babies

First Study to Examine Cognitive Development in Deaf Babies Finds Differences Begin in Infancy

By The Ohio State University Wexner Medical Center

Deaf children face unique communication challenges, but a new study shows that the effects of hearing impairment extend far beyond language skills to basic cognitive functions, and the differences in development begin surprisingly early in life. Researchers at The Ohio State University Wexner Medical Center are the first to study how deaf infants process visual stimuli compared to hearing infants and found they took significantly longer to become familiar with new objects.

 “This is somewhat counterintuitive because a lot of people assume that deaf children compensate for their lack of hearing by being better at processing visual things, but the findings of the study show the opposite,” said Claire Monroy, post doctorate otolaryngology fellow at The Ohio State University Wexner Medical Center and co-author of the study.

Macey Kinney plays with her 10-month-old son Zealand, who was born deaf. A new study shows that developmental differences in deaf babies extend beyond language and hearing, and begin surprisingly early in life. Credit: Ohio State University Wexner Medical Center

Macey Kinney plays with her 10-month-old son Zealand, who was born deaf. A new study shows that developmental differences in deaf babies extend beyond language and hearing, and begin surprisingly early in life. Credit: Ohio State University Wexner Medical Center

To test their visual processing skills, researchers showed infants different objects on a screen. When a baby has successfully encoded the object, they will lose interest and look away. This familiarization is what researchers call habituation. “Deaf infants took longer to habituate to the objects and looked away from them less than hearing infants,” said Derek Houston, associate professor of otolaryngology at Ohio State. “These results were surprising because you wouldn’t expect there to be such profound differences in a test that really has nothing to do with hearing.”

However, researchers say the results don’t necessarily mean that deaf children are learning at a slower pace. “Because they use vision to process the world around them, they may pay closer attention to visual objects,” said Houston. “They might actually be processing more about each object.”

Future research will examine why these differences in visual learning exist so that each child is taught in a way that works best for them and leads to healthy development. “Understanding the source of these differences can really help us tailor interventions specifically for these children,” said Monroy. “And the earlier that happens, the better.”

This article was republished with permission from the Ohio State University Wexner Medical Center. See the original press release here.

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A Reminder During Newborn Screening Awareness Month: Infant Hearing Tests Are Vital to Children’s Futures

By Nadine Dehgan

Hearing Health Foundation (HHF) joins the healthcare community and all parents in celebrating Newborn Screening Awareness Month.

Newborn screenings assess babies’ health within the first 24 to 48 hours of life. These quick and painless evaluations check for potentially harmful conditions that would otherwise not be apparent at birth. Included in this process are screenings for hearing loss, which is detected in three out of every 1,000 babies born in the U.S. 90 percent of babies identified with hearing loss have parents with typical hearing.

Hospitals use two safe and comfortable newborn hearing screening tests. Otoacoustic emissions (OAE) tests examine the nearly inaudible sounds, or emissions, produced by ear stimulation using a soft foam earphone and microphone. The inner ears of babies with typical hearing produce these emissions when stimulated by sound, while those with a hearing loss greater than 25-30 dB do not. Auditory brainstem response (ABR) tests measures how the hearing nerve responds to sounds. A hearing specialist plays sounds into the baby’s ears, while bandage-like electrodes are placed on the baby’s head to detect brain wave activity. Printed results show a pass or fail result.

A proactive approach to hearing health begins at birth. An early hearing loss diagnosis—before hospital departure—enables parents and families to pursue intervention, such as hearing devices, assistive devices, and/or sign language, as promptly as possible. Intervention of any kind permits children with hearing loss to enjoy healthier outcomes related to speech and language acquisition, academic achievement, and social and emotional development.

“When [profound bilateral] hearing loss was confirmed, I felt I had to do everything in my power,” recalls Dr. Nada Alsaigh, a pathologist, who made sure her son, Alex, was first amplified with hearing aids at three months. “We were lucky to know early, so Alex was not affected in a negative way.”

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“[My son] Ethan received his first set of hearing aids when he was eight weeks old,” explains Jason Frank, a corporate attorney and member of HHF’s Board of Directors. “It’s really been amazing to watch over the last seven years how far he’s come. He has a wonderful appetite for learning.”

Cognitive advancements for children like Ethan and Alex would not be possible without support for universal newborn hearing screening (UNHS) from HHF and likeminded organizations. In 1993, a staggeringly low rate of newborns—five percent—were tested for hearing loss in the hospital. This number increased to 94% by the end of the decade. Today, nearly all babies undergo this vital test.

“The institution of infant hearing screening at birth has been critical to speech and language development in the first two years of life [of a child with hearing loss],” says Anil K. Lalwani, M.D., Columbia University surgeon and member of HHF’s Board of Directors. “Before infant hearing screening was mandated, the average age of diagnosis for hair loss in a child with profound was two-and-a-half or three-years-old—later than recommended to begin intervention.”

In fact, a 2017 University of Colorado Boulder study of children with bilateral hearing loss further underscores the need for identification of hearing loss at a young age. Primary investigator Christine Yoshinaga-Itano, Ph.D., and team found that children who received intervention for hearing loss by six months had significantly higher vocabulary quotients than those who did not.

Though UNHS is highly-regarded by hearing experts like Drs. Lalwani and Yoshinaga-Itano, its security has been jeopardized. Last year, proposed cuts to the 2018 federal budget threatened to remove the $18 million allocated toward newborn hearing screenings in all 50 states. Given the lifetime costs of profound untreated hearing loss of nearly $1 million, a $18 million investment in screenings is surely worthwhile. Both the fiscal and health benefits of UNHS generated bipartisan support and, in 2017, the Early Hearing Detection and Intervention (EHDI) Act became law to sustain funding until 2022.

