Deafness and Hearing Loss Caroline’S Story
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Deafness and Hearing Loss Caroline’s Story Caroline is six years old, A publication of NICHCY with bright brown eyes and, at Disability Fact Sheet #3 June 2010 the moment, no front teeth, like so many other first graders. She also wears a hearing aid in each ear—and has done so since she was three, when she Caroline was immediately Hearing Loss was diagnosed with a moderate fitted with hearing aids. She in Children hearing loss. also began receiving special education and related services Hearing is one of our five For Caroline’s parents, there through the public school senses. Hearing gives us access were many clues along the way. system. Now in the first grade, to sounds in the world around Caroline often didn’t respond she regularly gets speech us—people’s voices, their to her name if her back was therapy and other services, and words, a car horn blown in turned. She didn’t startle at her speech has improved warning or as hello! noises that made other people dramatically. So has her vocabu- jump. She liked the TV on loud. lary and her attentiveness. She When a child has a hearing But it was the preschool she sits in the front row in class, an loss, it is cause for immediate started attending when she was accommodation that helps her attention. That’s because three that first put the clues hear the teacher clearly. She’s language and communication together and suggested to back on track, soaking up new skills develop most rapidly in Caroline’s parents that they information like a sponge, and childhood, especially before the have her hearing checked. The eager for more. age of 3. When hearing loss most significant clue to the goes undetected, children are preschool was Caroline’s delayed in developing these unclear speech, especially the skills.1 lack of consonants like “d” and Recognizing the importance “t” at the end of words. of early detection, the Centers So Caroline’s parents took is the for Disease Control and Preven- tion (the CDC) recommends her to an audiologist, who National Dissemination Center that every newborn be screened collected a full medical history, for Children with Disabilities. examined the little girl’s ears for hearing loss as early as possible, usually before they inside and out, ran a battery of NICHCY leave the hospital. Catching a hearing tests and other assess- 1825 Connecticut Avenue N.W. hearing loss early means that ments, and eventually diag- Washington, DC 20009 treatment can start early as well nosed that Caroline’s inner ear 1.800.695.0285 (Voice / TTY) and “help the child develop (the cochlea) was damaged. The 202.884.8200 (Voice / TTY) communication and language audiologist said she had senso- [email protected] skills that will last a lifetime.”2 rineural hearing loss. http://nichcy.org Disability Fact Sheet #3 (FS3) Types of Hearing Loss cells of the inner ear or the How Common is nerves that supply it. These Hearing Loss? Before we describe the types hearing losses can range from of hearing loss a person may mild to profound. They often Each year in the United have, it’s useful to know that affect the person’s ability to States, more than 12,000 babies sound is measured by: hear certain frequencies more are born with a hearing loss; than others. Thus, even with 4 • its loudness or intensity often, the cause is unknown. amplification to increase the (measured in units called Profound deafness occurs in 4- sound level, a person with a decibels, dB); and 11 per 10,000 children; in at sensorineural hearing loss may least 50% of these cases, the • its frequency or pitch perceive distorted sounds, cause is genetic.5 (measured in units called sometimes making the success- hertz, Hz). ful use of a hearing aid impos- Through the Universal sible. Newborn Hearing Screening Hearing loss is generally program, many states now described as slight, mild, mod- A mixed hearing loss refers to mandate that all newborns be erate, severe, or profound, a combination of conductive screened for hearing loss within depending upon how well a and sensorineural loss and hours of birth.7 person can hear the intensities means that a problem occurs in or frequencies most strongly both the outer or middle and Signs of a Hearing Loss associated with speech. Impair- the inner ear. or Deafness ments in hearing can occur in A central hearing loss either or both areas, and may Just as with Caroline, our results from damage or impair- exist in only one ear or in both first grader, there will be signs ment to the nerves or nuclei of ears. Generally, only children that a child may not be hearing the central nervous system, whose hearing loss is greater normally. Parents may notice either in the pathways to the than 90 decibels (dB) are that their child: brain or in the brain itself. considered deaf. A diagram of the ear.6 There are four types of hearing loss, as follows.3 Outer ear Middle ear Inner ear Conductive