Importance of Hearing in Children Flashcards
hearing loss is more prevalent in
babies receiving care in the NICU
20x greater
Hearing loss in children is a
silent developmental hidden disability
invisible but is still a disability
hearing loss ni kids
why is it a silent disability?
nothing physical you can see to tell you that child has a hl
how many new babies with HL are identified every year according to national Institute on Deafness and Other Communication Disorders.
approx 12,000
how many infants and young children between birth and 3 years of age pass the newborn screening test but acquire late-onset hearing loss.
4-6000
one of the most prevalent disabilities
HL
2-3 babies every 1000 are born with congenital permanent bilateral HL
true
what are risk factors for hearing loss
Family history of hearing loss
Genetic disorders or syndromes
Problematic pregnancy
Drugs or alcohol use during pregnancy
Maternal infections during pregnancy such as rubella, sexually transmitted diseases, cytomegalovirus, and numerous others
Trauma during pregnancy
Trauma during birth
Anoxia at birth
Apgar scores below 5 at 1 min or less than 6 at 5 min
Postnatal infections
Hyperbilirubenemia
Ototoxic medications including aminoglycosides alone or in combination with loop diuretics
Patients undergoing chemotherapy or radiation for cancer treatment
Craniofacial anomalies
Recurrent otitis media with or without ventilation tubes
Mumps, measles
Noise exposure, particularly excessive use of personal listening devices
Deaf child born into hearing family; In absence of intervention:
Does not learn to interpret sound patterns
Does not learn to produce sounds of spoken language around him/her
Unable to hear speech
Unable to acquire spontaneous language
Why hearing is important?
Speech and language development is critical and is considered as a prerequisite for cognitive development suggesting that appropriate intervention is crucial to facilitate this process.
HL not detected or treated, it can affect language development, school successfulness etc.
it affects many aspects of an individuals life
not just hearing and the ear
what is the role of a pediatric audiologist
prevent
evaluate
intervene
how does an audiologist prevent
prevent the hl from happening - why we screen (if we detect hl early, we can impact it has on their life)
Nbhs/School screening
how do you evaluate as an audiologist
do the testing, (behavioral, electropnysiology etc.) as appropriate to age of the child and find everything you can about their hearing
how do you intervene as an audiologist
manage the HL - counsel the parents, these are the options available for the child
what are the core audiological services
hearing screening
objective testing
behavioral testing
amplification
aural rehab
what are the challenges faced in ped aud
Identifying hearing loss early
Understanding the impact of minimal or unilateral hearing loss
Accurately assessing hearing thresholds
Providing effective counseling to caregivers
Minimizing the effects of auditory handicap
Ensuring proper follow-up for hearing-impaired patients
Any undetected hearing loss of any degree can have a significant impact on
speech, language, cognitive, and psychosocial development (also academic struggles)
what is the overall impact of mild HL
Communication, language learning, and educational achievement are affected.
perception of speechh sounds with a mild HL
Vowel sounds are heard clearly but voiceless consonants may be missed. The louder voiced speech sounds are only heard. The short unstressed words and less intense speech sounds (such as voiceless stops and fricatives) are inaudible.
Educational and behavioral impacts of mild hL
In children with this degree of hearing loss auditory learning dysfunction may result in inattention, classroom behavior problems and possible mild language delay and speech problems.
what is the impact on speech perception of a moderate HL
Miss most conversational speech sounds; vowels are heard better than consonants. Short unstressed words and word endings (-s, -ed) are particularly difficult to hear.
Communication Confusion of moderate HL
Reduced auditory cues can lead to confusion in distinguishing speech sounds and word meanings.
speech articulation of moderate hl
Speech articulation often characterized by omission and distortion of consonants. Strangers may have difficulty understanding their speech.
behavioral and learning impacts of moderate hl
May demonstrate behavioral problems, inattention, language delay, speech problems, and learning problems.
impact of severe hl on speech and language development
Language and speech do not develop spontaneously without intervention. With early intervention, properly fitted hearing aids, and specialized education, children can achieve significant functional improvement.
auditory perception w/out amp with severe hl
Cannot hear typical sounds or normal conversation; can hear distorted self-vocalization, very loud environmental sounds, and only the most intense speech at close range.
Significant language problems speech problems and associated educational problems.
severe hl
impact of profound hl on speech and language
Delays: Severe language delays, speech problems, and potential learning dysfunction without intervention. Intensive special education with powerful hearing aids or cochlear implants is essential for language and speech development.
