The Crucial Link Between Hearing and Speech Development in Babies

The Crucial Link Between Hearing and Speech Development in Babies

From the moment they are born, babies begin to absorb and process the sounds of the world around them. Hearing is a fundamental sense that plays a critical role in a baby’s development, particularly in the areas of communication and speech. Early hearing experiences lay the foundation for language development, cognitive skills, and social interaction. As such, understanding how hearing affects speech development is crucial for parents, caregivers, and healthcare providers alike.

The Connection Between Hearing and Speech Development

Speech development is a complex process that begins early in a baby’s life, and hearing is central to this process. Babies learn to speak by listening to the sounds, words, and speech patterns of those around them. Through repetition and exposure, they gradually start mimicking sounds and, eventually, forming words and sentences.

Hearing loss, whether mild or severe, can significantly impact a child’s ability to develop speech and language skills. Without access to sound, babies may miss out on essential auditory cues that support the development of speech. This underscores the importance of early detection of hearing issues and timely intervention to ensure that babies are exposed to sound during these formative early years.

Stages of Speech Development in Babies

While every child develops at their own pace, there are typical milestones in speech and language development that can be expected as babies grow. These milestones can help parents and caregivers track progress and identify potential concerns if development seems delayed.

1. The First Few Months: Listening and Responding to Sound

  • 0 to 3 months: At birth, babies can already hear, but they’re still learning how to make sense of the sounds around them. In the first few months, babies primarily respond to high-pitched voices, often reacting with a startle or calming response to sound.

  • 3 to 6 months: Babies begin to turn toward sounds and voices, especially familiar ones, and may start making cooing sounds in response. They will also begin experimenting with their vocalizations, making sounds like “ah” or “oo.”

2. Learning to Babble: Experimenting with Sound

  • 6 to 12 months: During this period, babies will begin to babble, repeating consonant and vowel sounds like "ba-ba" or "da-da." They may also begin to imitate simple sounds or facial expressions. This babbling phase is essential for the development of speech and language because it allows babies to experiment with their vocal cords and develop the muscle coordination needed for speaking.

3. First Words and Meaningful Communication

  • 12 to 18 months: By their first birthday, most babies will say their first word, such as “mama” or “dada.” During this period, they begin to attach meaning to words, even if their pronunciation isn’t perfect. They also start to understand simple commands and words like “no,” “bye-bye,” or their own name.

4. Building Vocabulary: Word Combinations

  • 18 to 24 months: Babies will begin to expand their vocabulary and may start combining two words together, such as "more milk" or "big truck." Their ability to understand speech will also grow, and they’ll likely follow simple two-step instructions (e.g., “Pick up the toy and give it to me”).

5. Early Sentences and Pronunciation

  • 2 to 3 years: By age 2, most children start speaking in short sentences and using basic grammar. They begin to learn to ask questions ("Where’s mommy?"), and their speech becomes more intelligible, though some pronunciation errors are still common.

How Hearing Impacts Speech Development

Hearing plays a central role in each stage of speech development. From the first cooing sounds to the ability to form complex sentences, babies rely on their ability to hear and process sounds to learn how to communicate effectively.

When babies have access to sounds, they can:

  • Learn to recognize speech patterns: Babies listen to the rhythm, pitch, and tone of the voices around them. These auditory cues help them understand how words are structured and used in conversation.

  • Imitate sounds: Hearing the sounds others make allows babies to mimic them. This imitation is how they practice and refine their own speech.

  • Develop listening skills: Babies need to hear and process different speech sounds, as well as environmental noises, to develop their auditory discrimination. This skill is vital for learning new words and understanding language.

  • Socialize through communication: Hearing is key to engaging in back-and-forth exchanges with caregivers, helping babies develop social skills like taking turns in conversation and understanding emotions conveyed through tone and voice.

Signs of Hearing Problems in Babies

Because hearing is so integral to speech development, it’s essential to monitor a baby’s hearing abilities, especially in the first few years. Early detection of hearing loss can help ensure that intervention occurs before significant delays in speech development occur.

