Early Detection Improved Vocabulary Scores in Kids with Hearing Loss

By Molly Walker

Children with hearing loss in both ears had improved vocabulary skills if they met all of the Early Hearing Detection and Intervention guidelines, a small cross-sectional study found.

Those children with bilateral hearing loss who met all three components of the Early Hearing Detection and Intervention guidelines (hearing screening by 1 month, diagnosis of hearing loss by 3 months and intervention by 6 months) had significantly higher vocabulary quotients, reported Christine Yoshinaga-Itano, PhD, of the University of Colorado Boulder, writing in Pediatrics.

The authors added that recent research reported better language outcomes for children born in areas of the country during years where universal newborn hearing screening programs were implemented, and that these children also experienced long-term benefits in reading ability. The authors said that studies in the U.S. also reported better language outcomes for children whose hearing loss was identified early, who received hearing aids earlier or who began intervention services earlier. But those studies were limited in geographic scope or contained outdated definitions of "early" hearing loss.

"To date, no studies have reported vocabulary or other language outcomes of children meeting all three components of the [Early Hearing Detection and Intervention] guidelines," they wrote.

Researchers examined a cohort of 448 children with bilateral prelingual hearing loss between 8 and 39 months of age (mean 25.3 months), who participated in the National Early Childhood Assessment Project -- a large multistate study. About 80% of children had no additional disabilities that interfered with their language capabilities, while over half of the children with additional disabilities reported cognitive impairment. Expressive vocabulary was measured with the MacArthur-Bates Communicative Development Inventories.

While meeting all three components of the Early Hearing Detection and Intervention guidelines was a primary variable, the authors identified five other independent predictor variables into the analysis:

• Chronological age

• Disability status

• Mother's level of education

• Degree of loss

• Adult who is deaf/hard of hearing

They wrote that the overall model was significantly predictive, with the combination of the six factors explaining 41% of the variance in vocabulary outcomes. Higher vocabulary quotients were predicted by higher maternal levels of education, lesser degrees of hearing loss and the presence of a parent who was deaf/or hard of hearing, in addition to the absence of additional disabilities, the authors said. But even after controlling for these factors, meeting all three components of the Early Hearing Detection and Intervention guidelines had "a meaningful impact" on vocabulary outcomes.

The authors also said that mean vocabulary quotients decreased as a child's chronological age increased, and this gap was greater for older children. They argued that this complements previous findings, where children with hearing loss fail to acquire vocabulary at the pace of hearing children.

Overall, the mean vocabulary quotient was 74.4. For children without disabilities, the mean vocabulary quotient was 77.6, and for those with additional disabilities, it was 59.8.

Even those children without additional disabilities who met the guidelines had a mean vocabulary quotient of 82, which the authors noted was "considerably less" than the expected mean of 100. They added that 37% of this subgroup had vocabulary quotients below the 10th percentile (<75).

"Although this percentage is substantially better than for those who did not meet [Early Hearing Detection and Intervention] guidelines ... it points to the importance of identifying additional factors that may lead to improved vocabulary outcomes," they wrote.

Limitations to the study included that only expressive vocabulary was examined and the authors recommended that future studies consider additional language components. Other limitations included that disability status was determined by parent, with the potential for misclassification.

The authors said that the results of their study emphasize the importance of pediatricians and other medical professionals to help identify children with hearing loss at a younger age, adding that "only one-half to two-thirds of children met the guidelines" across participating states.

This article was republished with permission from MedPageToday. 

When It's Not Just Hearing Loss

By Morgan Leppla & Laura Friedman

This year Autism Sunday, an international day to raise awareness of autism spectrum disorder (ASD), is on Feb. 12.

Did you know that one third or more of pediatric hearing loss cases overlap with another condition? This may sometimes be ASD, making treatment and management of co-occurring conditions a challenge.

In a 2007 report in the Journal of Deaf Studies and Deaf Education, British researcher Lindsay Edwards, Ph.D., cites an estimate that 30 to 40 percent of children with hearing loss have co-occurring conditions that could prohibit them from forming language, speech, and sociocognitive skills. But despite this large percentage, there is little research on hearing loss that occurs with other disorders. What research there is has shown the benefit of cochlear implantation for children with additional needs (such as physical or learning disabilities), and the difficulties of language acquisition and development for 3-year-olds with developmentally related conditions such as ASD, cerebral palsy, or Down syndrome.

