Assessment of the child's hearing
Until recently, it was not possible to assess the child's hearing before the age of 6 months, and the use of hearing aids was practiced only from 18 months. In many children, hearing damage was not detected until the age of two. Modern technologies provide diagnostics of hearing pathology in newborn children with the possibility of using the hearing aid for up to 6 months. It is necessary everywhere to introduce screening, which will preserve the child's speech abilities.
Reaction to sound
At the age of 6 months, a child with normal hearing responds to a sudden loud sound by blinking or widening the eyes. At the reception, the doctor will ask the parents if they observe such a reaction in the baby, and also about the presence of hearing problems in the family.
Hearing development
Kids over the age of three months turn in the direction of the source of sound. At the age of 6 months they already react to quieter sounds - this is the test that is checked with the auditory test. At 9 months the baby begins to babble. Older children perceive simple commands without a visual signal. Hearing disorders in children are congenital or acquired. The cause of the pathology of hearing can be localized in the outer, middle or inner ear.
Sensorineural hearing loss
Sensorineural hearing loss develops with damage to the cochlea of the ear, nerves that supply blood to the inner ear, or the area of the brain responsible for the hearing. There are several reasons:
- genetic - deafness can be congenital;
- infectious diseases of the pregnant woman - rubella, toxoplasmosis or cytomegalovirus infection;
- complicated labor with severe asphyxia (suffocation) of the child;
- neonatal jaundice - with an excessively high level of bilirubin;
- complication of bacterial meningitis.
Conductive Hearing Loss
Conductive hearing loss occurs when the conduction of sound to the cochlea in the outer or middle ear is disturbed. In the external auditory canal, a sulfur plug can be formed that causes earaches and deafness. Normally, the earwax is evacuated from the ear by itself. In older infants and children under three years of age, sometimes after a cold, exudative otitis develops, in which a viscous fluid accumulates in the middle ear, causing a decrease in hearing. Infection or trauma to the ear can lead to rupture (perforation) of the tympanic membrane between the middle and outer ear, which is accompanied by a sharp hearing loss. All children are screened for hearing during the first year of life. Traditionally, a child's hearing test is conducted between the ages of seven and nine months, often in conjunction with an overall developmental assessment.
Hearing Testing
During this gest, the child sits on the mother's lap, and the nurse is in front of the child and distracts him with a toy. Then the toy is removed, and the doctor, who is away from the child beyond his sight, makes a loud sound. The child should turn in the direction of the source of sound. The test is performed on both sides with different intensity of sound. If the child has a cold or is naughty and does not respond properly, the test is repeated after a few weeks. In case of doubt, as a result of the test, the child is referred for consultation to the audiologist. With otoscopy, the pathology of the middle ear can be identified, which should be differentiated from nerve damage with a simple device - an impedance audiometer.
Neonatal test
In developed countries, the test for determining the source of sound is being replaced by a neonatal screening test that allows one to evaluate the function of the inner ear. This painless procedure takes a few minutes and can be performed in a newborn child before discharge from the hospital or during the first three months of life. The device that makes clicking sounds is placed near the ear of a sleeping child. Normally, the snail of the inner ear generates an echo that is picked up by the device. This test allows you to clearly predict the normal development of hearing. However, there are also possible errors due to the presence of remnants of amniotic fluid and a damp grease in the ear of the newborn. In this case, the test is repeated after a few weeks. If the function of the child's auditory organ is still in doubt, resort to more complex tests to determine the degree of hearing loss.
Later tests
Children who have undergone a neonatal screening test do not need a hearing test at 8 months. However, hearing impairment may develop later, so if parents are worried or if there are risk factors such as deafness in the family or a history of meningitis, hearing acuity is checked in older children. After diagnosing the severe pathology of the hearing organ in a child, he is selected a hearing aid, working on the principle of an amplifier. Breasts usually carry well hearing aids, problems are more likely to occur in older children who may refuse to wear them. In such cases, the parents require great perseverance and patience.
Speech Therapy
Children with hearing impairment are included in the interdisciplinary program of speech and language therapy. In some children with deep bilateral deafness hearing aids improve hearing is not enough for the normal development of speech. In such cases, it is necessary, as early as possible, to teach parents and the child to communicate using sign language.
Cochlear Implants
Some children show the installation of a cochlear implant. This complex operation is carried out only in specialized centers. The technology involves the introduction of an electrode that bypasses the non-functioning parts of the inner ear. Although cochlear implants do not restore hearing, the patient can learn to interpret sounds that will help him communicate with people. Now we know what the physical development of a child with hearing impairment should be.