Article: What to Do if Your Baby’s Screening Reveals a Possible Hearing Problem

Why is a follow-up examination necessary?

A follow-up examination with an audiologist can help in many ways. Audiologists can identify the kind of hearing loss a child has and sometimes the cause. The audiologist also may recommend further medical attention, such as a visit to the otolaryngologist (OH-toh-LAYR-ehn-GAHL-oh-jist). An otolaryngologist is a physician specializing in ear, nose, and throat disorders who can determine the cause of a hearing loss as well as possible treatment options. If a hearing problem exists, the audiologist, otolaryngologist, pediatrician, or other professional who works with your child will point you to the various intervention services that can help you. The term intervention refers to the different steps that families can take to overcome communication barriers caused by a hearing loss. For example, you may be referred to a speech-language pathologist or a teacher who is experienced in working with deaf or hard-of-hearing children. You also may learn about special tools to help your child make use of what hearing she or he has as well as tips on how to best communicate with your child.

When should I have the follow-up examination performed?

If your child did not pass the hearing screening, you should schedule the follow-up examination immediately. The most important period in which a child learns language is during the first six months. If you suspect that your child has a hearing loss, you should schedule an appointment with an audiologist before your child reaches three months of age. Ask the hospital or facility staff who conducted your child’s screening to provide you with contact information for one or more certified audiologists. They may be able to help you schedule an appointment. You also can obtain a list of certified audiologists from the following Web sites: American Speech-Language-Hearing Association at www.asha.org or American Academy of Audiology at www.audiology.org. By the time your child reaches six months of age, he or she should be receiving some form of intervention services.

How can I help my child succeed if she or he has a hearing loss?

When intervention is introduced early, deaf and hard-of-hearing children can develop language skills that help them communicate freely and learn at the same rate as their hearing friends. Locate the services that are available in your community to help support your child. For example, the Individuals with Disabilities Education Act of 1997 (IDEA) ensures that all children with disabilities have access to the services they need to get a good education. In addition, Head Start and Early Head Start are federally funded programs that help young children in low-income families become better equipped to succeed in school.

Communicate with your child often. Keep informed about available intervention programs, and take part in all decisions regarding your child's progress. Remember: your child’s hearing--like your child’s overall health--is your responsibility. Acting responsibly can take many forms--from keeping an appointment for a hearing test, to learning sign language or strategies to support oral-auditory communication, to joining a support group, to making sure that your child’s doctors and specialists have your most current contact information, especially if you’ve recently moved.

What types of intervention services are available?

Many intervention options are available today. When your child uses more than one of these options, he or she has a better chance of understanding what others are saying, and of being understood.

Hearing Devices

A child with hearing loss can use various tools to communicate with the hearing and non-hearing world. One of the most common tools is the hearing aid, a device worn in or behind the ear that helps make sounds louder to the wearer. Hearing aids have improved over the years and can be used for different degrees of hearing loss--from mild to moderate to severe. An audiologist can help you choose the best hearing aid for your child and make sure that it fits securely. Make sure you consult an audiologist who has experience with the special needs of infants and children. Some audiologists, called pediatric audiologists, specialize in treating children.

If your child has profound hearing loss and would not benefit from a hearing aid, your doctor may suggest a cochlear (KOH-klee-uhr) implant. The cochlear implant is an electronic device that changes sounds to electrical signals and carries them past the nonworking part of the inner ear to the brain. With training, children with cochlear implants can learn to recognize sounds and understand speech. Talk with an otolaryngologist who specializes in cochlear implants to determine if the cochlear implant is the right form of intervention for your child.

Children who are deaf or hard-of-hearing can learn to communicate in a number of ways. All deaf or hard-of-hearing children living in the United States will need to learn English to communicate in writing. In addition, some families of deaf or hard-of-hearing children may choose to communicate manually using American Sign Language, a distinct language with its own grammar and syntax that uses hand signs and gestures, body movements, and facial expressions to represent words and phrases.

Other families may choose approaches that build upon the English language when communicating. Cued speech combines the natural lip movements of speech with hand shapes representing phonetic sounds, providing additional visual cues so that sounds such as "p" and "b" or "f" and "v" can be distinguished. Other families take an oral-auditory approach. Here, a child uses his or her natural hearing ability, along with lip reading and hearing devices, to enhance speaking and listening skills. Because language development begins early, you should select the approach you feel is best, and interact with your child as much as possible. Ask your audiologist, otolaryngologist, or pediatrician for more information about the choices that are available.

