Knowing if you infant has a hearing loss is almost impossible. One way that your doctor will indirectly assess hearing is by determining if he or she is reaching meeting speech and hearing developmental milestones.
By Six Months:
- turns to source of sounds
- startles in response to sudden, loud noises
- makes different cries for different needs – I’m hungry, I’m tired
- watches your face as you talk
- smiles and laughs in response to your smiles and laughs
- imitates coughs or other sounds – ah, eh, buh
By Nine Months:
- responds to his/her name
- responds to the telephone ringing or a knock at the door
- understands being told “no”
- gets what he/she wants through sounds and gestures e.g., reaching to be picked up
- plays social games with you e.g., peek-a-boo
- enjoys being around people
- babbles and repeats sounds – babababa, duhduhduh
By Twelve Months:
- follows simple one-step directions – “sit down”
- looks across the room to something you point to
- uses three or more words
- uses gestures to communicate – waves “bye bye”, shakes head “no”
- gets your attention using sounds, gestures and pointing while looking at your eyes
- brings you toys to show you
- “performs” for attention and praise
- combines lots of sounds as though talking – abada baduh abee
- shows interest in simple picture books
Click here to learn about the developmental milestones from 18 months to 30 months of age.
If your child is not meeting the milestones your doctor will recommend he or she has a hearing assessment. As your child cannot communicate yet the hearing tests that are performed are objective.
Hearing Test Battery
At Salus Hearing Centre we perform the following assessments on infants:
Outer Ear Assessment
The outer ear and ear canal are inspected with an otoscope that uses light to check for any blockages in the ear canal and determine the health status of the eardrum.
Middle Ear Assessment
The middle ear is assessed using a tympanometer machine. The probe of the machine is placed at the opening of the ear canal for a few seconds and to assess the eardrum’s reaction to a gentle sound and pressure wave. This test is NOT painful.
Inner Ear Assessment
If no middle ear pathology is present the inner ear will be assessed using a DPOAE machine. A probe is placed on the outside of the ear canal for 10 to 30 seconds and sounds are sent through the auditory pathway to assess the response of the delicate hair cells of the inner ear. Your child and you will have to remain silent during this test in order for it to be administered properly.
If a middle ear pathology is found during tympanometry your child will be tested in a soundproof booth to determine his or her sound awareness threshold for each ear if the child will wear headphones or for the better hearing ear in soundfield. You will sit in the booth with your child on your lap engaged in a passive activity without speaking. The audiologist will present sounds or words through the speakers on either side of you and will determine the softest level your child consistently responds by turning the the speaker. Visual reinforcements will be used after your child turns to the target sound to encourage your infant to listen for the sounds. The visual reinforcement box is above each speaker and consists of a toy that will be revealed and may make noise. Please ensure that you are not turning your head to cue your child to respond.
Some infants are prone to middle ear infections when they develop a cold. This can cause a temporary hearing loss; however, if the middle ear infection is chronic it can lead to permanent hearing loss. Therefore, if your child develops a fever with a cold and tugs on his or her ear it’s important to seek medical attention. If the ear infection lasts more than three months your doctor may prescribe medication or set up a referral to see an otolaryngologist (ear nose and throat doctor) to determine if other surgical intervention in the form of myringotomy tubes to drain the fluid in the middle ear is warranted.