Some common signs of hearing problems in babies include:

  • No response to loud sounds or a lack of startle reflex.

  • Not turning toward sounds by 6 months of age or not responding to their name being called.

  • Delayed babbling beyond 6 months or no cooing by 3 months.

  • Difficulty understanding simple commands (e.g., "wave bye-bye" or "come here") by 12 months.

  • Speech delay—not saying their first words by 12 months or using fewer words than expected at 18 months.

If any of these signs are observed, it’s important to consult with a pediatrician or audiologist for further evaluation. Hearing tests, such as otoacoustic emissions (OAE) or auditory brainstem response (ABR) tests, can be conducted to assess a baby’s hearing ability.

Early Intervention and Support

If hearing loss is diagnosed early, there are many options for intervention and support. The earlier a baby receives help, the better their chances of developing speech and language skills on par with their peers.

  • Hearing aids or cochlear implants: For babies with diagnosed hearing loss, hearing aids or cochlear implants can help amplify sounds and provide the auditory input needed for speech development.

  • Speech therapy: If a delay in speech development is noted, speech therapy can provide tailored support to help babies develop their communication skills.

  • Sign language or other communication methods: For babies with more severe hearing loss, learning sign language or using augmentative and alternative communication (AAC) systems can be vital in bridging the gap and helping children communicate effectively.

The Importance of Early Detection

Research shows that babies who receive early intervention for hearing loss—before 6 months of age—have a much better chance of achieving normal speech and language development. Early detection allows for timely support, whether through hearing devices, speech therapy, or other strategies that promote communication skills.

Routine hearing screenings at birth, often part of newborn care in many countries, help identify hearing issues early. Parents should also stay vigilant about developmental milestones and seek professional advice if they suspect any delays in speech or hearing.

Conclusion

Hearing plays a foundational role in a baby’s speech development. From the first cooing sounds to speaking full sentences, a baby’s ability to hear and process sound is crucial for learning language and communication. Early identification of hearing problems and timely intervention can make a significant difference in a child’s development, ensuring that they can reach their full potential in both speech and social interactions.

By supporting a baby’s hearing health from the very beginning, we lay the groundwork for strong communication skills that will last a lifetime.


Understanding Tinnitus: Causes, Symptoms, and Management

Understanding Tinnitus: Causes, Symptoms, and Management

Tinnitus is a condition that affects millions of people worldwide, yet it remains largely misunderstood. Characterized by the perception of ringing, buzzing, or hissing sounds in the ears, tinnitus can be temporary or chronic and may vary in intensity. While it is not a disease itself, it can be a symptom of an underlying health issue.

In this post, we’ll explore the causes, symptoms, and available management options for tinnitus to help you better understand the condition and how to cope with it.

What is Tinnitus?

Tinnitus is the perception of sound without an external source. It's commonly described as hearing ringing, buzzing, hissing, whistling, or even roaring sounds in one or both ears. The sound can be constant or intermittent and might be perceived at a low or high pitch.

Tinnitus is not a disease but rather a symptom of an underlying condition. It often occurs when there is damage or dysfunction in the auditory system, but it can also be related to other health problems, including issues with the circulatory or nervous system.

Common Causes of Tinnitus

The causes of tinnitus can vary widely, and sometimes the exact cause cannot be pinpointed. Some of the most common causes include:

  1. Exposure to Loud Noises: One of the leading causes of tinnitus is prolonged exposure to loud noises, such as music at high volumes, industrial noise, or gunfire. This damages the hair cells in the inner ear, leading to hearing loss and possibly tinnitus.

  2. Age-Related Hearing Loss: As people age, the sensitivity of the inner ear tends to decline, which can lead to a form of hearing loss known as presbycusis. This loss of hearing can often be accompanied by tinnitus.

  3. Ear Infections or Blockages: Blockages in the ear canal caused by earwax buildup or an ear infection can lead to temporary tinnitus. Once the blockage is cleared or the infection is treated, the tinnitus may subside.

  4. Ototoxic Medications: Some medications, such as certain antibiotics, diuretics, and chemotherapy drugs, can have ototoxic effects, meaning they can damage the ear and lead to tinnitus.