One silver lining is that the fact that 30 to 40 percent of pediatric hearing loss may occur with other conditions may prove helpful in predicting future disorders. A July 2016 Autism Research paper suggests that a noninvasive measure of otoacoustic emissions in the inner ear—a common hearing test for infants, who are preverbal—may help identify the risk of ASD at an early age, accelerating treatment. Study author Anne Luebke, Ph.D., of University of Rochester Medical School, found that children with ASD often have trouble hearing a frequency range (1–2 kHz) that is important for understanding speech. The range includes sounds for the meaning-conveying consonants S-, H-, and F-.

Scientific conclusions can help shape future research, but cannot illustrate daily life for families with children with co-occurring conditions. Dual diagnoses make unlocking any child’s learning style challenging, but reviving research and upgrading professional training are essential tools in order to advocate for and successfully educate children with co-occurring conditions.

If you’re interested in funding research related to diagnosing and treating co-occuring disorders, such as hearing loss and autism, please consider donating today: hhf.org/donate or contact us at development@hhf.org.

This blog was adapted from an article original appearing in Hearing Health magazine’s Fall 2016 issue. For references in this story, see hhf.org/fall2016_references.

Educating Children with Hearing Loss and Autism Spectrum Disorder

By Eric Sherman

Older Brother, Zach, Cole, and Eric (dad)

Gallaudet Research Institute’s 2009-2010 Annual Survey estimates that about 40 percent of children with hearing loss exhibit another disability and notes the prevalence of autism spectrum disorder (ASD) to be 1 in 59. Early intervention is critical for the development of speech, language, communication skills, and learning. Some families are fortunate to discover their child’s hearing loss at a young age so an early intervention program can be implemented to help their child stay on track with their hearing peers.

What happens when your child is diagnosed with profound to severe hearing loss at 6 months of age, receives his first cochlear implant at age 1½ (second at before his 5th birthday) and spends a couple of years in auditory-verbal therapy (AVT) or speech therapy, but is showing little to no progress?

This was the case with my youngest son. After receiving a second cochlear implant at 1½ and then two years of AVT, my son was nowhere near his hearing peers in communication and language skills. My wife and I knew language development could be a long process, but our gut was telling us that something else was wrong. Our auditory-verbal therapist advised us to seek additional medical evaluations to see if there was something else prohibiting our son’s language development. After having evaluations done, our son at almost 3 years of age was diagnosed on the autism spectrum.

Having a child with hearing loss takes lot of work. Add autism to the mix and it is like trying to solve a puzzle without knowing which pieces are in play.

With intensive behavioral and speech therapy over the years, our son, age 11, has done well. He has become more verbal and can certainly communicate his needs and wants. What is difficult is unlocking the doors into his learning style. There is this blurred line between his autism and hearing disability. When our son has difficulty doing schoolwork, we always question whether he is hearing the information, whether he has a problem processing the information, or whether he is just not interested in the material because it has no real meaning to his everyday life.

Our son has been lucky over the past three years having a teacher who is very creative and skillful in engaging her students. But this has not always been the case. My family’s experiences have taught us that the school district needs more information and training on how to educate a child with both hearing loss and ASD. Service providers need to know how to address each disability individually and collectively understand how they impact a child’s overall education. We have a school audiologist who wanted to create a goal for our son where he tells his aide or teacher when his CI processors are not working. This is a reasonable expectation for a child with hearing loss, but when ASD is added to the mix this may be difficult to achieve.

A child with ASD may have to be taught what it means for their processor not to be working, as well as what to do after they determine they are not working. Furthermore, generalization of whether the processor is “working or not working,” “broken,” or “on or off” may be confusing and difficult to understand. Our son believes his processor is “on” if his headpiece was attached to his head. Also, a child with autism may prefer the silence and not notify anyone their processors are off.

The dual diagnosis of hearing loss and ASD has been documented for the past 20 years; however, research and clinical guidelines on how to find and teach young children with this dual diagnosis are sparse. School professionals and educators need more tools and training to better equip the growing number of children afflicted with ASD and hearing loss. Both Advanced Bionics, which makes cochlear implants, and Illinois State University have done work on this issue, calling attention to the need for better diagnostic tools, early intervention, and training of education professionals. Still, significantly more needs to be done.

Eric Sherman is a father of two boys. In addition to advocating for his son and others, he serves as a parent representative on advisory boards on how special education and family support services are implemented in his local school district. To learn more about Eric Sherman visit ciwear.com/Ourstory/index.html

Proud Grandparents

By Darel Sorensen, Ed.D.

