New York Eye and Ear Infirmary
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Hearing Loss in Children

Early Intervention Program  212-979-4621

Parents often feel alone and overwhelmed when their child is first diagnosed with hearing loss. You will be asked to make decisions about hearing technology, what method your child will use to communicate and what kind of learning program you want for your child and family. First, remember you are not alone.

Early on, most families report that they struggle to know what is right or what feels like the best fit. Fortunately, early identification of hearing loss gives parents the opportunity to gather information and make informed decisions that are right for their child and their family from the very start. You can also talk to audiologists, speech-language pathologists, educators, social workers and psychologists who can help you sort through all the choices and find the answers that will keep your baby on track.

Contact parents who have experience raising children with hearing loss and can share their insights. Learning from their experiences may help you define your own choices. To find other parents in your area, ask your audiologist for other families or resources to connect with others.

Make sure your child has proper amplification

Diagnostic Audiologic Evaluation
A thorough hearing test conducted by an audiologist (hearing specialist). An in-depth ABR test is usually used to determine a baby’s hearing status. This test will confirm whether or not hearing problems exist, and if so, to what degree.

Digital Hearing Aid
A digital hearing aid is a hearing aid device that receives sound and digitizes it (breaks sound waves up into very small, discrete units) prior to amplification.

Dynamic Range
The difference between the softest sounds one can hear and the loudest sound tolerated.

ENT  (also Otolaryngologist)
Ear Nose & Throat - A physician who specializes in disorders of the ear, nose or throat.

Ear Canal
The passageway from the outer ear to the eardrum.

Eardrum
Also called the tympanic membrane; the eardrum separates the outer ear from the middle ear and is important in conducting sound to the middle ear and inner ear.

Ear Infection
The presence and growth of bacteria or viruses in the ear.

Earmold
A custom-made mold, used with a behind-the-ear hearing aid, which delivers amplified sounds into the ear.

Earwax
An oily substance that lubricates the ear.  Everyone produces earwax and the production of earwax regulates naturally. Earwax can harden in the ear canal and thereby block it. It should be removed only by an otologist. Also called cerumen.

Early Intervention
EI is a comprehensive interagency program that supports infants and children to age 3 with developmental delays in their efforts to realize their full potential. It reduces the likelihood of delays among at-risk children, assists and empowers families to meet their child's and their own needs, and entitles children to services through the program. Development delays may be in one or more of the following areas of development: cognitive, physical, communication, social/emotional, and/or adaptive

Evoked Otoacoustic Emissions (OAE, EOAE, TEOAE, DPOAE)
Otoacoustic emissions are clinically important because they are the basis of a simple, non-invasive, test for hearing defects in newborn babies and in children who are too young to cooperate in conventional hearing tests. An otoacoustic emission (OAE) is a sound which is generated from within the inner ear.This is a test that measures how well a child’s cochlea, or inner ear works. A soft rubber ear piece is placed in the baby’s outer ear and makes a soft clicking sound. Ears with a normal cochlear will “echo” the sound back to a microphone inside the ear piece that is in the baby’s ear.

Feedback
In hearing aids feedback is ‘whistling’ or ‘howling’, which is created when the amplified sound from the hearing aid escapes from the ear canal through ear mold vents or slit leaks and is picked up by the microphone of the same hearing aid.

FM System
Hearing aids alone do not always make listening easier in all situations. The things that can interfere with listening are background noises, distance from a sound and reverberation or echo. An FM system is a system which can be added to a hearing aid, when the hearing impaired person has to listen in difficult hearing situations. An FM system keeps the listening distance close no matter what the child is doing. It consists of a microphone,  amplifier and receiver, and can be used with a hearing aid or cochlear implant.

Frequency
The unit of measurement related to the pitch of a sound. Frequency is expressed in Hz (Hertz). The greater the Hz, the higher the pitch. Standard hearing evaluations usually test 250 Hz to 8000 Hz.

Hard of Hearing
Hard of hearing refers to someone who doesn’t hear well. A loss that is less than profound is generally considered hard of hearing. This may be because they were born with a hearing loss or they may have lost some of their hearing later in life. 