  5. Health Conditions: Tinnitus can sometimes be linked to underlying health conditions, such as:

    • High blood pressure or cardiovascular diseases.

    • Diabetes.

    • Thyroid disorders.

    • Temporomandibular joint (TMJ) disorders.

    • Meniere's disease, a disorder of the inner ear that affects balance and hearing.

  6. Head or Neck Injuries: Trauma to the head or neck can damage the auditory pathways or the nerves associated with hearing, resulting in tinnitus.

  7. Stress and Anxiety: Psychological factors like stress and anxiety can sometimes trigger or exacerbate tinnitus. The constant sound can be particularly bothersome during moments of high stress, creating a vicious cycle.

Symptoms of Tinnitus

Tinnitus symptoms can vary in severity from person to person. The main symptom is the perception of sound in the ears, but additional symptoms may include:

  • Constant or intermittent ringing, buzzing, or hissing sounds.

  • Difficulty sleeping due to the constant noise.

  • Trouble concentrating or focusing because of the persistent sounds.

  • Sensitivity to external sounds (hyperacusis).

  • A feeling of fullness or pressure in the ear.

In severe cases, tinnitus can significantly impact a person's quality of life, leading to emotional distress, anxiety, and even depression.

How is Tinnitus Diagnosed?

There is no single test for tinnitus, as it is a subjective experience. However, healthcare providers typically perform a thorough evaluation to identify potential causes and to rule out other medical conditions.

Common diagnostic tests include:

  • Hearing tests to determine if there is any hearing loss.

  • Physical examination to check for ear infections, blockages, or other structural issues.

  • Imaging tests like MRI or CT scans may be used in some cases to check for tumors or abnormalities in the auditory system.

Managing Tinnitus: Treatment and Coping Strategies

While there is currently no cure for tinnitus, there are various management strategies that can help reduce the severity of symptoms and improve quality of life.

  1. Sound Therapy: Using background noise to mask the ringing sounds of tinnitus can provide relief. This can include white noise machines, fans, or music. Some people find relief from hearing aids with built-in sound masking features.

  2. Cognitive Behavioral Therapy (CBT): CBT is a type of therapy that helps individuals change negative thought patterns and cope with the emotional distress caused by tinnitus. It is especially effective in managing the anxiety and frustration that often accompany the condition.

  3. Tinnitus Retraining Therapy (TRT): TRT combines sound therapy with counseling to help people recondition their brain's response to tinnitus. Over time, the goal is to reduce the emotional response to the sound, making it less noticeable.

  4. Hearing Aids: If tinnitus is associated with hearing loss, hearing aids can help amplify external sounds and make the tinnitus less noticeable. Some hearing aids are designed with features specifically for tinnitus management.

  5. Medications: While no medications are specifically approved for treating tinnitus, some may be prescribed to address symptoms of anxiety, depression, or insomnia that can result from the condition.

  6. Lifestyle Changes: Certain lifestyle adjustments can help alleviate tinnitus symptoms, including:

    • Avoiding loud environments to prevent further ear damage.

    • Managing stress through relaxation techniques, mindfulness, and regular exercise.

    • Getting enough sleep to help reduce the emotional and physical toll of tinnitus.

    • Limiting alcohol, caffeine, and nicotine, as these can exacerbate tinnitus.

  7. Dietary Considerations: While research is still inconclusive, some people find relief by avoiding foods or drinks that may trigger or worsen their tinnitus. These may include caffeine, salt, or alcohol. However, individual triggers vary, so keeping a food diary may help identify any patterns.

When to See a Doctor

If you experience persistent tinnitus, it’s important to consult a healthcare provider. While tinnitus itself is usually not a sign of a serious health condition, it can be a symptom of underlying issues that require medical attention. Seek medical advice if:

  • Your tinnitus is sudden or develops after a head or neck injury.

  • You experience hearing loss along with tinnitus.

  • The tinnitus is severe and affects your daily life.

  • You experience dizziness or balance problems.

