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Indiana State Department of Health

CDHHE Home > Early Hearing Detection and Intervention (EHDI) > Services for Children Services for Children

Evaluation

If your baby did not pass his/her newborn hearing screen, he/she should have his/her hearing evaluated by an audiologist as soon as possible. An audiologist is a health care provider who specializes in working with people with hearing loss.

 

It is important for parents to know that not every baby who did not pass his or her newborn hearing screen actually has hearing loss.

  • Sometimes the baby is too noisy (moving or crying) for accurate screening.
  • Often there is vernix (which normally is found on a baby’s skin at birth) in the ear canal, which can affect the screening test.
  • Sometimes there is fluid in the middle ear space.

It is important to have the diagnostic assessment completed to learn how your baby is hearing.

Your baby’s birthing facility or primary care provider should help you with making an appointment for your baby to be seen by an audiologist for additional hearing testing. You can also contact an audiologist on your own by clicking here and calling the audiology facility closest to your home. The Indiana State Department of Health Early Hearing Detection and Intervention (EHDI, pronounced “Eddie”) Program can also help you. To contact the EHDI Program, please call (888) 815-0006.

Babies who are referred for audiology diagnostic evaluation should receive a complete audiological (hearing) evaluation. This evaluation is done to determine how your baby is hearing, as well as look for possible causes of a baby’s hearing loss.

Diagnostic testing uses the automated auditory brainstem test and other tests to determine how your baby hears. The tests can be done at various loudness levels and at different pitches (high sounds and low sounds). If testing is done before your baby is 3 months of age, the tests can usually be completed while your baby sleeps. For older or more active babies, medicine may be needed to help your baby sleep during the tests. It is important for babies to be quiet and not move much during testing, so the results of the diagnostic testing are accurate.

For more information on diagnostic testing for hearing loss, please click here.

Intervention

If your baby has been confirmed to have hearing loss, he/she should be referred to First Steps for direct intervention services right away. These services will give you information about the range of available options so that you can make the best decision regarding care and treatment of your child. Babies who are enrolled in direct early intervention services, especially before age 6 months, tend to make the fastest progress.

There are many professionals available to help you. For more information about First Steps, please click here.

Treatment / therapies

  • Hearing aids
    Hearing aids are devices worn in the ear to allow a person to hear conversation and sounds in the environment. Your baby's doctor must approve use of this device.

  • Cochlear implant
    A cochlear implant is a hearing device placed in the ear by surgery. People can have either one cochlear implant or two cochlear implants. Cochlear implants are usually used to help people with severe or profound hearing loss who did not receive significant help from hearing aids. Your baby's doctor must approve use of this device.

  • Communication interventions

    • Auditory/oral (listening and talking) communication
    • Visual (by sight) communication (such as American Sign Language)
    • Combined auditory/oral and visual communication

    • Hearing technology (including FM systems)
      Hearing technology is available for every type and degree of hearing loss. One example of hearing technology for newborns or children is an FM system. An FM system is a two-part device—both the person talking and the person listening wear part of the FM system. The person talking wears a transmitter (of speech). The person listening wears a receiver (of speech). Speech is transmitted through an FM signal (like a radio signal). An FM system allows a child to be within “earshot” (about six inches away) from the speaker’s voice at all times.

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    What should I do if my baby is diagnosed with hearing loss?

    Learning that your child has been diagnosed with hearing loss can be overwhelming. You may be unsure about how you can communicate with your baby. Remember that you are already an expert at communicating with your child!

    Everyone has made a funny face at a baby and watched for that baby to smile. Communication is not just about spoken or written words- it involves touching, smiling, hugging or kissing your baby, rocking your baby, singing, or laughing. Most babies with hearing loss have some hearing (called residual hearing) and can partially hear voices, especially when you are close to the baby.

    Some suggestions and reminders for parents about early communication with your baby are listed below.