Hearing Aid
A wearable instrument intended to aid a person with impaired hearing, usually consisting of a microphone, amplifier and earphone, powered by a low voltage battery. Hearing aids can be worn behind the ear, in the ear and sometimes on the body. Hearing aids do not restore normal hearing but can improve the wearer’s ability to hear.

Hearing Loss
Hearing loss is reduced ability to perceive sound in relation to a person with normal hearing. There are different types of hearing loss. Conductive hearing loss, which is caused by a problem of the outer or middle ear, and sensorineural hearing loss, which is a result of a malfunction of the sensory cells and the nerve fibers in the inner ear. A diagnostic audiologic evaluation is needed to confirm if a child has a hearing loss, and to determine what degree of hearing loss a child has. It is important to diagnose a hearing loss as early as possible so that early intervention services can begin.

Hearing Screening
A hearing screening determines if an infant’s hearing is normal at the time of testing, or if more testing is necessary. A screening test is not the same as a diagnostic evaluation, which defines an infant’s hearing more thoroughly. If there are any problems on a hearing screening, the infant’s hearing will usually be re-screened. If necessary, after the second screening test, an infant may be referred for a diagnostic audiologic evaluation.

Hearing Threshold Level (HTL)
The faintest intensity level (in dB hearing level) that a person can hear a sound of a particular test frequency. Also known as HL.

Hz (Hertz)
When testing hearing, Hz is used to indicate the frequency of a sound, or the pitch. The lower the number, the lower the pitch. The higher the number, the higher the pitch. A 250 Hz sound is a very low pitch, and an 8000 Hz sound is a very high pitch.

Individualized Education Program
Although not directly related to hearing loss, IEPs are of interest because they are used to define the specific educational needs of individual children. For children with “disabilities” or “delays”, the IEP is required by law. An IEP team including professionals from the school system (in cooperation with the child’s parents) writes the IEP for each child.

Individuals with Disabilities Education Act (IDEA)
IDEA is a US federal law that requires certain educational standards and accommodations for people with disabilities, including children with hearing loss.

Infection
Both bacterial and viral infections may result in hearing loss. The most common infection causing hearing loss is middle ear infection, Otitis Media. Bacterial infections of the brain such as meningitis may affect the cochlear labyrinth, resulting in severe sensorineural hearing loss. Viral infections such as measles and mumps may result in a sensorineural hearing loss.

Language
Language is communication through a system of rules that include: what words mean, how to create new words, how to combine words together and what word combinations are best for certain situations. Language can be a system of arbitrary signals, such as voice sounds, gestures, or written symbols. A person can have difficulty understanding a language system resulting in a receptive language problem or a person may understand a language but is unable to effectively use the rules to share thoughts, ideas and feelings resulting in an expressive language problem.

Mainstreaming
Mainstreaming is a school placement option in which children go to regular classes and they also go to some special education classes.  These classes are called resource classes and are taught by specially trained teachers.  Inclusion is a placement option in which the children are totally involved in all aspects of public education. 

Nerve deafness
A lay term used to describe sensorineural hearing loss.

Newborn Hearing Screening
Newborn infant hearing screening programs are designed to identify hearing loss in infants shortly after birth. All states have implemented these screening protocols within hospitals and birthing clinics. About 95% of hearing screening tests are done prior to discharge from the hospital or birthing clinics.Typically, nurses or medical assistants are trained extensively on how to operate automated equipment for testing infants. Prior to discharge, each newborn has his/her hearing tested. If the newborn does not pass the screen, a rescreen is usually done. If the infant still does not pass the second hearing test, he/she is referred to a specialist for further testing.

Ossicles
The chain of three tiny bones in the middle ear (malleus, incus, stapes).

Otitis Externa
An inflammation of the outer part of the ear extending to the auditory canal.

Otitis Media
An inflammation of the middle ear caused by infection.

Otolaryngologist (ENT)
A medical doctor who specializes in ear nose & throat disorders. Otolaryngologists can diagnose and treat middle ear infections and medical problems that may affect your child’s hearing.

Pass
A “Pass” result on a hearing screening means that a baby has grossly normal hearing on the day of the test. It does not predict how a child will hear in the future. A child’s hearing should be re-tested at any time if speech-language milestones are not being met, or if there are parental concerns.