Conclusion

Tinnitus can be a challenging condition to live with, but there are various strategies available to help manage it. Understanding the causes and symptoms of tinnitus is the first step toward finding effective ways to cope. If you are struggling with tinnitus, don’t hesitate to seek professional help to explore treatment options that may improve your quality of life.


Dr. Sandler and Dr. Schechter Host Hear Us Out: A Podcast That Amplifies Voices and Stories

Hear Us Out: A Podcast That Amplifies Voices and Stories

At Hear Us Out, we believe that every voice has a story to tell—and some stories are meant to be heard far and wide. Since launching just three months ago, we’ve already seen incredible growth, with our podcast ranking in the top 10% of all podcasts based on first-week downloads. We’re proud and humbled by this early success, and it’s all thanks to the amazing guests we've hosted, the listeners who’ve tuned in, and the stories that continue to unfold on our show.

Each episode features candid conversations with thought leaders, creators, musicians, and industry innovators, and the response from our audience has been nothing short of overwhelming. From musicians to award-winning sound mixers to pilots and content creators, we’ve been lucky to host a range of incredible guests who are pushing boundaries and shaping their respective industries.

Here’s a closer look at some of the notable guests we've had the honor of speaking with:

1. Richard On – Lead Guitarist, O.A.R.

It was a true pleasure to sit down with Richard On, the lead guitarist of the iconic band O.A.R. In this episode, Richard took us behind the scenes of the band's journey from humble beginnings to becoming one of the most recognized names in the music world. We discussed the evolution of O.A.R.'s sound, the challenges of life on the road, and the deep connection they share with their fans. Richard also shared insights on what keeps the band motivated after more than two decades in the industry. This episode resonated with music lovers and fans of O.A.R., and continues to be one of our most downloaded episodes.

2. Simon Hayes – Academy Award-Winning Sound Mixer (Wicked)

In one of our most exciting episodes, we had the honor of speaking with Simon Hayes, the Academy Award-winning sound mixer behind some of Hollywood’s most iconic films, including the blockbuster musical Wicked. Simon took us through his incredible career and gave us a rare look into the world of sound mixing. From the technical intricacies of capturing sound to the creative process of ensuring every moment in a film or musical hits the right note, Simon’s expertise and passion for his craft were truly inspiring. This episode received rave reviews and sparked deep conversations about the unseen artistry behind film and theater production.

3. Stephen Kellogg – Musician and Storyteller

We had the pleasure of speaking with Stephen Kellogg, a talented musician known for his compelling songwriting and captivating performances. Stephen shared stories from his journey as a solo artist, his experiences with his band Stephen Kellogg & The Sixers, and how his music has been shaped by personal triumphs and challenges. His deep connection to his craft and ability to weave powerful narratives into his songs made this episode one of our favorites. For those who appreciate heartfelt, authentic music, this conversation continues to strike a chord with listeners.

4. Petter Hornfeldt – Airline Pilot and Content Creator (MenTour Pilot)

In a fascinating episode, we spoke with Petter Hornfeldt, an airline pilot and popular content creator behind the MenTour Pilot channel. Petter gave us a unique insider’s perspective on the life of a pilot, sharing the highs and lows of flying commercial jets around the world. He also discussed his journey into content creation and how he’s using his platform to demystify the aviation industry for a new generation of aspiring pilots. Petter’s enthusiasm for his work, combined with his dedication to educating and inspiring his audience, made for a truly engaging conversation that continues to be one of our most listened-to episodes.

A Podcast Built on Diverse Voices

The beauty of Hear Us Out lies in its commitment to showcasing diverse perspectives. Every guest brings something new to the table, whether it’s their expertise in their field, their personal journey, or their unique take on the world. By hosting guests from a variety of industries—whether it’s music, film, or aviation—we’re able to offer our listeners a broad spectrum of stories and ideas that challenge conventional thinking and encourage curiosity.

The response we've received from our listeners has been beyond encouraging, and it's clear that our audience is resonating with the stories shared on Hear Us Out. We’re excited to continue this journey and to bring on even more guests who inspire, motivate, and push boundaries in their fields.

