Congenital hearing loss, that is, hearing loss that is present at birth, is the most common chronic condition in newborn children worldwide. Nonetheless, it can be quite scary when your baby or child is diagnosed with permanent hearing loss. It can open up a daunting new world of questions and uncertainties about their future. The good news is, hearing loss in babies and young children is treatable if caught early.
First of all, you need to know that you are not alone. In Australia, about 39 in 10,000 children will be diagnosed with some form of hearing loss by the time they are 17 years old. Each year about 13,000-15,000 children are fitted with their first hearing aids.
In Australia, we are fortunate to have one of the best hearing healthcare systems in the world. This greatly increases the chances of your child having their hearing loss detected very early on, giving them the best possible chance to learn speech and language alongside their normal-hearing peers.
If your child has been diagnosed with hearing loss, the journey ahead may not always be easy, but you will be able to seek help from a team of healthcare and support workers who will help and empower you to find the most suitable solutions for your child’s hearing loss.
Hearing loss in children can come in many forms and severities. We distinguish between mild, moderate, severe or profound degrees of hearing loss. This means that hearing losses can vary from missing only very soft sounds due to a mild hearing loss, or not being able to hear any sounds with a very profound hearing loss.
The degree of hearing loss can also vary for different sounds, so some children with hearing loss may hear some sounds perfectly normally but have a hearing loss for other types of sounds.
Hearing loss in children can also be caused by different parts of the ear, or be mixed due to a couple of different parts of the ear. For example, some children may have conductive hearing loss caused by how their outer or middle ear formed, while others have a sensorineural hearing loss hidden away in the inner part of the ear.
Universal newborn hearing loss screening has been gradually rolled out across all Australian states and territories in the past two decades. The screening is non-invasive and looks at how the brainstem responds to different sounds, which allows the detection of any significant hearing loss present at birth. The screening is usually done while your baby is peacefully sleeping sometime before you leave the hospital.
If any risk factors for hearing loss are identified (for example family history of hearing loss, prematurity, low birth weight, newborn intensive care, and maternal illness during pregnancy), a follow-up hearing check will be recommended to ensure hearing loss that may develop later will still be detected.
If hearing loss has been detected during either of these tests, your child’s audiologists and Ear, Nose and Throat specialist (ENT) will conduct further diagnostic assessments to determine the cause and degree of the hearing loss so that they can help determine the best treatment options.
Once the cause and degree of your child’s hearing loss have been determined, your audiologist and ENT specialist will go through all the available management options. To ensure all children and young adults with a hearing loss are able to access the hearing aids, cochlear implants, or other technology that they may need, these treatment options are well funded in Australia.
Options that would be discussed may include some of the following:
Hearing aids are suitable for a wide range of children’s hearing losses. Hearing aids are digital devices worn at ear level and consist of a microphone, a processing chip, an amplifier and a receiver. Hearing aids are programmed specifically to a child’s hearing profile and help to amplify and process the sounds they need to help them hear clearly. Most modern hearing aids are small and discreet, but often children like to accessorise their hearing aids with fun colours and decoration.
Cochlear implants may be recommended when a child’s hearing loss is too significant for hearing aids to be helpful. Some cochlear implants also use a combination of a hearing aid and implant technology for the same ear if appropriate.
Cochlear implants are electronic devices that consist of an external processor that is worn behind the ear, and an implant that is surgically placed in the cochlea and under the skin. While hearing aids amplify sounds to the level needed for the ear to hear and transmit sound, a cochlear implant bypasses most of the ear’s anatomy to stimulate the hearing nerve.
Bone conduction hearing aids help children whose hearing loss is caused by the outer or middle ear. These hearing aids can be implanted or worn on a soft-band or in a cap, which is often done with young children. Bone conduction hearing aids work by bypassing the outer and middle ear and sending the sound straight to the cochlea.
There is a range of assistive listening devices that can help with hearing in specific situations, with or without hearing aids or cochlear implants. One that is particularly relevant for children with hearing loss is called an FM System or a Roger System, which can be used for children with mild hearing loss, hearing loss in just one ear, or to help give an extra boost for hearing with hearing aids and cochlear implants.
These systems consist of a transmitter microphone worn by a parent or teacher, and a receiver worn by the child with an ear-level device or integrated into their hearing aids or cochlear implants. The microphone picks up the sound of the parent or teacher’s voice and delivers it directly into the child’s ear through the receiver or their hearing aids. This is a great way to overcome the noise of shopping centres or the classroom, allowing the child to focus more easily on what has been said.
Communication tactics are helpful for everyone, not just children with hearing loss, but they are particularly important to help optimise the benefit we are able to get with hearing aids and cochlear implants.
Modern technology has come a long way in giving children with hearing loss the best possible chance to succeed in a world with sound, but ultimately even the best possible hearing aids still can’t give us 100% normal hearing.
It’s important to acknowledge this and for family, friends and teachers to adopt good communication habits. We can help make communication easier with simple tactics such as getting your child’s attention before talking, making sure you are face to face whenever possible, reducing background noise (best to turn down the blaring TV or turn off running taps before trying to talk), and rephrasing instead of repeating if what you said was missed.
The more cues and context we give to what is said, the easier it is for it to be understood clearly. Your audiologist will spend time on communication training for different situations because managing hearing loss is a way of life, not just a matter of wearing hearing aids or a cochlear implant.
Research has shown that any form of language exposure will help the language centre in the brain to develop, regardless of whether it is spoken or manual (signed).
Auslan (Australian Sign Language) is a full and expressive language, and a fantastic way to support children with hearing loss. Some children may use hearing aids and cochlear implants to develop speech and language, while others may use Auslan, particularly when they are part of the Deaf Community.
Many will use both with great benefit to foster language development and to help with communication in the early days when hearing aid or cochlear implant use is still being established. Babies can actually start to communicate their needs with sign language before they can talk. Auslan classes for parents and babies can also be a great way to connect with other families who are going through the same experience.
Early intervention refers to the group of services that promote your child’s growth and development in the critical years of 0-5 years of age. This period is particularly important for speech and language development.
Your intervention team may include:
Early identification of hearing loss and a range of well-established early intervention options give children with congenital hearing loss better opportunities than ever before to develop age-appropriately and gain their education in mainstream schools with support.
The journey ahead will be determined by your child’s individual needs and will be guided by you and your team of professionals who want to empower you to get the best outcomes for your child and family. We wish everyone embarking on this journey the very best and hope to be able to help you somewhere along the way!
Get in touch with us today to schedule a comprehensive hearing assessment for your child with Australia’s only accredited hearing healthcare provider. We can’t wait to support your family on your journey to better hearing health!