor. She can be reached at susan@susanweinernutrition.com.

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Help Mom Hear Better This Mother's Day

By Yishane Lee

Give the gift of hearing this Mother’s Day by taking your mom to get a hearing screening, and getting one yourself. One in five adults has a hearing loss—including adolescents—and the rate increases with age, with one in three seniors experiencing a hearing loss. But the average time between being diagnosed with a hearing loss and getting a hearing aid is seven years. That’s a long time to miss parts of conversations, misunderstand television dialogue, or be unable to fully enjoy a family gathering.

Now a new study puts more urgency into the need to check hearing. Researchers from the National Institute of Deafness and Other Communication Disorders (NIDCD) found a link between hearing loss and an increased risk of depression and published the results in the journal JAMA Otolaryngology–Head & Neck Surgery. The scientists examined data for 18,000 people and found that a decline in hearing more than doubled the risk for depression when compared with those who said they had excellent hearing.

Women ages 70 and older were particularly susceptible to depression with even a moderate hearing loss of 35 to 50 decibels. And when every level of hearing loss was considered, 14.7 percent of women of all ages were more likely to feel sad and depressed, compared with 9 percent of men with any degree hearing loss. The link between depression and hearing loss remained even when the researchers controlled for factors such as vision problems.

The NIDCD study underscores the importance of getting your hearing checked and treated, and of getting treated for depression as well in the event of a diagnosed hearing loss. However, and unfortunately, the researchers also found that depression was higher among those using hearing aids.

Don’t leave your mom out of the conversation. Book a hearing screening for both of you in honor of Mother’s Day. She’ll thank you, we promise!

Learn more about finding the right hearing health professional and taking care of your ears from the Spring issue of Hearing Health magazine:

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Eight Reasons to Get Your Hearing Checked This May

By Elizabeth Thorp

Did you know that nearly 50-million Americans have some sort of hearing loss? I'm one of them—I was born deaf in my left ear from genetic nonsyndromic senorineural hearing loss.

Hearing loss is actually the country's most common birth defect. In fact, two to three of every 1,000 children born in the United States are deaf or hard-of-hearing. And ninety percent of those kids have parents who can hear, like me. I wasn't fully diagnosed until I was a teen.

Perhaps even more interesting, the National Institute on Deafness and Other Communication Disorders (NIDCD) says that only 20% of the staggering number of people who could benefit from hearing aids are actually using them. Hearing research and technology have made huge leaps and bounds since I was a child, and the 40-million people not taking advantage of them are missing an opportunity to hear much better.

So in honor of Better Hearing and Speech Month—which continues through the end of May—here are eight reasons to get a hearing check now:

1. You've probably noticed a hearing problem already but done nothing about it. Don't worry, you're not alone. People generally wait seven to ten years between the time that they notice a hearing problem and the time they actually make an appointment with an audiologist or ENT.

2. Even if you've had regular physicals and appear to be in good health, you could have a hearing issue. Only 16% of physicians routinely screen for hearing loss.* Since a hearing exam is not a standard part of most examinations, you typically have to make a separate appointment—and you may not have known to do so since many general practitioners don't suggest it.

3. If you are a recent veteran, chances are your hearing was damaged during your service. 60% of veterans returning from Iraq and Afghanistan come home with hearing loss and/or tinnitus.

4. Hearing loss can cause learning delays, and your child might be among the 20% of preschoolers to fail a hearing screening*, but the earlier the problem is caught, the better.

5. Hearing loss can lead to depression and social isolation—it can affect nearly every aspect of your life. Treating hearing loss can help people re-engage with their communities and even be able to stay more involved with their families.

6. A recent study out of Johns Hopkins showed that people with mild hearing loss are twice as likely to develop dementia—a likelihood that increases with the severity of the hearing loss. Researchers are still searching for reasons for this correlation, but one hypothesis is that the isolation and depression caused by untreated hearing loss may contribute to cognitive decline. It's possible that, by treating hearing loss, we may be able to stave off dementia.

7. One in five teenagers now has a hearing loss. The supposition is that this is caused by toxic levels of noise from mp3 players. While parents have for years been encourage their teens to turn the music down (listening at maximum volume for more than 15 minutes a day can cause a permanent hearing loss!), it's also important to ask if they're having trouble hearing and get their hearing checked.

8. If you pledge to get your hearing checked, you can help the Hearing Health Foundation raise money. For each online pledge up to 10,000, healthyhearing.com will donate a dollar to the Hearing Health Foundation to help fund hearing research. And a bonus: the Foundation will help you find local audiologist and otolaryngologist and provide information about what questions you should be asking when you visit.

Elizabeth Thorp is a family travel expert and writer. She is the founder of Poshbrood, a curated catalog of mom-tested, upscale, family-friendly vacation properties. She has been navigating public affairs and communications in Washington for 20 years. Elizabeth lives in Bethesda with her husband, Almus, and three young daughters Isabelle, Lucy, and Penelope.

*Statistic provided by Center for Hearing and Communication, from data collected in New York City.

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HHF Provides Free Hearing Screenings for Students


NYC schools no longer offer hearing screenings for its students, so on May 2, the Hearing Health Foundation and Gordon Hearing Conservation partnered to provide free hearing screenings for students at the Speyer Legacy School on Manhattan's Upper West Side in honor of May's Better Hearing and Speech month.

On May 2, 2013, Hearing Health Foundation, a non-profit dedicated to finding a cure for hearing loss, partnered with Gordon Hearing Conservation and The Speyer Legacy School to provide a “Safe and Sound” presentation and free hearing screenings for its third-fifth graders.