Why You Should Tune In

Whether you’re looking for in-depth interviews with industry professionals, personal stories of resilience, or discussions on fascinating topics like music, film, and aviation, Hear Us Out has something for everyone. Our guests' stories are diverse, and so are the conversations we spark. With each episode, we aim to create a space for listeners to learn, reflect, and grow, while being entertained and inspired by the amazing individuals who have shaped their fields.

Our podcast may be only three months old, but we’ve already made a big splash—and we have big plans for the future. If you haven’t tuned in yet, now’s the perfect time to do so. You never know—the next episode could be the one that changes the way you see the world.


Understanding Cochlear Implants: A Life-Changing Technology for Hearing Loss

Understanding Cochlear Implants: A Life-Changing Technology for Hearing Loss

Cochlear implants have revolutionized the way people with severe hearing loss experience the world of sound. Unlike hearing aids, which amplify sound for those with residual hearing, cochlear implants bypass the damaged parts of the cochlea and directly stimulate the auditory nerve, enabling the brain to receive sound signals. This technology has transformed the lives of countless individuals, offering them an opportunity to engage with their environment in ways they once thought impossible.

What is a Cochlear Implant?

A cochlear implant is a small electronic device designed to help individuals with hearing loss that cannot benefit from traditional hearing aids. It works by converting sound into electrical signals, which are then sent directly to the auditory nerve. This process bypasses the damaged hair cells in the inner ear, which are usually responsible for transmitting sound to the auditory nerve and up to the brain. The implant consists of two main parts:

  1. External Components:

    • Microphone: Captures sound from the environment.

    • Processor: Converts sound into digital signals.

    • Transmitter: Sends the processed signals to the internal components via electromagnetic waves.

  2. Internal Components:

    • Receiver: Receives signals from the external transmitter.

    • Electrode Array: A set of electrodes implanted in the cochlea, which directly stimulate the auditory nerve.

How Does a Cochlear Implant Work?

The cochlear implant works by mimicking the function of the damaged cochlea, the part of the ear that is responsible for converting sound vibrations into electrical signals. Here’s a simplified breakdown of how it functions:

  1. Sound Capture: The external microphone captures sound from the environment.

  2. Signal Processing: The sound is sent to the speech processor, which analyzes and converts it into a digital signal.

  3. Signal Transmission: The digital signal is sent to the receiver, which is implanted under the skin behind the ear.

  4. Direct Stimulation: The electrode array in the cochlea receives the signals and directly stimulates the auditory nerve, bypassing the damaged hair cells.

  5. Auditory Perception: The auditory nerve sends these signals to the brain, where they are interpreted as sound.

Although cochlear implants don’t restore hearing to the level of a person with normal hearing, they significantly improve the ability to perceive sound, enabling users to hear speech and environmental noises that would otherwise be inaudible.

Who Can Benefit from Cochlear Implants?

Cochlear implants are primarily intended for individuals with severe to profound hearing loss, particularly those who do not benefit from traditional hearing aids.  However candidacy criteria has broadened in recent years.  This includes:

  • Adults with acquired deafness: Individuals who have lost their hearing due to age, injury, or illness.

  • Children with congenital hearing loss: Those born with hearing loss or those who lose their hearing before developing language skills.

  • Those with sensorineural hearing loss: A type of hearing loss caused by damage to the inner ear or auditory nerve, which is typically the result of aging, genetics, or exposure to loud noise.

However, successful implantation requires a thorough evaluation, including hearing tests, speech assessments, and an assessment of the patient’s ability to undergo surgery and rehabilitation. Cochlear implants are not suitable for everyone, and their effectiveness can vary depending on individual factors like the age of implantation, duration of deafness, and the overall health of the auditory system.

The Benefits of Cochlear Implants

Cochlear implants offer a variety of benefits that can significantly improve the quality of life for individuals with severe hearing loss:

  1. Improved Speech Understanding: Cochlear implants allow individuals to understand speech more clearly, even in noisy environments.

  2. Better Sound Awareness: Users can perceive a wide range of sounds, such as speech, alarms, and environmental noises, which can enhance safety and communication.

