Hearing loss in newborns and toddlers: when to worry

According to the Arizona Department of Health Services, approximately 300 newborns each year in the state have an inherited disorder that could be identified through screening.

Hearing loss is the most common of these disorders.

Babies born in hospitals are screened for hearing loss within the first few hours after birth.

Watch a newborn hearing screening at Cardon Children’s Medical Center/Banner Desert Medical Center

If a baby doesn’t pass the initial test, parents need to make sure they return for a repeat screening two to four weeks later, says Patty Shappell, AuD., CCC-A, an audiologist with Neonatology Associates, Ltd.

“Parents may get home and think the baby is responding normally, says Shappell, “but they still need to have a follow-up evaluation to assess hearing and rule out even mild or unilateral hearing loss.”

What happens if screening results are not within the normal range? Read about Brooke Gammie’s journey after her daughter, Payton, did not pass her newborn hearing screening.

For babies born outside of a hospital, screenings are available at outpatient clinics such as Neonatal Associates. Most insurance companies, including AHCCCS, cover the costs of the screenings.

What do babies miss if they are born with even a mild hearing loss? Hearing acuity directly affects the development of speech and verbal language skills. A baby with hearing loss, even during the first year, can be short-changed in his or her social, emotional, cognitive and academic development.

Diagnosis and early intervention are critical during the first year for the child with any degree of loss.

 How do you know if your baby is at risk for hearing loss?

Risk factors for hearing loss, according to the Arizona Department of Health Services include:

  • Babies who stay in the NICU for more than 5 days
  • Babies who have had an infection before or after birth such as CMV, herpes, rubella or meningitis
  • Babies who have a family member with hearing loss from birth or childhood

Follow-up with a physician is critical for babies at risk as it is possible that they may pass a hearing screening at birth but will still need more testing later.

New parents, says Shappell, should be sure to talk to their baby’s doctor and make an appointment with a pediatric audiologist or hearing specialist for further testing.

Normal milestones for the first year:

By 2 months of age a baby with normal hearing should be able to:

  • Quiet when hearing a familiar voice
  • Make sounds like ahh and ohh

By 4 months of age a baby with normal hearing should be able to:

  • Look for sounds with his eyes
  • Make sounds like squeals, whimpers or chuckles

By 6 months of age a baby with normal hearing should be able to:

  • Turn his head toward a sound
  • Make sounds like ba-ba, ma-ma, da-da

By 9 months of age a baby with normal hearing should be able to:

  • Imitate speech sounds made by others
  • Understand no-no or bye-bye
  • Turn his head toward a soft sound

By 12 months of age a baby with normal hearing should be able to:

  • Correctly use ma-ma or da-da
  • Respond to singing or music

Still, it is important to remember that babies with mild hearing loss may also be able to do these things.

During the second year, parents should continue to monitor any changes in a child’s development.

Candice L. Grotsky, Au.D., a Cigna audiologist who practices at the Stapley Hearing Center in Mesa, says that by twelve months to two years, children should still be turning to sounds from either side and “look up or down” for a sound if it comes above or below them.

They get better at  “localizing” or turning directly to a sound the older they get assuming hearing is normal and there are no developmental delays,  she adds.

Grotsky says that in toddlers, hearing loss is often caused by ear infections.  She says that most parents seem to know “when something is wrong” and bring their child in for testing.

“Maybe speech is delayed or mushy sounding, maybe speech was progressing well and all of a sudden stopped or regressed,” she says. ” Sometimes the child doesn’t respond if you are behind them and make a sound or noise.  These are all clues that hearing loss could be present.”

Grotsky says that most of those children in the age range of 2-4 years that she sees are coming in for the first time  — and it is usually a speech delay that prompts parents to seek testing.

If you suspect for any reason that your child — at any age — is having difficulty hearing or seems to be delayed in speech or in any other area, talk to your child’s physician.

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