When our grandchild Mikaela, now 15, was born, newborn hearing screening was not yet an option at their hospital in California. She was diagnosed with a sensorineural hearing loss at age 23 months, after we noticed she had delayed speech.

At age 2 she began attending an “early start program” and preschool at age 3. Two years later Mikaela was joined in preschool by her younger brother Christian Joseph (CJ), now 13. He had passed the newborn screening test, but by age 2 1/2 he began to lose his hearing. After an alert teacher suggested testing, CJ was also diagnosed with sensorineural hearing loss.

To attend school, Mikaela and CJ traveled for one hour each day. The bus ride is a long one for kids who are toddlers, but our anxiety was tempered knowing that Mikaela and CJ would be getting specialized assistance with their hearing, speech, and language skills as well as learning how to sign. It would help prepare them for mainstream school classes.

Before she was 3 years old, Mikaela had cochlear implant (CI) procedures in both ears. A few years later, also at age 3, CJ also received a CI for his left ear and a hearing aid in his right.

Since the deaf and hard-of-hearing (DHOH) program in their school district spans kindergarten through high school, they have benefited from learning communication and coping skills from the same DHOH and speech-language therapists as they got older. They know to ask to sit on the side of the classroom, so they can more easily rotate to face whoever is speaking, and to be specific about what part of a conversation they missed when asking for something to be repeated.

Mikaela and CJ - 2 1/2 and 1 years old

Thanks to this consistent help, Mikaela and CJ were able to be mainstreamed into their local schools. Now in middle school, CJ has tried his hand at sports and now plays clarinet in the marching band; he was also selected to play in the concert band. Mikaela has played on the school basketball team for four years and received this commendation from her DHOH specialist:   

“Mikaela exudes confidence in class, never shying away from raising her hand, offering her insights, speaking up about her ideas and opinions. She advocates for herself by talking with her teachers about what works best for her. She is energetic, personable, and hardworking. In addition to her own success, she looks out for her fellow hard-of-hearing peers in order to help them succeed as well.”

Recently there was talk that the DHOH program may be moving from its current locations. Mikaela was quick to contact the administration to tell them how much the program meant to her and to her success: “Both DHOH and mainstream teachers… helped me understand everything, and now I’m a straight-A student because of them,” she wrote.

“The DHOH campuses are safer, friendlier, and better than most schools…. If you move the program you’ll be losing the teachers, staff, and students who treated us like family [and] the hearing students at those schools will be losing the ability of learning another language (sign language) and being friends with the deaf. PLEASE KEEP THE PROGRAMS WHERE THEY ARE!! Thanks for reading.”

These steps toward self-advocacy, as well as their self-confidence and concern for others, will serve them well. We could not be more proud. We wanted to share this story about our grandchildren because we believe in HHF and its mission of research, education, and prevention of hearing loss.

Darel Sorensen, Ed.D., is a retired educational psychologist and director of special education services. He lives with his wife, Betty, in California. 

Ages and Stages

By Maureen Plain

Effective communication is one of life’s greatest pleasures, and for those of us with typical hearing, we so often take this gift for granted. The process of verbal communication starts with being able to hear what is said. We then apply knowledge of the words we hear, so we can decipher its message.

When crafting a response, we must have the words in our repertoire of vocabulary readily available, so we can express our thoughts and then pronounce the words clearly enough to be understood by others. As we verbalize our response, grammatical markers for our words, intonation patterns, and understanding the social setting helps us share our thoughts effectively. This process of verbal communication begins in infancy with the use of eye contact, sounds, and body language, and continues throughout our lives. 

For those with hearing loss, all of this can be especially challenging.

Imagine the challenge for a 3-year-old girl who has just been diagnosed with a moderate to severe sensorineural hearing loss in both ears. For three years until diagnosis, she communicated entirely by reading body language and other physical cues. But how did this affect her ability to effectively communicate with others in the hearing world?

In the first couple years of life, caregivers (i.e. parents, nannies, and family members) are acutely aware of small children and often times face them when speaking. This girl’s caregivers did not realize she was solely dependent on reading body language and other physical cues, including lips, to communicate. As she got older, her mother noticed that when faced away, her daughter was unresponsive. After many misdiagnoses, this little girl and her family were told she had hearing loss.