  3. Enhanced Social Interaction: By improving hearing, cochlear implants help individuals feel more connected to family, friends, and society, reducing the social isolation often experienced by those with severe hearing loss.

  4. Better Educational and Employment Opportunities: For children, cochlear implants can help them develop speech and language skills, improving their ability to integrate into regular education programs. For adults, it can make communication at work and in social settings easier, leading to improved professional and personal opportunities.

  5. Long-Term Effectiveness: Studies have shown that cochlear implants can provide lasting benefits. While users may need to undergo therapy to adapt to the new way of hearing, many report significant improvements in hearing abilities over time.

The Challenges of Cochlear Implants

While cochlear implants are life-changing, they do come with challenges. Some of the most common issues include:

  • Surgical Risks: Like any surgery, cochlear implantation carries risks, including infection, bleeding, or damage to the cochlea.

  • Adjustment Period: It can take several months or even longer for individuals to fully adjust to the sounds they are hearing, as the brain needs time to interpret the signals from the implant. This requires therapy and consistent rehabilitation.

  • Cost: Cochlear implants can be expensive, often costing tens of thousands of dollars for the device and the associated surgery. Insurance coverage varies by region and policy, making the cost a barrier for some families.

  • Maintenance: The external components of a cochlear implant processor, require regular maintenance and may need to be replaced after several years.

Cochlear Implants vs. Hearing Aids

It’s important to distinguish between cochlear implants and hearing aids. While both devices are used to help those with hearing loss, they function in fundamentally different ways.

  • Hearing Aids: These devices amplify sound for people who have partial hearing loss. They are most effective for individuals who still have some functional hearing in the cochlea and can benefit from increased sound volume.

  • Cochlear Implants: These are designed for people with profound hearing loss who do not benefit from hearing aids. They bypass the damaged cochlea entirely, directly stimulating the auditory nerve to provide sound information to the brain.

Conclusion

Cochlear implants have undoubtedly changed the lives of many people with hearing loss, providing them with the opportunity to reconnect with the world around them. While the technology is not a cure for deafness, it offers a powerful solution for those who are profoundly deaf or severely hard of hearing. With ongoing advancements in cochlear implant technology, the future holds even greater possibilities for improving the auditory experience of those with hearing loss.

If you or someone you know is considering a cochlear implant, it’s important to consult with a medical professional and an audiologist to understand the potential benefits and challenges. With the right support, a cochlear implant can be a transformative tool, enabling individuals to regain access to the sounds that are vital for communication and quality of life.


Hear Us Out Podcast with Richard On: Lead Guitarist of Rock band OAR

Listen to our 2 Part Episode with Richard On from OAR.

In this episode of Hear Us Out, we chat with Richard On, lead guitarist of the platinum selling rock band, O.A.R. They have sold out MSG, Red Rocks, and numerous venues in between! In our conversation, we discuss the band's current projects, life as a touring musician, song writing, becoming a part of people's story, what musician's need from audiologists, among other topics. Remember to check out our other episodes after you listen to this one! Check out Richard's work at www.liveoar.com and he is available for guitar lessons at richsguitarworkshop@gmail.com .

Listen here

Hear Us Out Podcast: Balance Awareness Week

Check out our short bonus sessions about balance and dizziness. On the Hear Us Out Podcast, we will be discussing a variety of audiology related topics. Subscribe to our YouTube channel, or on Spotify, Apple Podcasts, or where you typically stream content. You can also follow us on instagram at The Hearing Center on Instagram.

Hear Us Out Balance Awareness Week

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Check out our Hear Us Out Podcast

You can subscribe to the podcast on Spotify, apple podcasts, you tube, and most streaming sites. We speak with a variety of guests, including musicians, public figures, authors, professionals, and patients. You are sure to learn something from these conversations and you may be entertained as well!

Clip of Richard On on Hear Us Out

Why do hospitals, schools and pediatricians screen for hearing loss

What are school hearing screenings?


Screening programs are developed and used to identify individuals who are likely to have a specific condition.

