Every day close to 2 000 babies are either born with or will acquire permanent hearing loss within the first few weeks of life. At least 90% of them live in developing countries like South Africa. That means that every day there are at least 2000 new mothers and families faced with the emotional, social and financial challenges that come with caring for a hearing-impaired child.
This is according to Dr De Wet Swanepoel, who forms part of the Department of Communication Pathology at the University of Pretoria. According to Oticon, a global leader in hearing aids, the number of people in need of hearing support is predicted to increase by one third per generation over the coming century and there is currently estimated to be about 500 million people worldwide suffering from hearing loss.
While most people with hearing loss are over the age of 50, around 8 out of every 100 people with hearing loss are under the age of 18.
Hearing device like spectacles
“For any mother, dealing with the realisation of your child’s hearing impairment is massively heart wrenching and many things run through your mind: ‘How did this happen? Did I do something wrong? How will I take care of my child? Will my child live a healthy and happy life? What can I do to assist my child and provide the best opportunities? What will happen to my child when I am no longer around?’
The answers are never easy to find and dealing with the many stigmas that come with disability can be cruel and unkind. Maternal support and education about causes, prevention and early detection of hearing loss in infants and children, remains one of the most important factors in addressing childhood hearing loss,” explains Nicolene Schoeman, an Audiologist at Oticon South Africa.
“At Oticon, we believe in challenging everything we know and channelling this insight into solutions that will support any lifestyle and any age. It is our absolute passion to empower people with a hearing impairment to play an active part in life. It means focusing on living – not living with a hearing loss.
Ultimately, part of the journey to better hearing means getting to a point where wearing a hearing device is as normal as wearing spectacles to read. We believe hearing loss is a natural part of life, something that should be accepted and something that can be easily solved,” says Nicolene.
Educating mothers and families about childhood hearing loss
“The reality is that there are many causes of hearing impairment amongst children. Some are entirely out of our control, others can be rectified and treated and in these instances early detection is crucial. Identifying hearing loss in children and especially infants, is somewhat more complex than in an adult, but absolutely crucial if you are to avoid the long term repercussions of delays in speech, learning and socialising of your child,” says Nicolene.
Hearing loss can occur if an infant:
- is born prematurely
- has stayed in the neonatal intensive care unit
- is given medications that can lead to hearing loss - ototoxic drugs such ARVs
- has a family history of childhood hearing loss
- has had complications at birth
- has had infections such as Meningitis or Cytomegalovirus
- is exposed to very loud sounds or noises even for a brief duration
Early detection and Intervention
“Ideally children should be routinely tested at birth for hearing loss. Recommended screening technologies include oto-acoustic emissions (OAE), which assess cochlear functioning, and auditory brainstem responses (ABR), which record neural activity in response to sounds. The tests are accurate and take one to three minutes when testing a relaxed, quiet baby,” adds Nicolene.
“A hearing defect in babies inhibits the development of the baby’s communication skills. It is absolutely vital to have every infant tested. A hearing loss in a new-born baby can be overcome by means of either a cochlear implant or a hearing device once it is detected. Speed is absolutely of the essence. The earlier the hearing loss is identified and treated, the less effect it will have on the development of the baby,” explains Nicolene.
“A hearing loss in older children may lead to the child falling behind in school as a result of not understanding the teacher. By fitting a hearing device, students can often improve their scholastic performance by up to 25%.”
There are four major ways in which hearing loss affects children:
- It causes delays in the development of their speech and language skills.
- The language deficit causes learning problems that result in reduced academic achievement.
- Communication difficulties often lead to social isolation and poor self-concept.
- It may have an impact on vocational choices.
Some hearing milestones a child should reach in the first year of life:
- Most newborn babies startle or "jump" with sudden loud noises.
- By three months, a baby usually recognises a parent's or caregiver’s voice.
- By six months, an infant can usually turn his or her eyes or head towards a sound.
- By 12 months, a child can usually imitate some sounds and produce a few words, such as "Mama" or "bye-bye."
As a baby grows into a toddler, signs of a hearing loss may include:
- limited, poor, or no speech
- frequent inattentiveness
- difficulty in learning
- increasing the volume on the TV often
- failing to respond to conversation-level speech or answers inappropriately to questions
Supporting your hearing-impaired child
Besides the physical aspects of medical intervention, hearing aids and speech therapy, there are many other important factors that are essential in caring for and supporting your deaf child. According to the National Institute on Deafness and Other Communication Disorders (NIDCD) these are:
- Love and Respect: All children need love and encouragement from families and caregivers. Hearing impaired children are no different. Your hearing impaired child should receive the same love and discipline as any other child would. You need not treat a hearing impaired child with sympathy or leniency. Learn all you can, have a positive attitude, seek the best resources and be active in educating your child.
- Stimulate and Teach: If newborn hearing screening has identified hearing problems in your baby, interact with your child as often as you can by holding, facing and smiling at your infant. If your child is a little older, ensure that your child has a stimulating learning environment at home. Tell stories in a dramatic way, encourage questions, hang up educational charts and provide toys to play with. If your child doesn’t react, don’t lose hope. Keep at it, stay positive and vary the stimulation.
- Optimize Residual Hearing: Speak to your doctor or Audiologist about optimising the hearing that your child has so to develop his or her speech. This could result in your child being fitted with a hearing aid or cochlear implant. However, your audiologist will be best equipped to advise which is better suited to your child. Your child should also attend therapy sessions; find out if there is therapy that you can attend with your child. This will not only benefit him/her, but you will be able to learn ways in which you can teach your child as well.
- Coordinate Care: It may be beneficial to work with a team of professionals including a paediatrician; ENT specialist; audiologist; and speech-language therapist. These experts may be specifically trained to work with children. Encourage your team of professionals to talk to each other and discuss your child’s progress in order to assist them in coordinating care for your child.
- Mothers need support too: As a mother caring for a hearing impaired child, your days are longer and require a lot more concentration and diligence. Mothers are often so set on taking care of their children that they forget about themselves.
“We realise that from the moment you find out that your child is hearing impaired, it becomes an emotional journey. At Oticon, we encourage parents to seek support from family and friends. Finding a support group of families going through the same thing can be a fantastic help,” concludes Nicolene.
Advice from a mother with a hearing impaired child
“Being hearing-impaired doesn’t make your child any different from any other child. They have the same dreams and aspirations as any other child and hearing aids are an important bridge towards normality. Children develop amazing coping mechanisms themselves, if allowed to do so. Don’t take your child’s independence away from them. Remember that the limitations you place on them will become their reality,” says Chani Bruhns, mom to 13-year old Alex Bruhns, who despite his profound deafness, received a special placement at a mainstream high school based on his excellent academic achievements and dreams of becoming a structural engineer when he grows up.
(Press release, May 2012)