For older children and adults, other devices can help a child communicate within certain environments. The personal FM amplifier converts a classroom teacher’s voice, spoken through a microphone, into radio waves that are transmitted to a receiver that the child wears. In addition, deaf and hard-of-hearing viewers can watch almost all televised programming using closed captions, thanks to a special decoder that is now built into most television sets. More and more movie theaters across the country offer closed captioning as well. Telecommunications relay services, which are available through all telephone companies, enable deaf and hard-of-hearing people to communicate on the phone. They can type in messages on a keyboard, and view return messages on a display screen, all through the help of a communications assistant, who translates between the two telephone parties.

The follow-up exam revealed that my child’s hearing is OK after all. Does that mean we don’t need to check his hearing again?

Parents should interact often with a deaf or hard-of-hearing infant. All of the caregivers in your child's life should interact with him or her as much as possible. You can do this by holding, facing, smiling at, and responding to your infant from the very beginning. Children need love, encouragement, and care from their families and caregivers.

What should I do if my baby’s hearing hasn’t been screened yet?

Many hospitals now screen all newborns for hearing loss, and many more will do so as statewide screening programs are put into place. Currently, however, some hospitals screen only those newborns who are considered most at risk, such as those with a family history of deafness or who are of low birthweight. If you do not know if your child’s hearing was screened, call your child's pediatrician and ask to see a copy of your child’s records, or find out how the information can be obtained. If your child’s hearing has not been screened, ask your doctor how to make an appointment for a screening and then do so before your child is one month old. Publications such as the NIDCD fact sheet Has Your Baby’s Hearing Been Screened? can provide you with more detailed information about hearing screenings. You also can ask your doctor for written information about the screening process.

Follow-up Checklist for Parents:

Name of baby: _______________________________________
Birthday: ______/______/______

By one month of age:

By three months of age:

By six months of age:

Ongoing:

Where can I learn more?

Alexander Graham Bell Association for the Deaf and Hard of Hearing (A.G. Bell)

3417 Volta Place, N.W.
Washington, DC 20007-2778
Voice: (800) HEAR-KID or (202) 337-5220
TTY: (202) 337-5221
Fax: (202) 337-8314
E-mail: info@agbell.com
Internet: www.agbell.org
Publications: Facts About Hearing Loss in Children, Something To Talk About: Spoken Language Approaches for Children With Hearing Loss (PDF), Speech and Hearing Checklist, So Your Child Has a Hearing Loss: Next Steps for Parents

11730 Plaza America Drive
Suite 300
Reston, VA 20190
Voice/TTY: (703) 790-8466
Toll Free: (800) 222-2336
Fax: (703) 790-8631
E-mail: info@audiology.org
Internet: www.audiology.org
Publications: Newborn Hearing Screening

One Prince Street
Alexandria, VA 22314-3357
Voice: (703) 836-4444
TTY: (703) 519-1585
Fax: (703) 683-5100
E-mail: webmaster@entnet.org
Internet: www.entnet.org
Publications: Hearing Health Center

American Academy of Pediatrics (AAP)

141 Northwest Point Boulevard
Elk Grove Village, IL 60007-1098
Voice: (847) 434-4000
Fax: (847) 434-8000
E-mail: kidsdocs@aap.org
Internet: www.aap.org
Publications: Guide to Your Child's Symptoms: Hearing Loss

P.O. Box 3355
Gettysburg, PA 17325
Voice/TTY: (717) 334-7922
Toll-free: (800) 942-ASDC (2732)
E-mail: ASDC1@aol.com
Internet: www.deafchildren.org

10801 Rockville Pike
Rockville, MD 20852
Voice: (301) 897-5700
TTY: (301) 897-0157
Fax: (301) 897-7355
Toll-free: (800) 638-8255
E-mail: actioncenter@asha.org
Internet: www.asha.org

P.O. Box 17646
Raleigh, NC 27619
Voice/TTY: (800) 541-4327
E-mail: raleigh@beginningssvcs.com
Internet: www.beginningssvcs.com


Charlotte Office
7508 E. Independence Boulevard, Suite 106
Charlotte, NC 28227
Voice/TTY: (704) 566-0145
Toll-free Voice/TTY (out-of-state): (800) 541-HEAR (4327)
Toll-free Voice/TTY: (800) 556-2796
FAX: (704) 566-0653
E-mail: charlotte@beginningssvcs.com
Internet: www.beginningssvcs.com