  • In this case, we are talking about hearing screenings!


  • School-age hearing screenings are an integral tool in identifying children with hearing loss who were not identified at birth, lost to follow-up, or who developed hearing loss later.

  • A hearing screening is a simple “pass” or “fail” test. 

  • Its purpose is to determine if a child has normal hearing or not. 

  • It consists of a series of beeps or tones, played through headphones, at the limit of normal range to see if the child is able to hear them.

  • The child responds by raising their hand if the tone was heard across different pitches, and for each ear.


Purpose of a school hearing screening:

  • A hearing screening can detect potential hearing loss

  • The screening places a child into either a “normal hearing” group or “possible hearing loss group”

    • This would lead to a recommendation for further testing to rule out presence of hearing loss

  • School hearing screenings can pick up hearing losses that are missed at birth

    • Newborn hearing screenings that are done at the hospital do not reliably rule out potential mild hearing losses

When should we screen?

  • School districts have timelines set in place for when students will be screened: 

    • Children who are entering school (Kindergarten, 1st grade in some places)

    • Children in K-3 (annual evaluations at these ages)

    • Children in 7th grade

    • Children in 11th grade

    • Children who have failed a grade

    • Children with speech/language delay

    • Children entering a special education program


Who Else Should We Screen?

However, there are other times outside of routine school hearing screenings when a child should have their hearing screening: 

  • Concerns about hearing, speech language or learning

  • Family history of delayed or late onset hearing loss

  • Signs of syndromes that include hearing loss

  • Craniofacial/ear abnormalities

  • Persistent ear infections for more than 3 months

  • Head trauma and loss of consciousness

  • Ototoxic drug exposure (harmful to hearing)

  •  Noise exposure


What is Considered a “Pass”?

  • Each tone is presented to the child 3 times at 20 dB HL, which is the cutoff loudness level to be considered within the range of normal hearing. 


  • If a child hears it at least 2 out of 3 times, he/she passes at that frequency, or pitch. 


  • If the child passes at all frequencies, then the child passes the screening.



What is Considered a “Fail”?

  • If a child does not respond to one or more of the tested frequencies at a level greater than 20  dB HL, it is considered a “failed” hearing screening

  • The child “fails” the screening even if only one ear did not hear the tones at this level


If the Child Fails the Screening, What Happens Next?

  • The child should be re-screened, either:

    • On the spot

    • On another date (should be within 24-48 hours after the first screening)

  • Another type of screening tool may be used to compare to results from the first screening

  • The child may be referred to an Ear, Nose & Throat doctor (ENT) or an Audiologist for a full hearing test

  • Parents should be notified about results from the screening either by mail or over the phone

Consequences of Missed Hearing Loss:

  • Impaired hearing is a primary health condition, just as impairment of any sense organ.

    • Sensory deprivation results in restricted or non- development of the central auditory nervous system.

  • Communicative: Compromised speech-language development.

  • Social/Emotional: Family will use ineffective communication behaviors, experience frustration, and misinterpret the child’s behaviors and might experience guilt and anxiety when the hearing loss is diagnosed.

  • Cognitive/Academic: Negative effects on vocational and economic potential and contributions to society.

Microtia Awareness Day

Microtia Awareness Day

Microtia occurs when the ear does not fully develop during the first trimester of pregnancy

This leaves the child with small, underdeveloped ears, or in some cases, no external ear at all

One in every 9,000 children is born with microtia

There are four classes of microtia:

Absence of a normal ear canal prevents sound from being effectively transmitted to the inner ear,

leading to a conductive hearing loss on the affected ear

Treatment Options:

1) Ear Canal Surgery:

An Atresiaplasty procedure consists of drilling behind the bone behind the microtia to

create an ear canal. After a canal is drilled, skin graft is placed to line the canal and

eardrum. Risk factors of this procedure include narrowing of the ear canal and damage to

the facial nerve.

2) Bone Conduction Hearing Aid (Non-Surgical):

Children ages 5 and younger who are not of implantable age, or for those who do not

wish to undergo surgery, can use a hearing processor that is attached to a headband. The

device works via vibration, in which sound causes the skull to vibrate, allowing the

individual to hear through bone conduction.