Serving as the kickoff to May’s “Better Hearing & Speech Month,” the Hearing Health Foundation fulfilled a dire need, as NYC schools no longer offer hearing screening for their students. By providing this service, Hearing Health Foundation, Gordon Hearing Conservation, and The Speyer Legacy School are ensuring the protection of children’s hearing.

While hearing screenings are an overlooked necessity, they test whether an individual has normal hearing or some degree of hearing loss.

A rampant issue, hearing loss statistics can be shocking:

• 1 in 5 Americans have hearing loss in at least one ear.

• 20% of the US population aged 12 years and older has hearing difficulties severe enough to impact communication.

• There is a direct link between age and hearing loss: about 18% of American adults between the ages of 45 and 54, 30% of adults between ages 65 and 74, and 47% of adults ages 75 and older have hearing impairments.

• In the USA, three out of every 1,000 children are born deaf or hard-of-hearing.

• About 26 million Americans between ages 20-69 have high frequency hearing loss due to exposure to loud noises at work or in leisure activities.

• About 60% of deployed military service men and women have noise induced hearing loss, tinnitus and other hearing injuries.

About Hearing Health Foundation

Hearing Health Foundation is the largest private funder of hearing research, with a mission to prevent and cure hearing loss through groundbreaking research. Since 1958 Hearing Health Foundation has given almost $30 million to hearing and balance research, including work that led to cochlear implant technology. In 2011 Hearing Health Foundation launched the Hearing Restoration Project, a consortium of scientists working on cell regeneration in the ear. HRP's goal is a biologic cure for most types of acquired hearing loss within the next ten years.

Hearing Health Foundation also publishes Hearing Health magazine, a free consumer resource on hearing loss and related technology, research, and products. To learn more, to subscribe to our magazine, or support this work, visit hearinghealthfoundation.org.
Follow the Foundation on Twitter at @HearingHealthFn and Like the organization on Facebook at facebook.com/hearinghealthfoundation.

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Hearing Health Foundation Announces "Pledge for Hearing Health"



Occurring in Conjunction with National Better Hearing & Speech Month

New York, NY (May 1, 2013)—In honor of Better Hearing and Speech Month this May, Hearing Health Foundation (HHF), a non-profit dedicated to finding a cure for hearing loss through innovative research, has launched a campaign to encourage individuals to pledge online to get their hearing, or a loved one’s hearing, tested. To take the pledge, please visit: http://hhf.org.

Nearly 50 million Americans experience hearing loss, yet the average person has trouble hearing for seven to ten years before having their hearing tested by a hearing healthcare professional. HHF will provide resources to help those taking the pledge find local hearing healthcare professionals as well as topics to discuss with their providers. In addition, for every person who takes the pledge, HeathyHearing.com, a leading online resource for hearing health, will donate $1 to HHF to support groundbreaking research to prevent and cure hearing loss.

Also joining Hearing Health Foundation as partners in this initiative are the four major professional hearing associations: Academy of Doctors of Audiology (ADA), American Academy of Audiology (AAA), American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and American Speech-Language-Hearing Association (ASHA).

“We are thrilled to have the support of all these incredible organizations, uniting together to support a very important health initiative,” said Andrea Boidman, Executive Director of Hearing Health Foundation. “Nearly every single person is affected one way or another by hearing loss. While our Hearing Restoration Project works to find a cure for hearing loss, our goal is to make hearing health a national priority. There are so many treatments available to help people hear better, and we want to encourage Americans to have their hearing tested and speak with a hearing healthcare provider about what options are available.”

"Most people have their teeth and eyes checked every year, but neglect to check their hearing. Hearing loss is the third most common health problem in America behind high blood pressure and arthritis," said Paul Dybala, Ph.D., President of HealthyHearing.com. "We wanted to support this initiative with Hearing Health Foundation to encourage people to visit a hearing care professional to get their hearing checked regularly."

As people often delay treating hearing loss, HHF notes several critical reasons to have your hearing tested, including:

  • Only 16% of physicians routinely screen for hearing loss.

  • 20% of preschoolers fail hearing screenings.

  • 72% of people attending senior centers fail the hearing screening.

  • People with a mild hearing loss are twice as likely to develop dementia; the likelihood to develop dementia increases with the severity of the hearing loss.

  • Hearing loss can lead to depression and social isolation.

In 2011 Hearing Health Foundation launched the Hearing Restoration Project (HRP), a consortium of scientists working on cell regeneration in the ear. The goal of the Hearing Restoration Project is to find a biologic cure for hearing loss through innovative research surrounding inner ear hair cell regeneration. Most non-mammals spontaneously regenerate these specialized cells after they are damaged, which allow them to restore their hearing, but humans do not and the Hearing Restoration Project aims to understand why. The Hearing Restoration Project brought together a consortium of 14 senior scientists at leading universities around the country, requiring them to share data in order to find a quicker path to a cure.

For more information or to see how you can get involved please visit: http://hhf.org

About Hearing Health Foundation
Hearing Health Foundation is the largest private funder of hearing research, with a mission to prevent and cure hearing loss through groundbreaking research. Since 1958 Hearing Health Foundation has given away millions of dollars to hearing and balance research, including work that led to cochlear implant technology and now through the Hearing Restoration Project is working on a cure for hearing loss. Hearing Health Foundation also publishes Hearing Health magazine, a free consumer resource on hearing loss and related technology, research, and products. To learn more, subscribe to our magazine, or support this work, visit www.hhf.org.

Follow the Foundation on Twitter at: https://twitter.com/HearingHealthFn and like the organization on Facebook at: https://www.facebook.com/HearingHealthFoundation to stay current on hearing research, trends, technology and breakthroughs.

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