Hearing, hearing loss & deafness
Discover why your baby’s hearing is so crucial for development and how you can detect any problems early on
Baby's ear

Your baby experiences the world through all of her 5 senses. All senses are important, but when babies are born with hearing problems the consequences for other areas of development are dire.

The importance of hearing during childhood

Hearing makes it possible for your baby to recognise voices, imitate sounds and most importantly, develop language. Language and the ability to learn language hinges on your baby’s sense of hearing, as it is by hearing that she learns to recognise voices and mimic sounds.   Your baby’s ears develop while she is still in your womb. In fact, she starts hearing things around her before she’s even born.

Learning language

According to Olivedale Clinic audiologist, Fleur Bonnet, “From the age of about 6 months your baby starts learning language. Before this age her intonation is being developed. Intonation is the little gurgling sounds she makes, and it forms the foundation of language development. If your baby can’t hear changes in intonation, she isn’t able to recognise any language.”  

The earlier a hearing problem is identified, the better

This is why the earlier any hearing loss is identified, the less your baby’s development will be hampered. So how can you tell if there’s something wrong with your baby’s hearing and what can you do about it?

How do I tell something's wrong?

Fleur explains, “Congenital hearing loss can usually be detected within 24 hours by an audiologist. In fact, most hospitals have active audiologists on duty that perform screening tests on babies when they’re about 2 days old. This test will detect the presence of any hearing problem. "It is then recommended that your baby be retested at about 6 weeks of age to determine whether the problem has cleared up or if further testing and treatment should be performed.”  Wendy Deverson, an audiologist at The Centre for Language and Hearing Impaired Children recommends going through the following checklist to recognise a possible problem with your baby’s hearing: 

Hearing problem checklist

  • Your young baby (up to 6 months old) doesn’t startle or wake up to a loud noise
  • As she grows she doesn’t respond to softer sounds, nor does she make more definite responses such as searching for the source of a sound
  • By the age of 6 to 12 months your baby doesn’t respond to her name or noisy toys that don’t move or light up
  • By 18 months of age your baby doesn’t have a small vocabulary of words. By age 2 she hasn’t developed words into short phrases. Delayed speech development is the biggest indicator of hearing loss
  • Your baby responds better to a visual or tactile stimulus than to a sound. For example, she only responds to you when she can see you or feel you tapping on her shoulder
  •  There is a family history of hearing impairment or your baby had a difficult birth, or any other problems such as a cleft palate or a syndrome.

What happens now?

Take your baby to an Ear, Nose and Throat (ENT) specialist

If you suspect that your child has a hearing problem you should take her to an Ear, Nose and Throat specialist (ENT). This is to identify any physiological reason for your baby’s hearing loss. If the problem with your baby’s hearing lies in the middle or outer ear it can often be dealt with medically or surgically. It is important that ear infections be dealt with early on, as repeated or untreated ear infections can lead to hear loss - your baby’s ear drum could become scarred or perforated.  

If your baby's ear is healthy, the ENT will refer you to an audiologist

If your baby’s ear is healthy, the ENT will refer you to an audiologist. The audiologist will then perform a proper screening of your baby’s ear to determine whether there is a problem with her hearing. A probe is placed on your baby’s ear canal entrance and sounds are presented at different frequencies. The machine then waits to receive an echo response from the ear. This is not at all painful or even uncomfortable for your baby. The sounds are soft and will not do any further damage to your baby’s hearing.

If your baby doesn't pass the screening test, a diagnostic test will be performed

If your baby doesn’t pass the screening test, a diagnostic test will be performed. This works just like the screening test, but is performed to test that the ear structures and cochlea are all intact and functioning. This test is only performed once the middle ear is completely healthy – so once all infections have cleared up. 

Then an Auditory Brainstem Response test is performed

After this an Auditory Brainstem Response test is performed. Electrodes are placed on your baby’s head that measure how fast sounds reach the appropriate area in the brain. These results will tell you more about your baby’s hearing loss. This entire process can take up to a month. If necessary, a baby as young as 6 months old can be fitted with a hearing aid. This is often followed by oral rehabilitation to heighten awareness of sound and optimise use of the hearing aid. Wendy says, “If your baby doesn’t progress due to poor access to sound, meaning her ear doesn’t amplify sounds enough, you can pursue the option of a cochlear implant. This technology can give profoundly hearing-impaired babies the opportunity to hear, but for optimal results requires intensive therapy intervention.”   According to Dr van der Nest from Olivedale Clinic in Gauteng, a cochlear implant is inserted by making an incision behind the ear, drilling through the bone and implanting the device. 

Dealing with deafness and hearing loss

If your baby’s hearing is severely impaired you may want to look into sign language as a means to communicate with and educate her. Look up a sign language class in your area and enrol the whole family. Equip yourself with as much information as possible. Ask the professionals who are working with your child about her hearing loss, which will make you aware of all the helpful options available. Talk to parents of children with hearing loss. Look for support groups in your area or on the internet.  Remember that the earlier you act the better your baby’s chances of getting help. 

Hope and help

Hi Hopes (Home Intervention, Hearing and Language Opportunities, Parent Education Services) provides families with support, education and partnership from the moment a hearing problem is diagnosed until 3 years of age. Kelly Naude, a Parent Advisor at Hi Hopes says, “Not only does Hi Hopes provide support for children with a hearing loss, it provides support and education for the families of these children. Having family support and understanding empowers the child with a hearing loss, by helping her self-esteem, giving her access to language, and boosting her relationship with her parents and family members.”   A Parent Advisor visits the family for about an hour a week to give them information or answer questions.  A Deaf Mentor visits the family too, and provides lessons in whichever language the family has chosen, acts as a role model, and as a bridge between the Deaf and hearing communities. Resources Hi Hopes, Centre for Deaf Studies at hihopes@wits.ac.za or (011) 717 3750 www.helpkidshear.org is a forum for parents of children with hearing loss www.audiologysa.co.za www.speechandhearing4kids.org.za www.deafsa.co.za

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