Your child may have hearing loss, what happens next?

The first thing you need to know is that you and your child should come first. Follow your intuition, what is your gut telling you? You know your child best and will be the most important advocate for them.

You may choose a path and find that it is no longer working. It is okay to change your mind. It is okay to change your path… at any time. It is never too late!

What Steps You Can Expect for Diagnosis

What Age Is Your Child?

Birth to 12 Months

If your newborn fails their hearing test in the hospital, you may be asked to return 2 weeks later to test again. Should your baby still fail, you will need to follow up with a pediatric audiologist for an in-depth hearing test. (ABR)
At the audiologist newborn testing, it is highly recommended you bring a support person with you to the appointment. For the test, your baby must be sleep deprived so that they will sleep through the test for accuracy. It is okay to nap as well during the test since the test can take a few hours. There is nothing you can do and no information will be given during this time.
If your baby fails this test, then a second test is required to officially diagnose hearing loss. The same procedure will be used. Support is highly suggested at this appointment as well, as you may be getting a diagnosis and a lot of information on next steps.
If your baby fails both tests, you will discuss the next steps that need to be taken such as hearing technology or other testing that may need to be done. Recommendations for other professionals or testing may be made at this appointment.
When a baby is officially diagnosed with hearing loss, an audiologist is required to report the diagnosis to the state of Idaho. The state agency will put you in touch with Early Intervention teams which may include Infant/Toddler (IESDB) and/or a parent support organization (HATCH and Hands & Voices). The purpose of this reporting is to ensure you and your child have access to support and learning resources for educational assistance. You are not required to accept the early interventions and you can engage to whatever degree you are comfortable.
Depending on the reason for your baby’s hearing loss, it may be progressive or stable. Be sure to discuss with your audiologist the type of hearing loss your child has and what to expect moving forward. Other testing may be required, as well as periodic audiograms.
Your baby may need to see an Otolaryngologist (ENT), which may need to be referred to by your pediatrician. Your ENT doctor will diagnose the cause of hearing loss, they may recommend other testing to find the cause. If hearing aids will be used, they will be prescribed. If Cochlear or BAHA implants are chosen, your ENT will be the surgeon to implant the device.

Resources

Sound Beginnings (Newborn Screenings)

ISU Hatch Lab

Idaho Educational Services for the Deaf and Blind (IESDB)-Infant/Toddler Program

Infant to Age 3

If your baby passed their newborn screening, but is not meeting certain milestones or exhibiting certain behaviors (pulling at ears, crying, consistent ear infections, etc.), your pediatrician may refer your to an Otolaryngologist (ENT) or an audiologist for a hearing test.
At the audiologist testing it is highly recommended you bring a support person with you to the appointment. It may be required that your baby must be sleep deprived so that they will sleep through the test for accuracy. If they think your baby it old enough, they may use a behavioral observation test (looking at toys towards a sound, putting blocks in a bucket to a sound, etc.). You will be with your child in a sound-proof booth. Be sure to stay extremely quiet and do not do anything to prompt your child’s reaction.
If your baby fails this test, then a second test is required to officially diagnose hearing loss. The same procedure will be used. Support is highly suggested at this appointment as well, as you may be getting a diagnosis and a lot of information on next steps.
If your baby fails both tests, you will discuss the next steps that need to be taken such as hearing technology or other testing that may need to be done. Recommendations for other professionals or testing may be made at this appointment.
When a baby is officially diagnosed with hearing loss, an audiologist is required to report the diagnosis to the state of Idaho. The state agency will put you in touch with Early Intervention teams which may include Infant/Toddler (IESDB) and/or a parent support organization (HATCH and Hands & Voices). The purpose of this reporting is to ensure you and your child have access to support and learning resources for educational assistance. You are not required to accept the early interventions and you can engage to whatever degree you are comfortable.
Depending on the reason for your baby’s hearing loss, it may be progressive or stable. Be sure to discuss with your audiologist the type of hearing loss your child has and what to expect moving forward. Other testing may be required, as well as periodic audiograms.
Your baby may need to see an Otolaryngologist (ENT), which may need to be referred by your pediatrician. Your ENT doctor will diagnose the cause of hearing loss, they may recommend other testing to find the cause. If hearing aids will be used, they will be prescribed. If Cochlear or BAHA implants are chosen, your ENT will be the surgeon to implant the device.

Resources

ISU Hatch Lab

Idaho Educational Services for the Deaf and Blind (IESDB)-Infant/Toddler Program

Age 3 to Teen

Your child may have seemed to have normal hearing through early childhood, but for any number of reasons (illness, genetic causes, injury, etc.) they may be showing signs of hearing loss. Your pediatrician may refer you to an Otolaryngologist (ENT) or an audiologist for a hearing test.
At the audiologist testing it is highly recommended you bring a support person with you to the appointment. For younger children, or those that cannot be tested with vocal response, they may use a behavioral observation test (looking at toys towards a sound, putting blocks in a bucket to a sound, etc.). You might be with your child in a sound-proof booth. Be sure to stay extremely quiet and do not do anything to prompt your child’s reaction. Otherwise your child will wear a set of headphones and respond with a button or raised hand, as well as repeating words.
If your child fails this test, then a second test is required to officially diagnose hearing loss. The same procedure will be used. Support is highly suggested at this appointment as well, as you may be getting a diagnosis and a lot of information on next steps.
If your child fails both tests, you will discuss the next steps that need to be taken such as hearing technology or other testing that may need to be done. Recommendations for other professionals or testing may be made at this appointment.
When a child is officially diagnosed with hearing loss, an audiologist is required to report the diagnosis to the state of Idaho. The state agency will put you in touch with intervention teams which may include education specialists (IESDB) and/or a parent support organization (Hands & Voices). The purpose of this reporting is to ensure you and your child have access to support and learning resources for educational assistance. You are not required to accept the early interventions and you can engage to whatever degree you are comfortable.
Depending on the reason for your child’s hearing loss, it may be progressive or stable. Be sure to discuss with your audiologist the type of hearing loss your child has and what to expect moving forward. Other testing may be required, as well as periodic audiograms.
Your child may need to see an Otolaryngologist (ENT), which may need to be referred by your pediatrician. Your ENT doctor will diagnose the cause of hearing loss, they may recommend other testing to find the cause. If hearing aids will be used, they will be prescribed. If Cochlear or BAHA implants are chosen, your ENT will be the surgeon to implant the device.

