Your anxiety about your baby or young child’s hearing ability has led you to have his or her hearing tested. Testing hearing, especially in babies and young children takes time and cannot be completed in a single session. It is critical that the test battery of electrophysiological and behavioural tests be completed as each test gives information about the functioning of different parts of the hearing mechanism
Once complete and reliably obtained test results on your baby’s or young child’s hearing status is presented, your audiologist will begin discussing fitting your child with a hearing device. Make sure that you understand the information being conveyed by these test results: do not hesitate to ask your audiologist questions to seek a more complete understanding. Now that hearing loss has been established, your audiologist will proceed to recommend hearing aids. Understandably, this is a difficult time for you: you know that those hearing aids demonstrate that your baby or young child has hearing difficulty. Meeting other families with children of the same age with similar configurations of hearing loss may help at this time. Looked at another way, hearing aids represent the first steps you are taking as a family, towards facilitating growth in your baby, such that s/he can grow like others the same age. Delaying the fitting of hearing aids, deprives your baby of the tools his or her brain needs to grow like the brains of other babies the same age.
Your baby or child’s young brain is making connections to everything. Research shows that every interaction with a baby or child facilitates connections in his or her brain to be formed. Everytime you sing, play, talk to, smile at or engage your child, you are building "the architecture” of your child's brain. These connections were being formed even when you were pregnant. What your baby or young child understands today therefore, is a culmination of all these different interactions.
Hearing aids will make all that you say and all the sounds of your environment louder, so that your baby will hear sound and speech which were hitherto inaudible, in a manner that your baby’s brain can better understand and use to grow.
Appropriately fitting hearing aids without delay, connects your baby to the world of Sound and allows him or her to learn. Delaying the decision to fit hearing aids on to your baby deprives him or her of all the learning opportunities that the brain needs to grow like that of other children.
Hearing aids today are very sophisticated and need care in order to maintain them in good working order. For more information on the care and maintenance of hearing aids and earmoulds.
Your audiologist has informed you of your child’s hearing levels and explained the impact of that hearing difficulty on your baby or young child’s everyday living.
Your baby or young child needs to wear hearing aids throughout all waking hours so as to
-connect to the world of Sound, allowing him or her to feel safe and secure in the surrounding environment.
–to recognise the direction from which sound, speech and music are coming from.
-to understand (and not just hear) what you and the rest of your family, friends and community are saying, singing, whispering and reading to him or her.
–to hear better from a distance.
–to hear better in noise.
Your baby or young child needs to wear hearing aids to keep the hearing nerve or auditory nerve alive so that it carries the message of all these interactions to the brain, in a manner that can be used by your child’s brain, to grow.
If your audiologist recommends that your child’s hearing levels require him or her to be fitted with two hearing aids, you are best advised to follow this advice.
Binaural amplification (or fitting two hearing aids) helps your baby or young child recognise the direction from which sound is coming, giving your child a sense of predictability and security. Further, binaural amplification, allows your baby or young child’s brain to grow synchronously, as both sides of the brain are being stimulated. Binaural amplification provides a more natural quality of sound to the ear systems. Listening in noise, always a challenge especially for those with hearing difficulty, may become less exhausting. Research shows that children appropriately fitted with two hearing aids that are in good working condition, hear better.
Your audiologist will have explained to you that the damage to the hair cells in your child’s ear/s makes your baby’s or young child’s hearing loss, permanent. It may progress further over time, which is why your audiologist will have explained that it needs to be monitored on an on-going basis.
In specific instances, there may be a possibility of spontaneous recovery of hearing. Your audiologist will have already told you about any chance of spontaneous recovery that your baby’s ear structures may experience, together with the time frame within which that may happen, based on your baby’s specific birth history. In the event that this is applicable to your child, your audiologist will have explained the need to monitor your baby’s hearing loss and specified the time interval for this monitoring.
Hearing aids cannot grow the damaged hair cells back; nor can they restore hearing.
Your audiologist will have explained to you that your child’s behind-the-ear hearing aids use the same pathway that ears with typical hearing use,( as shown below) to deliver sound and speech to your child's brain.
Hearing aids make sounds and speech louder. Sounds and speech that were hitherto inaudible, may now become audible for your child. Your audiologist will explain to you that it is only through on-going observation while testing and in therapy that you will better understand what your baby or young child does not hear and does not understand of what you say or the sounds in your environment.
In order to derive the benefit your baby needs to develop age-appropriately (or like other babies with typical hearing the same age), it is critical that your baby wears his/ her hearing aids throughout all waking hours. Keeping hearing aids on tiny ears takes persistence. Persist! Allow your audiologist to guide you to get those hearing aids back on and immediately, everytime your baby yanks them off.
Your Auditory-Verbal therapist will guide you to facilitate that your baby will so accept hearing aids as being his or her "ears", that you will gently take them off only after your baby has fallen asleep every night.
In order to listen and understand, your baby’s brain needs the speech signal to be delivered clearly to it. Making the speech signal indiscriminately louder only creates distortion and doesn't facilitate better learning. More importantly, over amplification, or making the sound or speech signal inordinately loud, risks damaging your baby or young child's hearing.
It is therefore critical that you consult a qualified audiologist who will set your baby’s or young child’s hearing aids appropriately.
It is highly recommended that the hearing aids fitted on your baby or young child are those that your audiologist has recommended after having tested your child's hearing and set the hearing aids to best suit your child's hearing levels across the frequency range, in each ear.
It is important that hearing aids are fitted:
-after considering test results from both electrophysiological and behavioural testing.
- on the basis of behavioural testing, in which ear specific and frequency specific responses have been reliably obtained based on observation and in your presence. BERA in isolation cannot be the basis on which hearing aids are fitted.
– in accordance with the responses given by your baby or young child at different intensities across the frequency range and also in response to speech.
Your audiologist and Auditory-Verbal therapist will be continuously reviewing your baby or young child’s progress with hearing aids with you, especially in the early months following fitting. Together you will be observing and gathering diagnostic information that supports that your baby's hearing or auditory nerve is being sufficently stimulated by the hearing aids.The main question to consider is, whether or not hearing aids are allowing your child to progress at the pace s/he needs to, in order for his/her development to be the same as that of other children, the same age.This is termed age-appropriate development. At Sound Steps, it takes approximately eight weeks post hearing aid fitting to determine this, assuming that your baby or young child is wearing his/her hearing aids during all waking hours and you are consistently following up on targets set in weekly Auditory-Verbal Therapy sessions.
In the event that the conclusion on appropriate and consistent hearing aid usage suggests insufficient benefit for your child to learn at a pace that will facilitate age-appropriate development, despite all adjustments to hearing aid technology, other technologies, such as cochlear implants must be discussed, in a timely manner, provided the results of a CT scan and MRI do not suggest otherwise. This allows the intervention to capitalise on the brain’s ability to re-wire itself adeptly, as close to birth as possible.
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