Pediatrician
A medical doctor who diagnoses and treats most childhood illnesses. He or she can answer questions about your child’s general health.

Perforated Ear Drum
A hole or tear in your eardrum, the thin drum-like tissue that separates your ear canal from your middle ear. A perforated eardrum may result in hearing loss and make the middle ear vulnerable to infections or other injury. A perforated eardrum may heal within a few weeks without treatment. Sometimes, you may need a procedure to promote healing of a ruptured eardrum or need surgical repair for a ruptured eardrum.

Play Audiometry = The audiologist trains the child to respond with some action whenever (s)he hears the sound.

Pressure-Equalizing (PE) Tube
A tube that is surgically inserted in the eardrum by an otolaryngologist to equalize the pressure between the middle ear and the ear canal and to permit drainage. Also called a tympanostomy tube.

Refer
A “Refer” result means that further testing is necessary to evaluate an infant’s hearing. This could mean that a hearing problem may exist, but further testing is needed to confirm. Reasons for a refer following a newborn hearing screening include (but are not limited to)  birthing debris in the ear canal, middle ear fluid or infection, or a permanent hearing loss (3 in 1000 births).

Residual Hearing
The amount of measurable, usable hearing.

Sensorineural Loss
A hearing loss caused by damage to the inner ear (cochlea) and/or the hearing nerve.

Speech
Refers to the act or manner in which a person produces a sound.

Speech Awareness Threshold (SAT)
The lowest hearing level in dB at which a person can detect the presence of a speech signal. Also known as the speech detection threshold (SDT).

Speech Frequencies
The frequencies within the 500 to 4000 Hz region, which are most important for hearing and understanding of speech.

Speech-Language Pathologist
A professional who evaluates and provides treatment for aural habilitation, speech, language, cognitive communication, and swallowing problems of children and adults. Speech and language delays are frequently seen in children with hearing impairments. Minimum academic degree is a Master’s degree. State licensure is required to practice speech-language pathology in NYS.

Speech Recognition Threshold (SRT)
The lowest hearing level in dB at which 50 percent of two-syllable (spondee) words can be identified correctly. Also known as the ST (speech threshold or spondee threshold).

TTY
TTY is a telephone device, where dialog is achieved by typing words. The words are converted to phone signals and appear or are printed as words on a receiving TTY machine

Teacher of the Deaf
A.K.A. Deaf Educator or Developmental Therapist/ Hearing (DTH) Is a teacher with a Bachelor’s Degree in Special Education - Deaf and Hard of Hearing. Their studies focus on language acquisition and the unique learning and communication needs of students with hearing loss. A DTH has a background to offer families specialized information and supports related to hearing loss.

Telecoil
A wire coil contained within a hearing aid that picks up magnetic energy available from telephones or other assistive listening devices.

Threshold
The softest sound a person hears

Tinnitus
Tinnitus (pronounced ti-night’-us or tin’-i-tus), is the medical term for the perception of sound when no external sound is present; it is often referred to as “ringing in the ears.” It can also take the form of hissing, roaring, whistling, chirping or clicking. The noise can be intermittent or constant, with single or multiple tones; it can be subtle or at a life-shattering level. I

Total Communication
Total Communication is an educational philosophy. “Total Communication can best be defined as eclectic, borrowing techniques form a variety of different methods.” Ideally teachers can use sign, writing, mime, speech, pictures or any other communication method that works.  The method of communication should depend upon the needs of the student and the situation. Children are encouraged to work on speech and listening skills. Children are encouraged to develop skill in all areas (sign language, speech and audition), although children are allowed to develop a mode of communication that is best for them.

Tympanogram
The result of the tympanometry test is recorded in a visual output, called a tympanogram.

Tympanometry
A measure of the stiffness of the eardrum and thus evaluate middle ear function. This test can be helpful in detecting fluid in the middle ear, negative middle ear pressure, disruption of the ossicles, tympanic membrane perforation, and otosclerosis.

Unilateral Hearing Loss
A hearing loss in one ear only.

List of Support Groups and Information Sources

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  • DB-Link
    The National Information Clearinghouse on Children Who Are Deaf-Blind
    Teaching Research 
    Phone: 1-800-438-9376 (Voice)

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