    • Hold your baby close so that he/she can see your face.
    • Make eye contact often.
    • Use good lighting. If the room is too dark or too bright, your baby will have trouble seeing your face.  
    • Keep the room as quiet as possible. Turn off the TV, dishwasher, vacuum, etc. when you want your baby's attention.
    • Don't shout. Talk to your baby as you would any other child.
    • Imitate the sounds that your baby makes. When he/she makes noises, respond with a smile.
    • Make sure to talk and laugh with your baby often.
    • Enjoy each moment of communication with your baby.

    You are already building communication skills you will need to make decisions about formal communication opportunities for your baby later. Right now, you can begin developing his/her communication with touch, vision, gesture, and lots of love.

    Below are additional steps that parents should consider completing as soon as possible after hearing loss has been confirmed.

    Medical Evaluation

    Children who are diagnosed with hearing loss should be referred to an otolaryngologist (ear, nose, and throat physician, also called an ENT) for a thorough check-up. An otolaryngologist is a board-certified physician who has a specialized knowledge and skills regarding the ears, nose, and throat. He/she will evaluate your child to determine if there may be a medical reason for his/her hearing loss. After an ENT evaluation, the physician will determine if your child is "cleared" to receive amplification for treatment of his/her hearing loss (this is also called medical clearance for amplification). Most children with a hearing loss can benefit from the use of hearing aids and other assistive (helpful) technologies.  

    Hearing Technologies

    If you choose amplification for your child, return to your child’s audiologist so that your child can be fitted for ear molds and have an evaluation with hearing aids. Your child’s audiologist will determine which hearing aid is the best match to your child’s hearing loss. You can help the audiologist by observing your child’s behavior with his/her hearing aids and telling your child’s audiologist how you think your child is responding to sound.

    Some families who have children with a severe to profound hearing loss in both ears may consider a Cochlear implant. A cochlear implant is a hearing device placed in the ear by surgery. People can have either one cochlear implant or two cochlear implants. If you are interested in learning more about if a cochlear implant is right for your child, talk you child’s audiologist, ENT, or early intervention provider.  Your baby's doctor must approve use of this device.

    Other types of hearing technology may be appropriate to use with your child.  Hearing technology is available for every type and degree of hearing loss. One example of hearing technology for newborns or children is an FM system. An FM system is a two-part device—both the person talking and the person listening wear part of the FM system. The person talking wears a transmitter (of speech). The person listening wears a receiver (of speech). Speech is transmitted through an FM signal (like a radio signal). An FM system allows a child to be within “earshot” (about six inches away) from the speaker’s voice at all times. Talk with your child’s audiologist or early intervention provider if you would like more information about other hearing technologies.

    Intervention

    Most children with hearing loss (90%) are born into families in which both parents have normal hearing.  Because hearing loss affects how a child’s communication skills develop, most babies and toddlers with hearing loss will need and benefit from regular and consistent early intervention sessions.

    Children diagnosed with hearing loss should be referred to First Steps for direct intervention services right away. These services will give you information about the range of available options so that you can make the best decision regarding care and treatment of your child. Babies who are enrolled in direct early intervention services, especially before age 6 months, tend to make the fastest progress.

    Children with hearing loss should have a communication evaluation done by a professional who is trained and experienced in working with children with hearing loss. These professionals may be speech-language pathologists, audiologists, early childhood educators with special training in hearing loss, or early intervention deaf educators. These professionals usually have completed graduate-level studies in the field of hearing loss. This evaluation will take 3 – 4 hours and will give you information regarding your child’s abilities and levels of functioning in communication and other developmental areas.

    After the communication evaluation, most children diagnosed with hearing loss should be enrolled in treatment with an early intervention specialist who is trained and experienced in working with young children with hearing loss. An early intervention specialist may be a speech-language pathologist, an audiologist, an early childhood educator with special training in hearing loss, or an early intervention deaf educator.

    Children diagnosed with hearing loss should continue to see their audiologist for audiological (hearing) management. This management may include other hearing evaluations, ear mold impressions and fittings, or hearing aid adjustments.