Hearing is very important
to have screened early, at an early age.
A lot of learning for babies is from hearing,
from what they are just picking up.
That's why it's important to talk to your baby.
And so with the universal newborn hearing screening,
we want all babies to be screened by one month of age,
we want them to have, if they have hearing loss,
for that hearing loss to be diagnosed
by three months of age, and if they have hearing loss,
to have them fit with amplification
if needed by six months of age.
We also want interventions to start
by six months of age as well, because we know
that when hearing is not up to par,
that kids are not hearing as well,
they're not learning as well, and so those
developmental milestones such as speech
and language development might be delayed,
or drastically affected because they're not hearing as well.
When there's a child with hearing loss, we want to make sure
that we figure out exactly what the cause is.
Some forms of hearing loss can be treated easily,
either with tubes or repairs of problems
in the ear canal, or the eardrum.
Other types of pediatric hearing loss
may be permanent, from genetic issues
or structural and developmental problems.
In many cases, however, these types of hearing loss
can be treated either with amplification
with a hearing aid, or with a cochlear implant.
For babies, we can do a test
called an ABR, auditory brain stem response,
or an OAE, otoacoustic emissions.
With the ABR, we place electrodes on,
we put earphones in their ears,
and we're looking for a response from their auditory system.
They don't have to provide us a response at all.
For OAEs, we're putting a probe into their ear canal,
and it's putting sound into the ear canal,
and we're looking for a response back from the inner ear.
Again, they don't have to provide a response.
Very easy, very quick, as long as
the child's relatively quiet.
So, the earphones are going to be
delivering the test signal into his ear.
For kids who are about six months old,
six months, six to eight months old, we can do a test
called VRA, visual reinforcement audiometry,
where we play sounds through the speakers,
and we're looking for them to turn their head
in response to the sound. And then once they do
turn their head, they're rewarded by a toy
that lights up above the speaker.
Kids who are about two and a half to three years old,
we'll do a test called CPA, or condition play audiometry,
where we teach them to put a block in the bucket
when they hear the sound, or when they
hear us say, "Put it in."
And kids usually like that test, like that task, that game.
And then once kids get to be about four to five years old,
we can teach them to respond to sound like we all know,
raise your hand when you hear the beep, or say yes,
or tell us your favorite color when you hear the beep.
So when a child is diagnosed with hearing loss,
the first person we would like them to speak with
is their pediatrician, since they referred them,
and that is their medical home.
The next person would be an ear, nose and throat
physician who can order any other additional tests.
They'll do an examination of the ear,
and determine what else is needed, also educate the parents
a little bit more about their hearing loss.
We need to be able to diagnose any medical issues
that the child might have which might be
causing the hearing loss. And we also need
to be very careful about diagnosing
the exact type of hearing loss,
so that we can point our efforts in the right direction.
The other thing that we would recommend
is a referral to early intervention.
From there, a case manager would contact them,
and determine what the next steps are as far as evaluation.
Usually that means that a speech language pathologist,
and perhaps a developmental therapist,
might come into their home, and do an evaluation
of the child to determine what other therapies are needed.
At Rush, we have a team-based approach
to treating and diagnosing pediatric hearing loss.
Our audiologists use the highest technology
in diagnosing the different types of hearing loss,
using a variety of different tests.
At the ENT side, we have a variety of providers,
both from pediatric and otology,
who can provide diagnostic services and treatment options,
including surgical options.
I believe that parents should bring their children
to Rush to have their hearing tested,
because we have a wonderful team of pediatric audiologists.
We collaborate with our ear, nose and throat physicians
and our pediatricians. We have the ability
to use every test that's used in pediatric audiology,
and we also have the ability to have
two audiologists test a child if needed.
My favorite thing about being a pediatric audiologist
is working with kids and their families.
It's the most rewarding thing you can do.