Fortunately this child has a dedicated family that responded to her diagnosis with unwavering commitment, and immediately started designing a team of professionals to support the best learning possible, which included top-notch audiologists and a speech-language pathologist/auditory therapist. The school district provided great support and I was fortunate to be this child’s speech/language pathologist from the very beginning, working with her a few times each week from age 3 until she graduated from high school. 

Vocabulary growth and clear and proper pronunciation of words were always a crucial components of our therapy, as well as benchmarking and tracking progress. A toddler needs vocabulary to engage in play and to learn, just as a teenager needs vocabulary to navigate school and friendships.

At every age, building vocabulary with a person with a hearing loss is multifaceted and hard work. First we worked on hearing and saying each word until it became familiar enough to begin the process of developing listening for each word. We paid extra attention to words with syllables extremely difficult for her to hear, in this case those that are considered high-frequency (S-, SH-, CH-,TH-, -ECT.).

As the child grew older, she spoke intelligibly but would often leave off the ending syllables, such as a plural “s” because she was repeating only the sounds she heard. We worked on learning grammatical marker patterns so she would pronounce a plural “s” based on grammatical rules. Practicing the articulation for each sound component in a word is also very challenging, since a hearing loss makes it difficult to hear your own speech sound errors and correct them. We also used an oral motor approach to complement our work on sound production. We focused on how a sound felt when it was pronounced; where her lips, tongue and jaw belonged to articulate different sounds properly. We also practice oral vs. nasal air flow and practiced making sounds in front a mirror to see how it looked. Through this process, she developed speech that is clear and understood by all listeners, in addition to being able to use verbal cues and grammatical markers that she has been trained to watch for, but was otherwise unable to hear.

We also integrated speech therapy with auditory training exercises. Listening practice included her looking and listening when I was visible, and repeating the sounds she heard back to me. Once she mastered that, I then moved farther away from her sight to advance this skill. We then moved to improving listening without looking; while still facing her, I covered my mouth with a paper to develop better listening and discrimination of sound. As accuracy improved, I then would sit behind her and continually moved farther away until I was 6 feet away, with her back facing toward me. We also practiced listening to the word so it can be recognized in quiet and in noise.

Listening skills were paired with our work on vocabulary comprehension to enhance communication. Beyond pronunciation and listening, learning the definition of each word to build comprehension is crucial. Vocabulary shapes our conversation, and since mishearing words is a constant challenge for those with hearing loss, they must rely on their vocabulary knowledge to fill in the gaps for greater conversation participation and quality of life.

These are just a few of the many strategies that we used to improve speech, language, and listening during our 15 years together. To succeed she, as well as her parents and family, needed to fully trust the process and integrate these strategies into her everyday life. While therapy was only 2-3 hours a week, speech and verbal communication is a chosen part of her everyday life.

Therapy was a lot of hard work and sometimes frustrating for her, as not every milestone was easy. Until there’s a cure for her type of hearing loss, she will not have the ability to hear as seamlessly as those with typical hearing or have perfect speech. 

May is Better Speech and Hearing Month and serves as reminder that verbal communication is a shared pleasure that brings us laughter, learning, and love. We should take this month to treasure the gift of communication and celebrate the hard work and success of all individuals whose ability to communicate is challenged, for whatever reason.

Maureen Plain M.S., CCC-SLP, is a speech-language pathologist with 37 years of experience in the greater NY area. She is currently a Program Director for Sunny Days Consulting Services in New York.

A Neurological Emergency

By Jane Madell, Au.D.

Hearing loss is the most common disability in children worldwide. Annually in America approximately 3 in 1,000 babies are born with permanent hearing loss, making hearing loss one of the most common birth defects in the U.S. Hearing loss cannot be viewed in isolation; it can cause problems for auditory brain development. When a child with hearing loss is born, the child has already had 20 weeks of auditory deprivation.

Typical*-hearing babies
When babies with typical-hearing are born, they have been listening to their mother’s voice and the voices of others near their mother. They can tell the difference between their mother’s voice and their father’s voice. They recognize inflection; they can tell which words are important and separate them from words that are used to connect the important words. They recognize emotion in voices, and music they heard during pregnancy. Although the sounds they hear are softer and a little muffled compared with those heard outside the womb, they provide significant input to the auditory brain.

Babies with hearing loss
Babies with hearing loss are born with brain deprivation, which is why it is important to act quickly to reduce the effect of this delay. The critical thing to remember is that there is a short window for developing the auditory brain. If children do not get the opportunity to hear during the first 3 to 3 ½ years, they will lose that opportunity. We are not just talking about developing language (which is certainly critical), but also about literacy. Reading is in the same part of the brain as hearing, so if we want children to succeed, we need to build the auditory brain early.

