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CARE AUDIOLOGY & SPEECH THERAPY CLINIC

NORMAL AUDITORY DEVELOPMENT
Your baby should be able to do the following:

Newborn (0 to 4 months) : A newborn (0 to 4 months) usually reacts suddenly to loud sounds through movements such as widening the eyes, jumping or extending the arms and legs. Parents should look for signs of localization from their child. Localization is eye movement or turning the head towards the direction of the sound source.

3 to 6 months: A baby of 3 to 6 months of age should turn and search out a different sound. They should also be able to respond to the sound of their name. During this particular developmental time, the baby will play with sounds by cooing and babbling. The baby should be smile or stop crying when either of the parents speaks to him/her. In addition, the baby should act differently to the ways the parents talk to him/her (angry, friendly, loving).

6 to 10 months:  A baby of 6 to 10 months of age should be able to seek out the sound source. When his or her name is called, the baby should look towards the speaker. In addition, the baby should respond to both soft and loud sounds. Familiar sounds such as a doorbell ringing or a dog barking should get a response from the baby. The baby should also pay attention when the parents talk to him/her.

10 to 15 months: A baby or 10 to 15 months will begin to increase his or her babbling and begin to more closely resemble speech. The baby plays with sounds and is able to put sounds together in different patterns.

15 to 18 months: A child of 15 to 18 months is able to directly localize to most sounds. In addition, the child can understand simple phrases, identify familiar objects such as body parts and follow simple directions. A child at 18 months should have an expressive vocabulary of 20 or more words and short phrases.

WHAT ARE SOME OF THE CAUSES OF INFANT HEARING LOSS?

High Risk Criteria For Hearing Loss in Infants (0 to 28 days old) *Indicators associated with sensorineural and/or conductive hearing loss in infants:
Family history of hereditary childhood sensorineural hearing loss

1. Hyperbilirubinemia
2. Ototoxic medications
3. Bacterial meningitis
4. Birth weight less than 1500 grams (3.3lbs)
5. In utero infections (cytomegalovirus, rubella, syphilis, herpes, and toxoplasmosis)
6. Craniofacial anomalies (including pinna and ear canal)
7. Apgar scores of 0-4 at 1 minute or 0-6 at 5 minutes
8. Mechanical ventilation lasting 5 days or longer
9. Stigmata or other findings associated with a syndrome known to include a sensorineural and/or conductive hearing loss
10. Delayed Onset Sensorineural Hearing Loss Indicators: affects in the inner ear and possibly beyond.
11. Family history of hereditary childhood hearing loss
12. In utero infection
13. Neurofibromatosis Type II and neurodegenerative disorders
14. Conductive Hearing Loss Indicators: affects the outer and middle ear.
15. Recurrent or persistent otitis media with effusion
16. Anatomic deformities and other disorders that affect eustachian tube function
17. Neurodegenerative disorders

Hearing Loss due to Prenatal Factors: (Congenital Hearing Loss - the child is born with the hearing loss)
Prenatal damage to the cochlear may be due to the partial or lack of cochlear development (inner ear), viral or parasitical invasion, spontaneous malformations or inherited syndromes. The most common syndromes are Usher's syndrome and Pendred's syndrome. Usher's syndrome results in a hearing loss that ranges from moderate to profound and a degenerative visual loss. Any child with a profound hearing loss should be evaluated for eye disorders. Pendred's syndrome is a recessive endocrine-metabolic disorder characterized by goiter formation and results in a moderate to profound sensorineural hearing loss that is usually progressive in nature.
Other syndromes that cause hearing loss include:

1. Congenital Rubella
2. Toxoplasmosis
3. AIDS
4. Herpes I and II
5. Cytomegalovirus (CMV)
6. Congenital Rubella
7. Congenital hearing loss may be also diagnosed with the label "unknown".
8. Disorders Causing Hearing Loss at Birth:
9. RH-Incompatibility
10. Congenital Syphilis
11. Anoxia or asphyxia at birth
12. Persistent Fetal Circulation (pulmonary hypertension)
13. Low Birth Weight
14. High Forceps Delivery
15. Violent Uterine Contractions

IF MY CHILD HAS A HEARING LOSS, WHAT DOES THIS MEAN?

Most children with hearing loss can hear some speech, however, the speech tends to lack clarity since the hearing loss occurs in the higher frequencies that contain most of the consonant and vowel sounds necessary for understanding speech. However, since the child is able to respond to the lower frequencies, he or she will usually be identified later on. As a result of late identification, speech and language skills will have significant delays. Early identification is necessary before sixth months of age in order to catch that specific time frame in which optimal speech and language development occurs. Formal audiological evaluations are needed to rule out less severe but equally disabling degrees of hearing loss.