Hearing Impairment
Hearing deficits in early childhood can result in lifelong impairments in receptive and expressive language skills. The severity of the handicap is determined by the age at which the hearing loss occurred; the nature of loss-its duration, the frequencies affected and the degree; and the susceptibilities of the individual child (e.g., coexisting visual impairment, mental retardation, primary language deficits, inadequate linguistic environment) children who have other sensory, linguistic or cognitive deficiencies anre affected most severely.
Hearing loss can be classified as conductive, sensorineural or both (mixed loss). Conductive hearing loss occurs secondary to lesions in the external auditory canal, tympanic members or middle ear. These lesions prevent sound from being effectively conducted to the inner ear. Sensorineural hearing loss is caused by lesions of the either fo the inner ear (sensory) or the auditory (8th) nerve. This distinction is important, because sensory hearing loss is sometimes reversible and is seldom life threatening. A neural hearing loss is rarely recoverable and may be due to a potentially life-threatening brain tumor-commonly a cerebellopontine angle tumor. Mixed loss may be caused by severe head injury with or without fracture of the skull or temporal bone, by chronic infection, or by one of many genetic disorders. It may also occur when a transient conductive hearing loss, commonly from otitis media, is superimposed on a sensorineural hearing loss.
With the advent of Newborn Hearing Systems sweeping the nation, more babies are now being identified with deafness or hearing loss earlier than ever before. Historically, 50% of children with a degree of deafness were not identified through the high risk registry, so
the identification of hearing loss typically came through delays in speech after 12 months of age or through parental concern. With the newborn hearing screening system, parents who had no concerns about hearing and finding out through a simple and routine “test” that their child is deaf or hard of hearing. This sequence of events put into motion a different journey for a family than they had anticipated, to say the least.
Research has now shown that:
1. Children who are early identified and receive intervention prior to six moths of age have significantly better receptive language, expressive language, personal-social skills, receptive vocabulary, expressive vocabulary and speech production.
2. The benefits of early identifications and intervention (prior to six months of age) can be demonstrated from 12 months of age through seven years of age.
3. Language developments of children who are early-identified and receive early intervention services does not differ by degree of hearing loss, from mild through profound.
4. Both children who use speech as their mode of communication and those who use sign language benefit form early identification and intervention.
5. Parents of early-identified reports significantly less stress than parent of later-identified children.
(Yoshinaga-itano, 1998, Audiology Today, “Hearing in Infants”)
in light of this research, families should be very motivated to act quickly for the sake of their child. But what is the reality for families as they begins this journey with their child? Families do not always have this information on the importance of early intervention. They may be hearing conflicting opinions and suggestions as to what to do. The “system” may not be in place for the families to move as quickly as they would like to.
As families sift through this new discovery, the emotional impact and the choices they must now make for their child, there is a balance between “hurrying up” and getting their child into early intervention, and “slowing down” to make informed choices, allowing for the emotional implications as parents and looking at the unique situation of their particular child.
The following is a list of “first steps” a family may want to remember as they begin the process of guiding their child to a successful life.
1. Remember that the major goal of early identification and intervention is to give your child access to immediate communication. The “mode of communication” is not as important as “connecting” with your baby right away.
2. Step back and do not succumb to the pressure to make any decision before you are ready. Give yourself the time you need to make decisions that feel right for your family.
3. Keep in mind there are very few decisions you will make that you cannot change.
4. Get as much information as you possibly can, from as many sources as possible. Learn how to differentiate between personal opinion and factual information.
5. Look for professionals who can provide you with their professional expertise, yet at the same time respect your rights as a family to make the decisions that you feel are appropriate.
6. Work with Audiologists who have expertise in fitting infants.
7. Look for Early Interventionists who have specific training in deafness and hearing loss.
8. Talk to other parents; meet other children and adults who are deaf or hard of hearing. Their perspective is invaluable.
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