Typical-hearing babies who are not exposed to language
Lack of exposure to auditory stimulation affects everyone’s brain. Typical-hearing children who live in homes where their parents do not talk with them will also show a lack of auditory brain development. Hart and Risley (1995) have demonstrated that the number of words heard directly affects both the number of words in a child’s vocabulary and the child’s IQ at age 3 years. Children who heard ~30,100 words in a 14-hour day had a vocabulary of ~1,100 words and an IQ of 117 at age three years, while children who heard ~8,600 words in a day had a vocabulary of 525 words and an IQ of 79.

So what should we be doing?

Every child needs good exposure to language. While professionals have a role, the most important people in providing language stimulation to children are their parents. Everyone who works with children needs to help parents understand that EVERY child needs a lot of auditory input. Parents need to be encouraged to talk, read, and sing to their children. Ten books a day should be the goal. We need to help parents learn how to talk to their children, and, most importantly, how to enjoy talking to their children. All children with limited language — not just those with hearing loss — have reduced economic possibilities.

Empowering parents
Ears are the pathway to the brain; the brain is the organ of hearing. Just as parents are the people who need to feed their children and keep them warm, parents are also the people who have to give children power to use their brain. It is essential that parents are properly educated about their child's hearing loss and the role they play in their child's auditory development. If children can learn to listen and talk, they will be able to:

• Talk to people around them and learn from them

• Hear and learn great ideas

• Read well and learn about the world

• Receive a good education

• Have life choices

The ability to get a good education and to increase life choices has the added advantage of reducing poverty, as well as the possibility of making major changes in a child’s life.

Take action today to protect your children's ears against the dangers of noise and consider donating today to help us find a cure for hearing loss and tinnitus.

This post originally appeared on Hearing Health @ Hearing Health & Technology Matters’ blog on February 10, 2015. The author, Jane Madell, Au.D., is an audiologist, speech-language pathologist, and auditory verbal therapist with 40-plus years of experience in the greater New York City area.  

*Typical Hearing was use in place of Normal Hearing. 

Your Brain Is a Muscle: Use It or Lose It

By Sloan Blanton

Brain Awareness Week (March 16-22, 2015) celebrates one of the most important organs in the human body and current progress and breakthroughs in brain research. While the brain literally affects every organ and bodily function, did you know hearing loss, especially when it goes untreated, can affect brain function and size? It can also affect quality of life. Depression rates are higher for those with hearing loss, as is the likelihood of emotional issues, such as anger and withdrawal, which can lead to poor mental health.

I was born with a sensorineural hearing loss in both ears so it is all that I have ever known. While I sometimes feel socially isolated because I am not always able to follow the conversations around me, and I also know my speech development has been directly affected by my hearing loss, my cogitative ability has been in no way impaired. However, several studies have found a correlation between aging, cognitive function, and hearing loss. For a long time, many researchers believed the two to be unrelated, but recent findings have proven otherwise.

From 2001 to 2007, the Health, Aging, and Body Composition study tested the hearing and cognitive abilities of nearly 2,000 adults between ages 75-84. In the study, those with hearing impairment lost cognitive abilities up to 40% more quickly than typical-hearing participants. Additionally, participants with hearing loss developed cognitive issues on average three years sooner than those with typical hearing.

Numerous theories dive into the relation between the brain and hearing loss, such as that the brain must work harder to process sounds when there is an inability to hear, which then takes the brain’s attention away from other cognitive functions. "We take for granted that processing sound is simple, but for the brain it's very energy intensive," Dr. Frank Lin, the assistant professor conducting the study, reported. "The most powerful computers in the world are no match for the sound-processing capabilities of the brain of a 3-year-old child."

The decline of cognitive ability impairs other brain functions, such as thinking and memory retention. Social isolation resulting from hearing loss can put the elderly at greater risk for dementia and other cognitive impairments. "It's early days yet, but we have seen that if you take an adult with typical hearing and put her in an MRI scanner while listening to garbled speech, the scans reveal that the brain has to spend extra energy to decode it," says researcher Jonathan Peelle.

In 2014, Neurolmage published Lin’s study on hearing loss possibly causing the brain to atrophy, like an unused muscle. Those who have had hearing loss for at least seven years or longer tended to have brains with small temporal lobes, making short- and long-term memory and processing meaning from sensory input difficult.

