PEDIATRIC CARE
Hearing Loss
Have you ever realized that every sound is different, every person or thing sounds different to your ears. That is because each sound generates its own unique sound waves. When the ears capture the sound waves, they convert them into messages that the brain can understand. We hear with our brain! How well is the sound captured and how clearly is the message sent to the brain, depends on the child’s hearing ability.
Hearing is crucial, because hearing is strongly correlated to learning. Children pick up the speech and language they hear in their environment. This helps in building their communication skills. A hearing evaluation may help explain why a child’s speech and language skills are poorer than another child of the same age. Informal tests done at home, such as clapping, bell ringing, name calling may not provide precise information as the child may be seeing or feeling the vibrations of these sounds rather than hearing them. Further, the loudness of these sounds and the distance from which they are presented to the child at home is not measured. It is critical to measure a child’s hearing ability with great care and precision. Even with a mild hearing loss, many speech sounds (z, v, p, h, g, ch, sh, k) may be affected. Thus, tests done at home are meaningless in deciding a child's hearing status. When it is about the child's future, one must exercise caution. Sounds Good Clinic has a custom built two room audiological booth that is ideal for testing children and adults with hearing loss. It is compatible with the specifications for permissible ambient noise pressure levels. This booth is equipped with sophisticated technology to provide valid and reliable audiological reports.
Audiology and why is it needed?
Audiology is the science of hearing and related disorders. An audiologist specializes in evaluating and treating children and adults with hearing loss. At Sounds Good Clinic, the hearing assessment sessions are customised for every child, keeping in mind their individual interests and age. After the assessment, it is ascertained whether a treatment is required. If yes, the treatment option that is most suitable for the child is decided. Children with irreversible or permenant type of hearing loss are fitted with hearing devices (hearing aids or cochlear implants) to help them listen, learn and talk. Further, the child’s hearing ability with the hearing technology (hearing aids or cochlear implant) is continually monitored to chart the development of his listening behaviour.
Fitting of hearing devices (hearing aids or cochlear implants) in the child is followed by another extremely significant step- initiation of auditory, speech and language therapy. The management of a child with hearing loss is incomplete without auditory, speech and language therapy. Each therapy session is tailored according to the child’s developmental age, functioning level and attention span. The activities in each session aim at working on the following skill areas- Listening, Language, Speech, Cognition and Communication. This is achieved through structured sessions and parental involvement. Parents are guided, supported and trained to carry over the activities in the child’s daily environment to maximise progress in the most efficient ways.
Sounds Good Clinic provides comprehensive family-centred care in the prevention, identification, diagnosis, and evidence-based treatment of hearing and other auditory disorders for all age groups.
Check these age specific developmental milestones that describe the expected growth in many areas like Listening, Receptive Language, Expressive Language, Speech, Cognition and Pragmatics. It helps in tracking and monitoring a child’s progress.
Learn more about Hearing Aids: Hearing aids are medical devices that help a child with hearing loss to listen, communicate, and participate more fully in daily activities. The digital behind-the-ear (BTE) variety of hearing aids are best suited for the growing ears of children. At Sounds Good Clinic, hearing device fitting is a sophisticated affair that follows international protocols. The results of all audiological tests are considered during this important step. Fitting hearing aids to children based on one test like BERA is inaccurate and not advisable. The hearing aids are programmed according to the child’s nature and degree of hearing loss. Also, the performance of the hearing aids is periodically monitored to maximise their benefit to the child.
Common questions about hearing aids:
After hearing loss is confirmed, treatment options are discussed with the parents. Children whose inner ear structures are not functioning optimally, such that it deprives them of auditory stimulation and stunts their brain growth, are suggested to wear hearing aids. At Sounds Good Clinic, parents are guided for the most suitable treatment option for their children depending on the type and degree of hearing loss.
Children with normal hearing are able to hear the sounds in their environment from the time they are in the womb of the mother. Hearing ability develops at 5th month of pregnancy. When a child with normal hearing is born at 9 months, he has been hearing for 4 months. These children listen and learn from their surroundings and then start speaking at 1 year of age. Children with hearing loss are deprived of these early learning experiences. Delaying the decision to fit hearing aids deprives him/her of all the opportunities that the brain needs to learn and grow like children of the same age. Every learning experience must be capitalised for the wholistic development of the child. We must race to close the gap between the hearing age and the chronological (actual) age of the child. At Sounds Good Clinic, hearing aids are suggested after the audiologist has made an absolute and confirmed diagnosis. Hearing aids are fitted after collating all the audiological test reports and is not based on a single test report. Parents are informed if their child’s hearing loss is of fluctuating or progressive type. It is extremely important that the child is fitted with optimally programmed hearing aids immediately after a confirmed diagnosis is made.
In most children who need hearing aids, the hearing loss is permanent in nature. Hearing aids help the child in the following ways:
- Connect the child to his/her environment
- Help the child listen to his/her loved ones’ voices and understand their speech Make the child a part of all the conversations
- Stimulate the auditory centres of the brain to bring about development in the child’s speech, language and cognition
- Without hearing aids, the child will miss out on all of the above-mentioned experiences. Thus, wearing them at all times is critical.