“We can’t imagine what it would have been like not to know,” Jason says. Ethan taught himself to read at three-and-a-half years old, which Jason and his wife believe is a direct result of Ethan’s access to sound and language at a very early age.

HHF implores policymakers to preserve newborn hearing screenings come 2022. The elimination of UNHS would be a tremendous disservice to our nation’s children with hearing loss. Learn more about how early intervention created positive health outcomes for Ethan and Alex in HHF’s short video (also shown above).

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

 
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Hearing Better Through the Ages

By Rebecca Huzzy, Au.D.

Chances are, you visit your doctor for an annual physical, wear a seatbelt, and use sunscreen. These are just a few small efforts we regularly make to stay healthy and injury-free.

Tending to the health of our hearing is another important, simple way we can maintain our overall physical and emotional well-being. Supporting hearing health begins at birth, when we test newborns for hearing loss, and continues into our elder years, when assistive technology can vastly improve overall health and quality of life.

Diagnosing Newborns & Infants

According to the Centers for Disease Control and Prevention, hearing loss is one of the most common congenital conditions, impacting approximately 12,000 infants per year. About half of these cases are linked to certain genetic syndromes, such as Down syndrome, Treacher Collins, and Usher syndrome.

But with the advent of universal newborn hearing screening programs in the early 1990s, hearing loss can now be identified and treated very early. According to what we call the “1-3-6” EHDI (Early Hearing Detection and Intervention) national goals, infants should be screened by age 1 month; diagnosed by age 3 months; and in an early intervention program by age 6 months.

“The effects of providing acoustic stimulation to the immature neurological system, including the brain, and combining the input with a rich and meaningful environmental experience, allows children to develop sufficient auditory skills to learn spoken language at a very young age,” says Janice C. Gatty, Ed.D., the director of Child & Family Services at Clarke Schools for Hearing and Speech.

This means families should expose their infants to sound frequently and consistently—talking to them, naming objects, narrating actions, singing, and reading books. With access to sound and an early intervention program at this young age, a child with hearing loss can begin learning to listen, babble, and eventually talk.

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Common Risks for Adolescents & Teens

Since the prevailing cause of hearing loss in young people with typical hearing is noise exposure, we need to educate kids early, as many begin listening to music on personal devices, playing in bands, and attending concerts at a young age.

According to the American Speech-Language-Hearing Association, exposure to sound that is higher than 85 decibels (the volume of a blender, hair dryer, or siren) for an extended period of time can cause permanent hearing damage. And the maximum output of most MP3 players is a powerful 110 decibels!

Fortunately, there are options for volume-limiting software that can mitigate unhealthy sound levels. Many devices offer parental controls and volume-controlling apps that limit noise levels, and there are various kid-friendly, hearing-healthy headphones available.

Follow the 80/90 rule: Set the maximum headphone volume to be 80 percent (not 100 percent), and listen for up to 90 minutes daily. If you listen for longer, lower the volume even more.

How Sound Exposure Catches Up With Us in Middle Age

“Adult onset hearing loss typically progresses slowly over the course of a number of years,” says audiologist John Mazzeo, Au.D., the audiology supervisor at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware.

Noise-induced hearing loss (NIHL) can have a sneaky, cumulative effect, similar to the impact of years of exposure to the sun. The people at the highest risk for NIHL work in noisy professions and include musicians, farmers, dentists, airport workers, and military service members. For those who spend time in loud environments, wearing hearing protection is the best way to guard against NIHL.

Ototoxic drugs (drugs harmful to hearing) and certain conditions, such as Ménière’s disease, can also contribute to progressive hearing loss over time. Regular screenings, prior to the recommended age of 50, are especially important if hearing loss runs in the family, or if you have symptoms associated with hearing loss, such as tinnitus, dizziness, or a perceived decrease in hearing.

Caring for Seniors as Hearing Abilities Change

Hearing loss becomes much more prevalent with age, affecting more than 30 percent of people over age 65, and 80 percent of adults over 80.

Hearing loss in seniors is linked to serious health conditions, including dementia. When communication is difficult, many people will avoid social situations, and research shows that social isolation is linked to cognitive decline, a key symptom of dementia. Additionally, difficulty hearing can impact the effectiveness of our other neural processes.

The risk of falls also becomes more likely with age, due to both decreased spatial awareness and increased cognitive load. A 2012 Johns Hopkins study found that older adults with mild hearing loss were nearly three times more likely to have a history of falling.

Staying Fit

If you’re diagnosed with a hearing loss, remember: Hearing loss is not only very common, it’s also very treatable! A licensed audiologist or hearing healthcare professional can discuss options with you, including hearing aids and assistive listening devices.

When it’s a loved one struggling to hear, or being stubborn about getting help, be patient. Gain their attention before talking, rephrase sentences instead of repeating them, and encourage trying out some kind of amplification.

Think of your hearing health as essential to your body’s complete performance. Our bodily systems are all interconnected; neglecting to protect our ears or refusing helpful interventions can have cascading health effects. When you take even small steps to protect your hearing health and that of loved ones, such as through regular hearing screenings and using earplugs in noisy environments, take heart in knowing you have bolstered your overall well-being.

Rebecca Huzzy, Au.D., CCC-A, is an educational audiologist at Clarke Schools for Hearing and Speech at its Philadelphia location and a clinical audiologist at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware. For more, see clarkeschools.org. This article also appeared in the Spring 2018 issue of Hearing Health magazine. For references, see hhf.org/spring2018-references.

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

 
 
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