hearing losses are caused by Semicircular diseases or obstructions in canals the outer or middle ear (the pathways for sound to reach the inner ear). Conductive hearing losses usually affect all frequen- Pinnus cies of hearing evenly Auditory and do not result in nerve severe losses. A person with a conductive hearing loss usually is able to use a hearing aid well or can be helped medically or External surgically. auditory canal Sensorineural hearing Eustachian Cochlea losses result from damage Eardrum tube to the delicate sensory hair NICHCY: http://nichcy.org 2 Deafness and Hearing Loss (FS3) • does not respond • complications during To access early interven- consistently to sounds or pregnancy (such as tion: To identify the EI to his or her own name; the Rh factor, program in your neigh- maternal diabetes, borhood, consult • asks for things to be re- or toxicity). NICHCY’s State-Specific peated or often says “huh?” Information for your A child’s hearing • is delayed in developing state (online at: http:// loss or deafness may nichcy.org/state- speech or has unclear also be a characteristic speech; organization-search-by- of another disability state). Early interven- • turns the volume up loud such as Down syn- tion is listed under the on the TV and other elec- drome, Usher syndrome, first section, State Agen- tronic devices.8 Treacher Collins syn- cies. The agency that’s drome, Crouzon syn- identified will be able to Causes of Hearing Loss 10 drome, and Alport syndrome. put you in contact with the and Deafness In all cases, early detection early intervention program in your community. There, you can Hearing loss and deafness and treatment are very impor- have your child evaluated free can be either: tant to the child’s development. of charge and, if found eligible, • acquired, meaning that the Is There your child can begin receiving loss occurred after birth, due Help Available? early intervention services. to illness or injury; or Yes, there’s a lot of help To access special education and • congenital, meaning that the available, beginning with the related services: We recommend hearing loss or deafness was free evaluation of the child. The that you get in touch with your present at birth. nation’s special education law, local public school system. Calling the elementary school The most common cause of the Individuals with Disabilities Education Act (IDEA), requires in your neighborhood is an acquired hearing loss is expo- excellent place to start. The 9 that all children suspected of sure to noise. Other causes can school should be able to tell include: having a disability be evaluated without cost to their parents to you the next steps to having • build up of fluid behind the determine if they do have a your child evaluated free of eardrum; disability and, because of the charge and, if found eligible, he disability, need special services or she can begin receiving • ear infections (known as under IDEA. Those special services specially designed to otitis media); services are: address your child’s needs. • childhood diseases, such as • Early intervention | There are also special mumps, measles, or chicken A system of services to services available to low-income pox; and support infants and toddlers children through the Early Periodic Screening, Diagnosis, • head trauma. with disabilities (before their 3rd birthday) and their and Treatment (EPSDT) pro- Congenital causes of hear- families. gram, the child health compo- ing loss and deafness include: nent of Medicaid. To learn more • Special education and about the EPSDT program, visit: • a family history of hearing related services | Services http://mchb.hrsa.gov/epsdt/ loss or deafness; available through the public • infections during pregnancy school system for school- (such as rubella); aged children, including preschoolers (ages 3-21). NICHCY: http://nichcy.org 3 Deafness and Hearing Loss (FS3) More on IDEA “hearing impairment.”12 How- ever, the number of children It’s helpful to know that, with hearing loss and deafness while the terms “hearing im- is undoubtedly higher, since pairment” and “hearing loss” many of these students have are often used to describe a other disabilities and may be wide range of hearing losses, served under other categories. including deafness, IDEA actually defines the two terms Educational Implications separately, as follows: Hearing loss or deafness Hearing impairment is does not affect a person’s idiomatic expressions, and defined by IDEA as “an intellectual capacity or ability to other aspects of verbal commu- impairment in hearing, learn. However, children who nication. For children who are whether permanent or are hard of hearing or deaf deaf or have severe hearing fluctuating, that generally require some form of losses, early, consistent, and adversely affects a special education services in conscious use of visible com- child’s educational order to receive an adequate munication modes (such as sign performance.” education.