Hearing things

How well can your child hear? Jane Bartlett reports on government plans to test all newborn babies

New hearing tests employing the latest state-of-the-art technology, are going on trial in 20 health authorities across the country by the autumn. Babies will be given the minute-long Oto-Acoustic Emission test, within two days of birth. The test involves sending sound into the baby’s ear and measuring the level of sound returned, thus calculating the level of hearing function. It can be adjusted according to the complexity of each case, which means if there are concerns after a test, a more detailed one will be offered.

This will be a great advance on the present system, which fails to detect three quarters of the children born deaf each year in the UK. At the moment, parents wait until their baby is seven to eight months old before the health visitor carries out a ‘distraction test’. The baby sits on her parent’s lap and is encouraged to play with a toy, while the health visitor makes sounds out of sight to both the left and right of the child to see whether they notice.

Poor testing means that many children with hearing problems aren’t identified until they start school, by which time their language development is dramatically behind their peers’. One American study showed that if babies can’t hear well, their communication skills suffer from the age of six months.

It’s estimated that three in every 100 children experience some degree of hearing loss by the time they go to school. It may affect one or both ears, and a child may be able to hear some sounds or nothing at all.

There are basically three types of deafness:

Conductive hearing loss – a problem with the outer or middle ear. This includes temporary hearing loss caused by ear infections, colds and allergies. It’s usually a mild hearing loss.

Sensory hearing loss – malfunction of the inner ear or damage to the auditory nerve. When the nerve is damaged, hearing loss is usually permanent. This type of hearing loss can be genetic, or may be caused by a serious illness like meningitis. It can also occur in the womb, if the mother contracts German measles while she’s pregnant or suffers with severe food poisoning such as salmonella or listeria. Babies born prematurely and those deprived of oxygen at birth may also suffer deafness.

Central Hearing Loss – caused by changes in the auditory centre of the brain, due to injury, disease or a tumour. It can also be hereditary.

Children are rarely totally deaf, and for most the problem is a conductive hearing loss, caused by wax blockage or glue ear. Parents are usually the first to pick up on the problem.

Signs to look for:

  • Your baby isn’t startled, doesn’t blink or open her eyes in response to a sudden noise.
  • At one month your baby doesn’t stay still to listen if you make a sudden, continuous sound.
  • At three months your baby doesn’t calm down when you quieten your voice.
  • At six months your baby doesn’t turn towards the sound of your voice across the room, or to quiet noises made from the side.
  • At nine months your infant doesn’t babble or search for sounds made out of sight.
  • At 12 months your infant doesn’t respond when you call her name
As time goes on, you may notice that your toddler is late learning to speak, shouts and is inattentive, especially at story time. She may not respond to music, give inappropriate answers to questions and have difficulty distinguishing between similar sounding words – particularly when the words begin with f, sh or s. You might also notice a tendency to favour one ear when turning towards sound.

What can be done about deafness?

  • If it’s caused by glue ear (also known as otic media), a simple operation to fit a minute plastic tube called a grommet may be all that’s needed. This balances the pressure in the middle ear by draining the fluid from it.
  • A hearing aid can be fitted.
  • Those who are more profoundly deaf are taught to communicate by signing, lip-reading, gesture and body language.
It’s crucial that deafness is picked up early, which is why the Royal National Institute for the Deaf has been campaigning for the new neonatal testing and is delighted that the trials will start this autumn. ‘This news is great for deaf children,’ says James Strachan, Chief Executive of The Royal National Institute for Deaf People. ‘It will increase their chances of receiving the right kind of support from a very early age.’

Early detection of deafness is important, as it enables families and professionals to begin working with a child before substantial language and communication problems build up. If you’re concerned about your baby’s hearing, tell your health visitor or consult your GP.