Auditory Perception Without intervention with profound hl
Cannot hear or understand sounds; amplification is critical. Early detection and treatment significantly improve outcomes.
speech characteristics of profound hl
Speech often includes issues with voice, articulation, resonance, and prosody. Vocal pitch may be higher, with a monotone quality due to lack of intonation and stress.
what are communication parts affected by hl
vocab
sentence structure
speaking
Children with hearing loss have difficulty with all areas of academic achievement, especially
reading and mathematical concepts.
children with mild to moderate hearing losses, on average, achieve one to four grade levels lower than their peers with normal hearing, unless appropriate management occurs
true
Children with severe to profound hearing loss usually achieve skills no higher than the ______ -grade level, unless appropriate educational intervention occurs early.
third- or fourth
The gap in academic achievement between children with normal hearing and those with hearing loss usually widens as they progress through school.
true
social functioning in children with HL
Children with severe to profound hearing losses often report feeling isolated, without friends, and unhappy in school, particularly when their socialization with other children with hearing loss is limited.
These social problems appear to be more frequent in children with a mild or moderate hearing losses than in those with a severe to profound loss.
economic burden of hearing loss
Medical and audiological expenses
Education and training expenses
Special living expenses
Lifetime loss of income considerations
what does research tell us about HL
Many deaf children have difficulties in large social settings . They cannot attend to multiple simultaneous conversations, especially when there is background noise
Joining an existing group of peers and maintaining play behaviours with them is socially challenging
Deaf children often have an inadequate concept of how others think and feel
How do we typically define minimal and mild hearing loss for kids?
why is this different than adults?
normal - -10-15
minimal/slight - 15-25
mild - 26-40
they already have their s/l development but children have not so the loss really matters
The category of minimal hearing loss is broad, severity and configuration are also important.
true
he most commonly accepted definitions of minimal and mild hearing loss were proposed by the Centers for Disease Control (CDC) Early Hearing Detection Intervention Program
unilateral hl
Unilateral hearing loss: PTA (0.5, 1, 2 kHz) is ≥ 20 dB HL, with no more 10 dB ABG at 1, 2, and 4 kHz in the impaired ear. AC thresholds are 15 dB or better in the other ear.
he most commonly accepted definitions of minimal and mild hearing loss were proposed by the Centers for Disease Control (CDC) Early Hearing Detection Intervention Program
bilateral snhl
both ears have average AC thresholds between 20-40 dB HL and average ABG ≤ 10 dB 1, 2, and 4 kHz.
the most commonly accepted definitions of minimal and mild hearing loss were proposed by the Centers for Disease Control (CDC) Early Hearing Detection Intervention Program
HF SNHL
in or both ears, AC thresholds >25 dB HL at two or more frequencies above 2 kHz (3, 4, 6, or 8.0 kHz) with no more than 10 dB ABGs at 3 and 4.0 kHz.
Studies showed that by the time children reach school age, the prevalence of minimal hearing loss increases from approximately
why a huge increase?
0.03% to about 1% to 14%
because they do school screenings and progressive hearing loss- even if they pass NBHS doesn’t mean they wont develop hl later on so why the numbers get larger during school age
Why is there such a large discrepancy in prevalence rates of minimal hearing loss from birth to school-aged children?
school screenings
could miss 60% of case with slight/minimal HL because
we screen at 20/25dB
Hearing screening programs do not target minimal and mild degrees of hearing loss, these children are not likely to be referred for diagnostic evaluations.
true
Real-world outcomes for children with minimal hearing loss
50% of children either repeat a grade or need resource support in school
Increased behavioral and linguistic problems compared to hearing controls.
Children with minimal SNHL experienced more difficulty than NH children on a series of educational and functional test measures.
% of children with minimal SNHL had failed at least one grade.
31
what to expect with minimal hl children
they are more likely to repeat a grade, linguistic issues, behavioral issues & educational and functional test measures will be flagged as delayed on those tests
are there differences bw audiologist with fitting amp with unilateral loss
yes
Inconsistent practice from audiologists who recommended amplifications in 60.1% of children with mild loss and 26.1 % of those with unilateral hearing loss.
minimal hearing loss needs _____ SNR
higher
Why may a 15 dB hearing loss result in language delay?
Nature of speech sounds!
Major amount of speech energy reside in the voiced vowels and consonants.
The unvoiced consonants /s, p, t, k, th, f, sh/ contain so little speech energy that they often fall below even normal hearing thresholds in an average rapid conversation.
