Home Health Info Hearing, Ear Infections, and Deafness What to Do if Your Baby’s Screening Reveals a Possible Hearing Problem

What to Do if Your Baby’s Screening Reveals a Possible Hearing Problem

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Why is a follow-up examination necessary?

When should I have the follow-up examination performed?

How can I help my child succeed if she or he has a hearing loss?

What types of intervention services are available?

The follow-up exam revealed that my child’s hearing is OK after all. Does that mean we

don’t need to check his hearing again?

What should I do if my baby’s hearing hasn’t been screened yet?

Follow-up Checklist for Parents

Where can I learn more?

Most new parents can’t wait for the day when their child talks for the first time. When it finally

happens, grandparents are telephoned, baby books are inked in with dates and times, and the

computer’s default sounds are replaced with the newly recorded cooing of "da-da." But in order

for your baby’s first words to be on schedule, you need to make sure that his or her hearing is

OK.

About 2 or 3 out of every 1,000 children in the United States are born deaf or hard-of-hearing.

Unfortunately, many of these children are not identified until after the age of two. This is long

after what is called "the critical period"--the time when children begin to develop their speech and

language skills.

A hearing screening lets you know if your child has a possible hearing problem. But in order to

be sure, you must have your child's hearing fully tested. Like "heelstick" and immunization testing,

a hearing screening is one important part of the complete set of services that you need to make

sure that your baby is healthy and receiving the proper care. (See the NIDCD fact sheet Has

Your Baby’s Hearing Been Screened? for more information about hearing screenings.)

Remember, the hearing screening is only the first step. If a screening reveals that your child

may have hearing loss, the next step is to schedule--and keep--an appointment for a follow-up

examination with an audiologist (aw-dee-AH-luh-jist). An audiologist is a health professional who

conducts a series of tests to determine whether your child has a hearing problem and, if so, the

type and severity of that problem. To do so while your child is still an infant will help you make

sure that he or she develops the necessary language skills to be successful--with family and

friends, at school, on the job, and in all other life activities.

Why is a follow-up examination necessary?

A follow-up examination with an audiologist can help in many ways. Audiologists can identify the

kind of hearing loss a child has and sometimes the cause. The audiologist also may recommend

further medical attention, such as a visit to the otolaryngologist (OH-toh-LAYR-ehn-GAHL-ohjist). An otolaryngologist is a physician specializing in ear, nose, and throat disorders who can

determine the cause of a hearing loss as well as possible treatment options. If a hearing problem

exists, the audiologist, otolaryngologist, pediatrician, or other professional who works with your

child will point you to the various intervention services that can help you. The term intervention

refers to the different steps that families can take to overcome communication barriers caused

by a hearing loss. For example, you may be referred to a speech-language pathologist or a

teacher who is experienced in working with deaf or hard-of-hearing children. You also may learn

about special tools to help your child make use of what hearing she or he has as well as tips on

how to best communicate with your child.

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When should I have the follow-up examination performed?

If your child did not pass the hearing screening, you should schedule the follow-up examination

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immediately. The most important period in which a child learns language is during the first six

months. If you suspect that your child has a hearing loss, you should schedule an appointment

with an audiologist before your child reaches three months of age. Ask the hospital or facility

staff who conducted your child’s screening to provide you with contact information for one or

more certified audiologists. They may be able to help you schedule an appointment. You also can

obtain a list of certified audiologists from the following Web sites: American Speech-LanguageHearing Association at www.asha.org or American Academy of Audiology at www.audiology.org.

By the time your child reaches six months of age, he or she should be receiving some form of

intervention services.

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How can I help my child succeed if she or he has a hearing loss?

When intervention is introduced early, deaf and hard-of-hearing children can develop language

skills that help them communicate freely and learn at the same rate as their hearing friends.

Locate the services that are available in your community to help support your child. For example,

the Individuals with Disabilities Education Act of 1997 (IDEA) ensures that all children with

disabilities have access to the services they need to get a good education. In addition, Head

Start and Early Head Start are federally funded programs that help young children in low-income

families become better equipped to succeed in school.

Communicate with your child often. Keep informed about available intervention programs, and

take part in all decisions regarding your child's progress. Remember: your child’s hearing--like

your child’s overall health--is your responsibility. Acting responsibly can take many forms--from

keeping an appointment for a hearing test, to learning sign language or strategies to support

oral-auditory communication, to joining a support group, to making sure that your child’s doctors

and specialists have your most current contact information, especially if you’ve recently moved.

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What types of intervention services are available?

Many intervention options are available today. When your child uses more than one of these

options, he or she has a better chance of understanding what others are saying, and of being

understood.

Hearing Devices

A child with hearing loss can use various tools to communicate with the hearing and non-hearing

world. One of the most common tools is the hearing aid, a device worn in or behind the ear that

helps make sounds louder to the wearer. Hearing aids have improved over the years and can be

used for different degrees of hearing loss--from mild to moderate to severe. An audiologist can

help you choose the best hearing aid for your child and make sure that it fits securely. Make sure

you consult an audiologist who has experience with the special needs of infants and children.

