Infant Hearing Loss Facts

Each day infants are discharged from the hospital at birth without receiving an initial hearing screening. By missing these critical opportunities, infant hearing loss goes undetected for several years in nearly half of the cases. Consequently, these children miss out on early intervention to increase their language, cognitive, and social skills and their overall development is severely delayed..

• Approximately 33 babies are born every day with a significant hearing loss in the United States. Nearly 50% of newborns with hearing loss are not diagnosed until at least the second year of life.
• Hearing loss among newborns is 20 times more prevalent than phenlyketonuria (PKU), a condition for which all newborns are screened for.
• The average age that children with hearing loss are initially diagnosed, ranges from 12 to 25 months. Studies have shown that when hearing loss is detected later, an important time frame for developing speech and language skills has passed. As a result, speech and language development is delayed and academic and social skills may be adversely affected.
• Research has confirmed that treatment has the best results when infant hearing loss is identified and intervention is begins before the child reaches six months of age.
• Less than 20% of the children born in the U.S. are born in hospitals that offer universal newborn hearing screening programs.
• The National Institute of Health, American Academy of Pediatrics, American Academy of Audiology, the Joint committee on Infant Hearing, and the Healthy People 2000 Report recommend that children with congenital hearing loss be identified before six months of age.
• A unilateral hearing loss that remains undetected will have negative consequences. Even children with a hearing loss in one ear are ten times as likely to be held back by a grade as compared to children with normal hearing in both ears.
• Infants identified with hearing loss may be fit with hearing amplification as young as four weeks of age. Appropriate and comprehensive early intervention helps these children develop with better language, cognitive, and social skills.

High Risk Criteria For Hearing Loss in Infants (0 to 28 days old)

(*Indicators associated with sensorineural and/or conductive hearing loss in infants)

• Family history of hereditary childhood sensorineural hearing loss
• Hyperbilirubinemia
• Ototoxic medications
• Bacterial meningitis
• Birth weight less than 1500 grams (3.3lbs)
• In utero infections (cytomegalovirus, rubella, syphilis, herpes, and toxoplasmosis)
• Craniofacial anomalies (including pinna and ear canal)
• Apgaar scores of 0-4 at 1 minute or 0-6 at 5 minutes
• Mechanical ventilation lasting 5 days or longer
• Stigmata or other findings associated with a syndrome known to include a sensorineural and/or conductive hearing loss

Delayed Onset Sensorineural Hearing Loss Indicators:

(affects in the inner ear and possibly beyond)

• Family history of hereditary childhood hearing loss
• In utero infection
• Neurofibromatosis Type II and neurodegenerative disorders
  

Conductive Hearing Loss Indicators

(affects the outer and middle ear)

• Recurrent or persistent otitis media with effusion
• Anatomic deformities and other disorders that affect eustachian tube function
• Neurodegenerative disorders

Delayed Onset Sensorineural Hearing Loss Indicators:

(affects in the inner ear and possibly beyond)

• Family history of hereditary childhood hearing loss
• In utero infection
• Neurofibromatosis Type II and neurodegenerative disorders

Hearing Loss due to Prenatal Factors

(Congenital Hearing Loss - the child is born with the hearing loss)

Prenatal damage to the cochlear may be due to the partial or lack of cochlear development (inner ear), viral or parasitical invasion, spontaneous malformations or inherited syndromes.

The most common syndromes are Usher's syndrome and Pendred's syndrome. Usher's syndrome results in a hearing loss that ranges from moderate to profound and a degenerative visual loss. Any child with a profound hearing loss should be evaluated for eye disorders. Pendred's syndrome is a recessive endocrine-metabolic disorder characterized by goiter formation and results in a moderate to profound sensorineural hearing loss that is usually progressive in nature.

Other syndromes that cause hearing loss include:

1. Congenital Rubella
2. Toxoplasmosis
3. AIDS
4. Herpes I and II
5. Cytomegalovirus (CMV)
6. Congenital Rubella
7. Congenital hearing loss may be also diagnosed with the label "unknown".

Disorders Causing Hearing Loss at Birth

1. RH-Incompatibility
2. Congenital Syphilis
3. Anoxia or asphyxia at birth
4. Persistent Fetal Circulation (pulmonary hypertension)
5. Low Birth Weight
6. High Forceps Delivery
7. Violent Uterine Contractions

Normal Auditory Development (Your baby should be able to do the following)

• Newborn (0 to 4 months)

usually reacts suddenly to loud sounds through movements such as widening the eyes, jumping or extending the arms and legs. Parents should look for signs of localization from their child. Localization is eye movement or turning the head towards the direction of the sound source.

• 3 to 6 months

A baby of 3 to 6 months of age should turn and search out a different sound. They should also be able to respond to the sound of their name. During this particular developmental time, the baby will play with sounds by cooing and babbling. The baby should be smile or stop crying when either of the parents speaks to him/her. In addition, the baby should act differently to the ways the parents talk to him/her (angry, friendly, loving).

• 6 to 10 months

A baby of 6 to 10 months of age should be able to seek out the sound source. When his or her name is called, the baby should look towards the speaker. In addition, the baby should respond to both soft and loud sounds. Familiar sounds such as a doorbell ringing or a dog barking should get a response from the baby. The baby should also pay attention when the parents talk to him/her.

• 10 to 15 months

A baby or 10 to 15 months will begin to increase his or her babbling and begin to more closely resemble speech. The baby plays with sounds and is able to put sounds together in different patterns.

• 15 to 18 months

A child of 15 to 18 months is able to directly localize to most sounds. In addition, the child can understand simple phrases, identify familiar objects such as body parts and follow simple directions. A child at 18 months should have an expressive vocabulary of 20 or more words and short phrases