The audiologist will recommend two hearing aids if both the ears have hearing loss. Wearing two hearing aids instead of one helps the child in the following ways:
- Children are exposed to noisy environments at home and in school. Listening in noise is far superior with two hearing aids.
- Enables the child to identify the direction from which the sound is coming.
- Listening and interacting is more enjoyable with two instruments because they do not have to strain to hear with one ear. It also creates a sense of comfort and balanced reception of sound from the two ears.
- Both sides of the brain are stimulated to integrate the incoming auditory signals. This leads to synchronous brain maturation.
An in-depth knowledge regarding speech & sound acoustics is a must to successfully fit hearing aids to a child. A qualified audiologist is equipped with the requisite diagnostic and device programming skills. The audiologist chooses the hearing aids that are best suited for your child based on the degree, type, configuration and nature of your child’s hearing ability. The chosen hearing aids are tuned according to the child’s hearing status and continually monitored for further fine tunings, if the need be. Hearing aids are meant to connect the child to the world of sound. It is critical that accurate fitting takes precedence over any other factors.
Children with normal hearing listen to sounds in their environment before birth, from the womb of the mother (5th month of pregnancy onwards). They listen and learn that certain sounds have certain meanings. In this way, they learn to understand and speak words. As they grow and interact with more people, they continue to build their vocabulary and language skills. All children with hearing loss have some amount of auditory deprivation. This deprivation prevents them from learning the listening skills that children with normal hearing develop automatically. Only fitting advance and sophisticated hearing aids will not serve the purpose; the brain needs help to learn to detect, recognize and make meaning out of the sounds. They must be taught that listening is necessary to learn and talk. Hence, regular and effective therapy from a qualified specialist is a must after hearing aid fitting or cochlear implantation.
In some cases, benefit with hearing aids maybe insufficient even though the child is consistently wearing hearing aids and regularly attending auditory, speech and language therapy. Other hearing technologies, such as cochlear implants must be considered for these children, provided the results of CT Scan and MRI fulfill the candidacy criteria.
Learn more about Cochlear Implants :
It is the most significant advancement in hearing technology for those children who are not benefitting or have limited benefit with hearing aids. This is because it bypasses the damaged/non-functional inner ear hair cells and directly delivers sound to the auditory centres of the brain through the hearing nerve. Even a child with the highest degree of hearing impairment can develop near normal hearing and listening skills with cochlear implantation and effective habilitation (provided other factors like age, concomitant conditions etc are favourable).
Common questions about cochlear implants
When considering either of these devices, it is important to understand that neither one offers a “cure” for hearing loss. Hearing aids make the sounds louder and deliver this amplified sound to the damaged/non-functional inner ear structures. In certain children (especially those with high degrees of hearing loss) hearing aids may only help to keep the hearing nerve active and provide some sound awareness to the child. This may not be sufficient for the child’s brain development. A cochlear implant bypasses the damaged ear structures and directly stimulates the hearing nerve. This helps the child to overcome the listening limitations posed by a hearing aid. Both the devices should not be viewed as alternatives. Determining whether cochlear implants or hearing aids are the better option is entirely based on the child’s auditory performance. Sounds Good Clinic provides guidance and assistance to families in reaching the ideal solution for their child.
If hearing aids are not benefitting your child adequately, decision regarding cochlear implantation must be made as early as possible. Cochlear Implant Surgery is a crucial step that you take as a family, to help your child to grow and develop like other children of the same age. Research shows that when a child is implanted early in life (especially before 18 months of age), his ability to learn, listen, speak clearly and attend school is like that of other children of the same age. Delaying cochlear implantation deprives your child of the best learning time. You are justified in worrying about the possible risks in putting your child through surgery at such a young age. Cochlear implant surgery is a safe and well-tolerated procedure for babies and young children across the globe.
At Sounds Good Clinic, we understand that this is a big step for the family. Cochlear implantation is advised after reviewing all the audiological reports, child’s developmental age, associated medical conditions and child’s progress with hearing aids. Yes, it will have to be used throughout life. The damaged inner ear hair cells are non-functional, making the child’s hearing loss permanent in nature. The Cochlear Implants thus become the child’s “ears”.
Cochlear Implantation gives access to the world of sound; therapy helps the child to derive meaning of these sounds that are present in his/her surroundings. Remember, hearing and listening are the foundation for speech and communication. Developing speech and language is a critical requirement in order for the child to attend school like children of his age. Cochlear Implantation without subsequent therapy sessions does not guarantee age-appropriate thinking, language and social skill development.
Once age appropriate conversational competence is achieved, the child is discharged from therapy as he no longer needs communication support.
Specific Conditions
Chris Fox. CEO at Mighty Schools.
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Chris Fox. CEO at Mighty Schools.
John Doe saved us from a web disaster.
Rebecca Flex. CEO at Company.
No one is better than John Doe.
Chris Fox. CEO at Mighty Schools.
John Doe saved us from a web disaster.
Rebecca Flex. CEO at Company.
No one is better than John Doe.