Some audiologists, called pediatric audiologists, specialize in treating children.

If your child has profound hearing loss and would not benefit from a hearing aid, your doctor may

suggest a cochlear (KOH-klee-uhr) implant. The cochlear implant is an electronic device that

changes sounds to electrical signals and carries them past the nonworking part of the inner ear

to the brain. With training, children with cochlear implants can learn to recognize sounds and

understand speech. Talk with an otolaryngologist who specializes in cochlear implants to

determine if the cochlear implant is the right form of intervention for your child.

Language and Communication Considerations

Children who are deaf or hard-of-hearing can learn to communicate in a number of ways. All deaf

or hard-of-hearing children living in the United States will need to learn English to communicate in

writing. In addition, some families of deaf or hard-of-hearing children may choose to

communicate manually using American Sign Language, a distinct language with its own grammar

and syntax that uses hand signs and gestures, body movements, and facial expressions to

represent words and phrases.

Other families may choose approaches that build upon the English language when

communicating. Cued speech combines the natural lip movements of speech with hand shapes

representing phonetic sounds, providing additional visual cues so that sounds such as "p" and "b"

or "f" and "v" can be distinguished. Other families take an oral-auditory approach. Here, a child

uses his or her natural hearing ability, along with lip reading and hearing devices, to enhance

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speaking and listening skills. Because language development begins early, you should select the

approach you feel is best, and interact with your child as much as possible. Ask your audiologist,

otolaryngologist, or pediatrician for more information about the choices that are available.

Assistive Technological Devices

For older children and adults, other devices can help a child communicate within certain

environments. The personal FM amplifier converts a classroom teacher’s voice, spoken through a

microphone, into radio waves that are transmitted to a receiver that the child wears. In addition,

deaf and hard-of-hearing viewers can watch almost all televised programming using closed

captions, thanks to a special decoder that is now built into most television sets. More and more

movie theaters across the country offer closed captioning as well. Telecommunications relay

services, which are available through all telephone companies, enable deaf and hard-of-hearing

people to communicate on the phone. They can type in messages on a keyboard, and view

return messages on a display screen, all through the help of a communications assistant, who

translates between the two telephone parties.

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The follow-up exam revealed that my child’s hearing is OK after all. Does that mean

we don’t need to check his hearing again?

Parents should interact often with a deaf or hard-of-hearing infant. All of the caregivers in your

child's life should interact with him or her as much as possible. You can do this by holding, facing,

smiling at, and responding to your infant from the very beginning. Children need love,

encouragement, and care from their families and caregivers.

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What should I do if my baby’s hearing hasn’t been screened yet?

Many hospitals now screen all newborns for hearing loss, and many more will do so as statewide

screening programs are put into place. Currently, however, some hospitals screen only those

newborns who are considered most at risk, such as those with a family history of deafness or

who are of low birthweight. If you do not know if your child’s hearing was screened, call your

child's pediatrician and ask to see a copy of your child’s records, or find out how the information

can be obtained. If your child’s hearing has not been screened, ask your doctor how to make an

appointment for a screening and then do so before your child is one month old. Publications such

as the NIDCD fact sheet Has Your Baby’s Hearing Been Screened? can provide you with more

detailed information about hearing screenings. You also can ask your doctor for written

information about the screening process.

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Follow-up Checklist for Parents:

Name of baby: _______________________________________

Birthday: ______/______/______

By one month of age:

Make sure that your child's hearing has been screened either before you leave the hospital,

or immediately afterward. If your child's hearing has been screened, find out the results. If it

has not, schedule a screening before your child reaches one month of age.

By three months of age:

If your child did not pass the hearing screening, schedule a follow-up appointment with a

certified audiologist immediately. Ask your doctor for a list of certified audiologists in your

area. Your doctor may be able to help you schedule an appointment. Or find a list of

audiologists in your area by visiting the following Web sites: American Speech-LanguageHearing Association at www.asha.org or American Academy of Audiology at

www.audiology.org.

If you must cancel the follow-up appointment, reschedule! Make sure you take your child

to a follow-up examination before she or he reaches three months of age.

By six months of age:

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Start your child in some form of intervention by six months of age. Intervention can include

hearing devices, such as hearing aids or cochlear implants; communication methods,

including oral approaches such as lip reading, or manual approaches such as American Sign

Language; or a combination of options, including assistive devices. Ask your pediatrician,

otolaryngologist, or speech-language pathologist about the range of options that are

available to you. Find a list of otolaryngologists in your area by visiting the American

Academy of Otolaryngology-Head and Neck Surgery Web site at www.entnet.org; find a

speech-language pathologist at the American Speech-Language-Hearing Association Web

site at www.asha.org.

Ongoing:

Remain active and involved in your child's progress.

