Teeny, tiny newborns have a lot of assessments right after their born. There's their APGAR scores, vitamin k shot, antibiotic eye drops and a few more I can't remember off the top of my head. The first few hours after my baby was born were a blur but I do remember when his hearing was tested.
A really nice Speech-Language Pathologist came to my room to check Little Guy's hearing. The OAE probes were quickly put into his little ears and the assessment was over before the SLP and I were done really getting acquainted.
Really, it was that simple.
Little Guy slept the whole time and didn't even know that there were otoacoustic emissions echoing in his ears!
I was so relieved that his hearing was alright!
So I'm a a Teacher of the Deaf and know that 2-3 out of every 1,000 infants have a hearing loss at birth. It's fairly common which is why it's such a big deal that there's universal newborn hearing screenings. (Ever heard of "NCHAM"?) I remember trying to emotionally prepare myself that he may be deaf or have a hearing loss and if that was the situation, then I'd make sure he fit the 1-3-6 timeline.
The 1-3-6 timeline is the guide for how quickly early intervention needs to begin for a baby who has hearing loss.
1= 1 month old
By one month old, your baby's hearing loss should be identified. This means that your baby has been assessed by an audiologist and officially does or does not have a hearing loss.
3=3 months old
By the time your baby is three months old, your baby needs to have appropriate hearing amplification. Hearing amplification are hearing aids or bone-anchored hearing aids.
Your child could need cochlear implants but this the surgery doesn't happen until about 12 months old. Before the surgery, your child will most likely be wearing hearing aids.
6=6 months old
Your child should be receiving early intervention services before she is six months old. Early intervention could be through your state's school for the deaf and blind or another agency like your local school district.
Baby Boy's first six months flew by and I now can't believe how big he has gotten! Now that I have personally experienced the newborn stage, I get that this whole 1-3-6 timeline can seem on ambitious. Even though it seems like not a lot of time, every day is crucial for language and auditory development.
Now that you know the general timeline of identification, amplification, and intervention. What exactly is really happening as your baby turns one, three, and six months old?
Newborn Hearing Screening
Your baby's hearing will be tested at the hospital before she is discharged. OAEs are the quick and simple tests that screen your child's hearing.
OAE stands for Otoacoustic Emissions. When this test is performed, a sound is emitted into your child's ears and a machine will detect if the sound echoes back. This test is screening whether the cochlea, or inner ear, is working.
"Pass" or "Referral" are the potential results of the newborn hearing screening.
You'll sometimes hear that a baby "failed" a hearing screening but this is misleading. A "failed" result should really be called a "referral." Referral is more accurate because there are multiple reasons why this may happen (some of which mean that your child doesn’t have hearing loss). And if your child is deaf, it doesn't mean they failed a hearing screening anyway.
Because there's uncertainty about whether there actually is a hearing loss, you should always be referred to an audiologist for follow-up testing. The audiologist will then determine whether there is a hearing loss, how severe it may be, or if there isn’t a hearing loss. Maybe it was just fluid in your newborn's ears blocking the transmission of the otoacoustic emissions.
Even if the audiologist appointment reveals that your child's hearing is fine, it's really important that you went and find out what was really happening.
Follow-up with the Audiologist
While in the sleep-depriving, exhausting, cuddly, and bonding newborn stage, you've got to stay on top of your baby's audiology referral.
Assuming that a referred hearing screening is nothing to be concerned about can have long term consequences for your child. You need to know as soon as possible if your child doesn't have a hearing loss because of her language and auditory development. Your baby’s brain development is on a timeline and language is developing even before birth.
Don’t wait until you suspect there’s a problem with your child’s hearing. Earlier is always better. It'll be so much harder for your child to develop language and listening skills the longer she goes without auditory input.
(If you don’t receive a referral but your child didn’t pass the newborn hearing screening, take the initiative to get those follow-up appointments.)
Referral to the Audiologist
At the hospital, your baby has a newborn hearing screening and may receive a referral to a pediatric audiologist for "Diagnostic Audiology."
When you go to the pediatric audiologist, they’ll performing additional hearing tests to determine whether your newborn does or doesn’t have a hearing loss.
The tests that are most often performed are Otoacoustic Emissions (OAEs) and ABR (Auditory Brainstem Response).
ABR is Auditory Brainstem Response. This test is when they put the electrodes on your child's head to assess their brain/hearing nerve. ABRs are very accurate and can give a lot more information about your baby's hearing.
Your baby needs to hold really, really still during the ABR testing. Typically babies that aren't 6 months old yet can be asleep while this test is completed.
If you're baby is older than 6 months, then they need to be sedated. (Another reason why it's important to get to the audiologist early.)
Here's a video of an ABR.
After these tests are completed, your pediatric audiologist can tell you if your baby does or doesn't have a hearing loss. If your baby has a hearing loss, then the audiologist will explain what steps are needed next.
What if there's a Hearing Loss?
Being told that your child has a hearing loss is a surprising and emotional experience. There are support groups, Facebook groups, and community resources that can help you better understand and process the situation.
There are also early intervention services that help your child develop language and can help you navigate everything that's going on. This is where people like me come in! 🙂
I have to research all possible details when I encounter a new situation. Like choosing a grad school? I made an excel spreadsheet of pros, cons, and costs. Having a baby? I read all the books. You'll be consuming tons of information from everywhere possible if you're like me. Here are a handful of resources to start your research.
- SMALL TALK
- Children with Hearing Loss: Developing Listening and Talking
- Auditory Verbal Therapy
- The Parents' Guide to Cochlear Implants
- Language Development from Theory to Practice
- Hearing Sonya Rose
- Infant Hearing @ NCHAM
- A.G. Bell: Association for the Deaf and Hard of Hearing
- Hearing First
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