3) Bone Anchored Hearing Apparatus (BAHA):

A BAHA bypasses the outer and middle ear and stimulates both cochleae via bone

conduction. It consists of a metal abutment that is surgically implanted into the patient’s

skull, and an external piece that snaps on. A risk factor for this option is that it has a

higher infection rate, since the abutment site requires thorough hygiene.

4) Osia Implantable Device:

The Osia implantable device is similar to a BAHA, as it bypasses the outer and middle

portions of the ear to stimulate the cochlea via bone conduction.With the Osia device, an

internal implant is drilled into the mastoid bone, and an external processor connects to the

internal piece via magnet to stimulate both cochleae. This device requires less hygienic

maintenance, but is not ideal for someone who undergoes frequent MRIs as it can cast a

What is EVA Enlarged Vestibular Aqueduct

What is an Enlarged Vestibular Aqueduct (EVA)?

 The vestibular aqueduct is a bony canal that begins inside the temporal bone and travels

within the inner ear to deep inside the skull

 Running through the aqueduct is a fluid-filled tube called the endolymphatic duct, which

connects the inner ear to the endolymphatic sac

 The role of these two structures is to maintain a normal ion concentration

 Some believe that the vestibular aqueduct is mature at birth, while others believe it

continues to grow postnatally until about age 3-4

A vestibular aqueduct is considered enlarged if it is greater than 1-1.5mm. Usually, when the

aqueduct is enlarged, the endolymphatic duct and sac are large too. This causes the regulation of

cochlear fluid and ion concentration to be disrupted

EVA & HEARING LOSS

 EVA can occur in isolation, but also can co-occur with congenital disorders such as

Pendred syndrome, CHARGE syndrome and Branchiootorenal syndrome

 EVA can lead to both hearing loss (most likely sensorineural) and balance issues

 It can be identified with a CI Scan or an MRI

 There is no “cure” for EVA, but hearing aids are most commonly used to manage hearing

loss associated with it

 Vestibular therapy can be beneficial to those who have balance problems due to EVA

EVA & CONTACT SPORTS

 Those with EVA may be at risk for progressive hearing loss, in which the hearing can

gradually or rapidly decrease or fluctuate over time

 Head injury or barotrauma increase the likelihood of progressive hearing loss

 People with EVA are *strongly advised* to avoid contact sports such as football and

soccer, as well as wear helmets when engaging in activities that put them at risk for head

injury

Contact us for more information on EVA!

What are vestibular disorders

Vestibular Disorders

How does my ear affect my balance?

 The Organ for Balance, or the vestibular system, lies within the inner ear

 It consists of three fluid-filled loops call the semicircular canals

 The fluid within the canals changes in response to head motion

 Our vestibular system, eyes and proprioceptive system help us move our bodies within

space and maintain our balance

Vestibular conditions can be caused by:

 Changes in medication

 Poor circulation of the ear

 Movement of “ear crystals” within the semicircular canals

 Infections

 Debris in the semicircular canals

 Traumatic brain injury

Symptoms of a vestibular disorder:

1. Falling, swaying or tilting

2. Vertigo

3. Floating feeling

4. Feeling off-balance

5. Leaning to one side

How do I test for a vestibular disorder?

An audiologist may perform a videonystagmography (VNG) to test for certain vestibular

conditions. This gives the audiologist information about how the vestibular portion of the inner

ear is functioning. The patient wears goggles to monitor eye movements. The patient will

perform several tasks, including following a moving target on a screen, moving their head and

body in various positions, and having warm and cool air put into the ear canal. During these

tasks, the audiologist monitors eye movements and attempts to simulate dizziness to determine

the potential source of symptoms.

What happens next?

Depending on the results of the testing, an audiologist may refer for vestibular therapy.

Sometimes, the audiologist may refer to a specialist, such as an Ear, Nose and Throat physician

or a neurologist to determine if additional testing is warranted. In certain cases, home exercises

may be recommended to alleviate dizziness symptoms.