Resources

Idaho Educational Support for the Deaf and Blind (IESDB)

US Department of Education-Individuals with Disabilities Education Act

Idaho Department of Special Education Manual

Types of Hearing Tests

Pure-Tone Audiometry (Audiometry/Audiogram)

Sounds played through headphones at different volumes and pitches.

Behavioral audiometry will use visual cues, blocks, buttons etc. Headphones may or may not be used. This is typically used with small children.

Speech Test

Uses words, letter sounds, and or/phrases said through headphones at different volumes and with/without background noice to measure the amount of speech a patient can understand.

Otoacoustic Emissions (OAE)

Checks the inner ear’s response to sound while patient is asleep. Typically used for newborn screening.

Auditory Brainstem Response (ABR)

Measures the nervous system’s response to sound, checks for sensorineural hearing loss. This is done by placing electrodes on the scalp. Usually done when newborn screening is failed.

Bone Conduction Test

A type of pure-tone test that bypasses the outer ear and measures the inner ear’s response to sound. Done by placing a type of head phone on the jaw/skull near the ear.

Tympanometry

Measures the movement of the eardrum and can detect abnormalities in the inner ear fluid.

Other Testing the Doctor May Require

MRI-images of the inner ear to look at its structure which may help identify the cause of hearing loss.
Genetic Testing-blood test that may determine if hearing loss is due to genetic factors. This may also give information on severity, possibility of progression, best type of assistive technology to use, or if it is syndromic (such as Usher or Pendred syndrome. This test may also give additional information about other body systems that may be at risk (heart, thyroid, etc).
Eye Exam-some syndromes that cause hearing loss can also cause vision loss.
Speech Assessment-assesses how your child’s speech is impacted by their hearing loss.

Professionals You May Encounter

Audiologist

Assesses hearing loss, dispenses, fits, programs, and helps to maintain hearing devices. May be in a school or clinical setting.

Otolaryngologiest (Ear, Nose, and Throat or ENT)

Doctor that specializes in conditions of the ear, nose, throat and neck. Will prescribe hearing aids or be the surgeon that implants cochlears or BAHAs

Speech Language Pathologist (Speech Therapist or SLP)

Therapist that works on listening and spoken language, lip reading, use of other communication methods (speech generating devices or picture boards), use of hearing assistive technology. May be seen in a home, school, or clinical setting.

Educational Specialists

Families with children under the age of 3 will be visited in their home to work on developmental goals with Infant/Toddler Program personnel. Children over 3 can access support from a Consulting Teacher of the Deaf who will visit their classroom periodically and consult with the educational team. This personnel is normally provided by IESDB. You may also work work school counselors, special education teachers, behavioral aids, speech teachers, and general education teachers who will be a part of your support team.

Genetic Counselor

Specialist trained in medical genetics and counseling to guide and suport families regarding genetic conditions and potential impact.

Types of Assistive Technology

Hearing Aids

Amplifies sound and delivers it directly into the external ear. May use a ear mold or ear piece.

Cochlear Implants

Devices surgically implanted into the inner structure of the ear which stimulates the auditory nerve. The signal is sent to the brain and recognized as sound.

Bone-Anchored Hearing Aid (BAHA)

Externally worn or surgically implanted device that transmits sound vibrations to the inner ear through the skull bone instead of the ear canal. Often used for those with conductive or mixed hearing loss, single-sided deafness, or those unable to wear hearing aids.

Osia Implant

A bone conduction implant that bypasses the outer and middle ear to send sound directly to the inner ear through the skull using direct bone conduction.

Assistive Listening Devices

FM/Bluetooth Systems, Mini-Microphones, etc. are wireless devices that are often used with hearing aids or cochlear implants to reduce background noise. Teachers or other speakers can wear a microphone which transmits their voice to the listener. These are helpful for reducing listening fatigue.

Other

Amplified handsets, TTY phones, doorbell lights, vibrating clocks, lighted smoke alarms, closed-captioning devices for television/movies

Language Choices

American Sign Language (ASL)

A living visual language that has its own grammar and syntax. It uses hand and facial movements to convey meaning.

Handspeak.com

Listening and Spoken Language (LSL) or AuditoryOral

Using amplification devices and speechreading (aka lipreading) of the oral language a family uses as home. No signing is used, only listening and responding orally.

Bimodal/Bicultural

The use of ASL AND spoken language for communication. Includes the learning aspects of deaf culture and implementing them with your family.

Cued Speech

Visual code for transmitting spoken language. Hand signals are more for representing sound than words.

Cuedspeech.org

We Support ALL Communication Choices!