555 North 30th Street
Omaha, NE 68131
Voice: (402) 498-6511
TTY: (402) 498-6543
Toll-free: (800) 282-6657
Fax: (402) 498-6755
E-mail: bthospital@girlsandboystown.org
Internet: www.boystownhospital.org
Publications: My Baby's Hearing (developed with support from NIDCD), Boys Town Pediatrics

Clearinghouse on Disability Information
Office of Special Education and Rehabilitative Services (OSERS)
Communication and Media Support Services (CMSS)
U.S. Department of Education

330 C Street, N.W., Room 3132
Washington, DC 20202-2524
Voice (202) 205-8241
Fax: (202) 205-9252
Internet: www.ed.gov/offices/OSERS

Conference of Educational Administrators of Schools and Programs for the Deaf (CEASD)

P.O. Box 1778
St. Augustine, FL 32085-1778
Voice/TTY: (904) 810-5200
Fax: (904) 810-5525
E-mail: eamil@ceasd.org
Internet: www.ceasd.org

Convention of American Instructors of the Deaf (CAID)

P.O. Box 377
Bedford, TX 76095-0377
Voice/TTY: (817) 354-8414
E-mail: caid@swbell.net
Internet: www.caid.org

Council on Education of the Deaf (CED)

Gallaudet University, 207 FH
800 Florida Avenue, NE
Washington, DC 20002
Voice/TTY: (202) 651-5525
Fax: (202) 651-5749
E-mail: roz.rosen@gallaudet.edu
Internet: www.deafed.net

Deafness Research Foundation-The National Campaign for Hearing Health

1050 17th Street, N.W., Suite 701
Washington, DC 20036
Voice/TTY: (202) 289-5850
Toll-free: (800) 535-3323
Fax: (202) 293-1805
E-mail: drf@drf.org
Internet: www.drf.org and www.hearinghealth.net

Early Hearing Detection and Intervention Program
Centers for Disease Control and Prevention
National Center on Birth Defects and Developmental Disabilities

Voice: (770) 448-7510
E-mail: ehdi@cdc.gov
Internet: www.cdc.gov/ncbddd/ehdi

ERIC Clearinghouse on Disabilities and Gifted Education

1110 North Glebe Road
Arlington, VA 22201-5704
Voice: (703) 264-9472
Toll-free/TTY: (800) 328-0272
Fax: (703) 620-2521
E-mail: ericec@cec.sped.org
Internet: www.ericec.org
Publications:Deafness/Hearing Impairment

Harvard Medical School Center for Hereditary Deafness
Harvard-partners Genome Center

65 Landsdowne Street
Cambridge, MA 02139
Voice: (617) 768-8291
Fax: (617) 768-8510
E-mail: hearing@hms.harvard.edu
Internet: http://hearing.harvard.edu
Publications: Understanding the Genetics of Deafness: A Guide for Patients and Families

Laurent Clerc National Deaf Education Center at Gallaudet University

KDES PAS-6, 800 Florida Avenue, N.E.
Washington, DC 20002-3695
Voice: (202) 651-5051
TTY: (202) 651-5052
Fax: (202) 651-5054
E-mail: clearinghouse.infotogo@gallaudet.edu
Internet: clerccenter.gallaudet.edu or
clercenter2.gallaudet.edu/KidsWorldDeafNet/e-docs/EI/index.html

National Association of the Deaf (NAD)

814 Thayer Avenue, Suite 250
Silver Spring, MD 20910-4500
Voice: (301) 587-1788
TTY: (301) 587-1789
Fax: (301) 587-1791
E-mail: nadinfo@nad.org
Internet: www.nad.org
Publications:Parents, Family, and Friends

National Black Association for Speech-Language and Hearing (NBASLH)

P.O. Box 959
Athens, OH 45701
Voice: (740) 594-4989
Fax: (740) 549-6229
E-mail: Nbaslh@aol.com
Internet: www.utexas.edu/coc/csd/multicultural/network/resource/nbaslh/nbaslh1.htm

Office of Special Education Programs (OSEP)
Office of Special Education and Rehabilitative Services
U.S. Department of Education

400 Maryland Avenue, SW.
Washington, DC 20202
Voice: (202) 205-5507
Internet: www.ed.gov/offices/OSERS/OSEP/index.html
Publications: Parent Training and Information Centers and Community Parent Resource Centers

The Deafness & Family Communication Center The Children's Hospital of Philadelphia

3535 Market St., 9th floor
Philadelphia, PA 19104
Voice: (215) 590-7440
TTY: (215) 590-6817
Fax: (215) 590-1335
E-mail: bainl@email.chop.edu
Internet:www.raisingdeafkids.org