According to Healthy Hearing, a deeper understanding of hearing loss, both its causes and its effects, is crucial. The hope is that individuals with age-related hearing loss could benefit from cognitive and perceptual training exercises, and thus can have an improved quality of life. That includes better physical health, better mental health, improved relationships, and the ability to continue to engage in society. To make sure you're receiving the best care and are living the highest quality life possible, make an appointment with your hearing healthcare professional for your annual checkup; more than just your hearing will benefit.

Watch out for the “Break the Stigma” issue of Hearing Health Magazine this spring, which will include research on how addressing, and then treating, hearing loss leads to happier, healthier outcomes. If you're not already a subscriber to the FREE magazine, subscribe here.

Ten Clues Your Child Has Hearing Loss

Ten clues your child has hearing loss

Universal hearing testing for newborns has helped to identify most children with hearing issues quickly and accurately. With a simple test, 80 to 90 percent of hearing loss can be detected, and children can begin early intervention with the best possible outcomes for language development.

“Even if your child passed the newborn screening at birth, however, keep in mind that hearing loss that is genetic or progressive in nature can manifest when your child is a toddler or older,” says Dr. Barbara Jenkins, an audiologist and writer of this article, with Hearing Health Magazine. “It’s important to identify signs that may suggest possible hearing loss in your child, so that testing can be done and treatment and management undertaken.”

Delayed or absent speech development is the most important clue indicating a possible hearing loss in the very young child. Identifying hearing loss in the infant and young child requires watching for critical developmental milestones.

Use the following milestones from Hearing Health Foundation as a guideline, and always discuss any concerns with your pediatrician.

* By 3 months, your baby recognizes and quiets to your voice, makes cooing noises, and is startled by sudden, loud noises.

* By 6 months, your baby recognizes speech sounds and familiar voices, turns his head toward interesting sounds, plays with his own voice, and laughs. Your baby uses his voice to indicate pleasure and discomfort, and has speech-like conversations with caregivers.

* By 9 months, your baby can understand simple words like “mommy,” “daddy,” “no,” “bye-bye” and his own name.

* By 10 months, your baby’s babbling should sound speech-like with strings of single syllables (“da-da-da-da”).

* By 12 months, one or more real, recognizable spoken words emerge.

* By 18 months, your toddler should understand simple phrases, retrieve familiar objects on command (without gestures), and point to body parts when asked, “where’s your ... ears, nose, mouth, eyes,” etc. Your toddler has a spoken vocabulary of between 20 to 50 words and short phrases (“all done,” “go out,” “mommy up”) and is learning new words each week.

* By 24 months, your toddler’s spoken vocabulary should be 200 to 300 words and simple sentences can be spoken. Adults not with your child on a daily basis can understand your child’s speech. A toddler at this age should be able to sit and listen while being read books.

Children who have developed speech skills are more difficult to identify. Use these guidelines from Hearing Health Foundation to discern a possible newly acquired hearing loss.

1. Your child seems to hear fine some of the time and then not respond at other times.

2. Your child wants the TV volume louder than other members of the family.

3. Your child says “what” more often than he used to.

4. Your child moves one ear forward when listening, or he complains that he can only hear out of his “good ear.”

5. Your child’s grades fall, or his teacher notes that he doesn’t seem to hear or respond in the classroom as well as other children.

6. Your child says that he didn’t hear you. This may seem obvious, but many parents assume that their children are not paying attention when in fact there may be an unidentified hearing loss.

7. It seems as though your child is just not paying attention.

8. Your child starts to speak more loudly than previously.

9. Your child looks at you intently when you speak to him. He may be depending more on visual cues for interpreting speech.

10. You just have a feeling. Sometimes you just can’t put your finger on what your concern is. Don’t let that stop you. Ask your child’s doctor for a referral to ease your mind.

There are many possible causes of acquired hearing loss that present themselves months or years after birth. Most hearing loss in children without obvious risk factors (such as premature birth) has a genetic cause. If you have any concerns, contact your pediatrician for a referral to a hearing health care provider for a complete hearing evaluation.

To learn more about genetic hearing loss, visit Hearing Health Foundation to read the Summer 2012 issue of Hearing Health magazine, available online at hearinghealthfoundation.org/hearing-health-magazine.  

To learn more about the types of newborn hearing screenings and the importance of early detection and early intervention, visit hearinghealthfoundation.org/newborn-screening-information.