If you move, make sure that your child's doctors and specialists have your new address.

Even if your child passed the follow-up examination, schedule periodic hearing tests, such as

before your child begins school or if he or she shows signs of hearing loss.

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Where can I learn more?

Alexander Graham Bell Association for the Deaf and Hard of Hearing (AG Bell)

3417 Volta Place, NW

Washington, DC 20007-2778

Voice: (202) 337-5220

Toll-free Voice: (866) 337-5220

TTY: (202) 337-5221

Fax: (202) 337-8314

E-mail: info@agbell.org

Internet: www.agbell.org

American Academy of Audiology (AAA)

11730 Plaza America Drive, Suite 300

Reston, VA 20190

Voice: (703) 790-8466

Toll-free Voice: (800) 222-2336

TTY: (703) 790-8466

Fax: (703) 790-8631

E-mail: info@audiology.org

Internet: www.audiology.org

American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS)

One Prince Street

Alexandria, VA 22314-3357

Voice: (703) 836-4444

TTY: (703) 519-1585

Fax: (703) 683-5100

E-mail: webmaster@entnet.org

Internet: www.entnet.org

American Society for Deaf Children (ASDC)

3820 Hartzdale Drive

Camp Hill, PA 17011

Voice: (717) 703-0073

Toll-free Voice: (866) 895-4206

TTY: (717) 703-0073

E-mail: ASDC4U@aol.com

Internet: www.deafchildren.org

American Speech-Language-Hearing Association (ASHA)

10801 Rockville Pike

Rockville, MD 20852

Voice: (301) 897-5700

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Toll-free Voice: (800) 638-8255

TTY: (301) 897-0157

Fax: (301) 571-0457

E-mail: actioncenter@asha.org

Internet: www.asha.org

BEGINNINGS for Parents of Children Who Are Deaf or Hard of Hearing, Inc.

(BEGINNINGS)

P.O. Box 17646

Raleigh, NC 27619

Voice: (919) 850-2746

Toll-free Voice: (800) 541-4327 (In-state only)

TTY: (919) 850-2746

Fax: (919) 850-2804

E-mail: info@ncbegin.org

Internet: www.ncbegin.org

Boys Town National Research Hospital (BTNRH)

555 North 30th Street

Omaha, NE 68131

Voice: (402) 498-6511

TTY: (402) 498-6543

Fax: (402) 452-5027

E-mail: moeller@boystown.org

Internet: www.boystownhospital.org/Hearing/index.asp/ www.babyhearing.org

Conference of Educational Administrators of Schools and Programs for the Deaf

(CEASD)

P.O. Box 1778

St. Augustine, FL 32085-1778

Voice: (904) 810-5200

TTY: (904) 810-5200

Fax: (904) 810-5525

E-mail: nationaloffice@ceasd.org

Internet: www.ceasd.org

Council on Education of the Deaf (CED)

P.O. Box 2094, 800 Florida Avenue, NE, Gallaudet University

Washington, DC 20002

Fax: (202) 651-5749

E-mail: roz.rosen@gallaudet.edu

Internet: www.deafed.net

Deafness Research Foundation (DRF)

2801 M Street, NW

Washington, DC 20007

Voice: (202) 719-8088

Toll-free Voice: (866) 454-3924

Toll-Free TTY: (888) 435-6104

Fax: (202) 338-8182

E-mail: info@drf.org

Internet: www.drf.org

National Association of the Deaf (NAD)

814 Thayer Avenue, Suite 250

Silver Spring, MD 20910-4500

Voice: (301) 587-1788

TTY: (301) 587-1789

Fax: (301) 587-1791

E-mail: nadinfo@nad.org

Internet: www.nad.org

National Black Association for Speech-Language and Hearing (NBASLH)

P.O. Box 61328

Charleston, SC 29419

Voice: (843) 574-6441

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Fax: (843) 820-5026

E-mail: nbaslh2@aol.com

Internet: www.nbaslh.org

Clearinghouse on Disability Information, Office of Special Education and

Rehabilitative Services (OSERS)

550 12th Street, SW, Room 5133

Washington, DC 20004

Voice: (202) 245-7303

TTY: (202) 205-5637

Fax: (202) 245-7636

Internet: www.ed.gov/about/offices/list/osers/index.html

Office of Special Education Programs (OSEP), Office of Special Education and

Rehabilitative Services (OSERS)

550 12th Street, SW, Room 4109

Washington, DC 20202-2600

Voice: (202) 245-7426

Fax: (202) 245-7616

Internet: www.ed.gov/about/offices/list/osers/osep/index.html

NIH Pub. No. 03-5338

February 2003

For more information, contact the NIDCD Information Clearinghouse.

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National Institute on Deafness and Other Communication Disorders

National Institutes of Health

31 Center Drive, MSC 2320

Bethesda, MD USA 20892-2320

E-mail: nidcdinfo@nidcd.nih.gov

Page last updated: February 13, 2006

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