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What is hearing loss?


A hearing loss is a drop in a child's ability to hear. Sometimes it can be cured with medical treatment; many times it leads to a permanent disability. Hearing losses can mean anything from losing only a small portion of hearing to being unable to hear any sounds at all (deaf). Most hearing losses fall somewhere in between (hard of hearing).

About three in 1,000 babies are born with hearing losses, making that among the most common birth defects. Some children with hearing loss have other serious problems, too. Hearing problems also can happen later in a child's life because of an injury, illness or an accident.


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What effect does hearing loss have on my child?


Just because your child can't hear well or at all, he or she can still learn to talk. Hearing aids or other devices can help. And sign language, a combination of sign language and speaking, lip-reading and other communication options are other ways people can "talk" with each other. Start early. The child's first year is when he or she are learning to communicate.

Speaking skills develop quickly in the first three years life. Find out about a hearing loss as early as possible so treatment can begin right away. Untreated hearing loss can cause learning problems, frustration and unhappiness in the whole family.


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How do I get my child’s hearing tested?


No child is too young to be tested. In Florida, all newborns are tested for hearing loss shortly after birth in hospital. But hearing loss can often happen later. A hearing test is safe and painless and can be done in about 10 minutes. If you think your child has a hearing loss, take him or her to an audiologist (hearing specialist) or center for testing. (See the parent checklist Getting Started for a center that can provide a free hearing screening depending on the age or needs of your child.)

Dial 211 for a list of Audiologists

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What can I do to help my child?


You have made an important first step by reading more information on hearing loss. You also should talk with other parents of children with hearing loss. They have gone through what you are going through now and perhaps can help. You also can get great help from parent support and advocacy groups such as Parent to Parent of Miami. Research tells us that the earlier we begin to help children, the better the results for the child and family.


Below are some checklists of things you can do to help your child. Remember, you are not alone.


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Checklists of things I can do to help my child with Hearing Loss:







THINGS I CAN DO TO HELP MY CHILD WITH HEARING LOSS

Getting Started

IN THE STATE OF FLORIDA:
 Get my child's hearing evaluated (tested):

If your child is between ages birth to 3 years old and seems to have a problem hearing, speaking or learning, your child can be evaluated by a team of experts through the Early Steps program for free. Your child may be eligible for free services. Contact a center close to your home.



If your child is 3-5 years old and has problems with hearing, learning, speaking, playing, seeing and/or walking he or she can still receive free testing through Child Find/Florida Diagnostic and Learning Resources System (FDLRS/South). Testing also is provided for special-education programs. (If your child is already in the Miami-Dade Public School system, your child must be tested through the school.)



Contact Children's Medical Services (CMS): CMS local offices sometimes refer children to medical centers that work with CMS. They provide services to help care for children with disabilities, special needs or major medical conditions. These services can range from early intervention programs such as Early Steps, to ones for a specific medical condition.



Work with my child's service providers: A service provider can be your pediatrician, an audiologist, a teacher, a principal, a social worker or any professional. Remember that you know more about your child than anyone else and are the main influence in your child's life. Service providers are there to help you and your child. Some tips for speaking with service providers:
  • Feel free to ask questions and make comments. Be specific about what you know about your child and what you want and need for your child. Be honest about what you expect, any worries you may have or about anything you don't understand.


  • If you think your child needs something in particular (such as a speech evaluation or a new hearing aid), keep asking until you get it or until you understand why it is not needed.


  • Work with professionals in early intervention or in your school to write your child's IFSP or IEP to reflect your child's needs and abilities. Be sure it includes related services such as speech-language pathology and occupational therapy if your child needs these. Don't forget about assistive technology either.
 Get more information: Visit more websites. Read a book. Watch a video on hearing loss. Include your child and family. Talk with another parent. Parent to Parent of Miami  can help you meet other parents and get services.





 Help my child at home:

You can combine many things you do in an ordinary day with things to help your child's development. Bath time, mealtime, shopping, traveling in the car and family outings are great times to do this. Look below for suggestions.

Take part in family fun, recreation activities, play and all parts of your daily life: A hearing loss doesn't mean your child can't enjoy the day. Many outdoor activities are available for children with special needs. A list of activities and programs is below.

Dial 211 for a list of recreation areas and programs

Talking and signing to your child during daily life encourage speech and language skills:. When you talk, speak clearly and not too quickly. Let your child see your mouth, so she or he can lip-read. Do this during ordinary tasks. For example, while going grocery shopping, say the name of each item as you put it in the cart. Talk about its color, texture and purpose. If your child tries to speak or sign in return, give plenty of time to answer.

Ask your child's speech and language therapist for more suggestions.

 Help my child's speech and language skills: Talk with him/her: Just talking with your child encourages speech and language skills. While shopping in the grocery store, for example, name each item as you put it in the grocery cart. Talk about its color and shape. Your child learns to talk from listening to you.

If your child tries to speak back to you, give plenty of time to answer. Your child may have lots to say, but it may take longer to get it out.

Play with your child: Try to spend time each day just playing and talking with your child. This can be hard to arrange with big families or hectic life styles, but often helps. Music tapes with which a child can sing along also can be effective. Marching around the room in rhythm to the music is a wonderful activity.

Read with your child, pointing to objects in the pictures to help develop language.

Ask your child's speech and language therapist what you can do at home: Get your child's speech and language skills evaluated (tested). Don't worry if your child is too young to talk yet. Speech and language therapists see very young children, even infants.


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What are other ways to describe hearing loss?


There are four types of hearing loss: Conductive, sensory, neural and central auditory. Some children may have more than one type. You may hear one or more of the terms below from your doctor, audiologist (hearing specialist) or others.

  • Conductive hearing loss happens when there is a problem with the middle or outer ear. Usually it is something actually blocking normal hearing in your child - for example, a middle-ear infection, a plug of earwax or fluid in the middle ear (sometimes referred to as "glue ear"). This usually is medically treatable.


  • Sensory hearing loss happens when a part of the ear called the cochlea doesn't work. (The cochlea is a snail-shaped bony cavity in the inner ear.) Some children are born with this problem (called congenital hearing loss), and some get it later from a disease such as meningitis or Meniere's disease. Your child may be able to hear most sounds, some sounds, or no sounds at all.


  • Neural hearing loss happens when there is a problem with the connection from the cochlea to the brain. Neural hearing loss means the nerve that carries the messages from the cochlea to the brain is damaged.


  • Sensorineural hearing loss is a term that is used often because hearing tests can't always tell the difference between a sensory and a neural hearing loss. So the terms are combined, and hearing loss is called sensorineural.


  • Central auditory happens when the brain has difficulty making sense of the sounds that are heard. Other names you might hear for this condition are auditory perception problem, auditory comprehension deficit, central auditory dysfunction, central deafness, auditory processing disorder and "word deafness." The cause is often unknown. Children with this type of hearing loss often have other disabilities.
Sometimes conductive and sensory hearing loss are combined. That's called mixed hearing loss.


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What does a hearing loss mean for my child’s intelligence and learning?


Children with hearing loss can learn what other children do, but these children can fall behind in school. Sometimes a child with a hearing problem is thought to have a learning problem. If your child is doing poorly at school, work with your school and your child's teachers to come up with plan to make sure your child catches up.

Children with hearing losses may have other problems. If your child has other problems or you suspect he or she may have other disabilities, have your child evaluated (tested). A qualified psychologist can tell you if your child's ability to learn has been affected. An evaluation is painless and usually doesn't take long. You can have your child tested at one of several places.

Ask an audiologist to help you select hearing aids and other devices to help your child communicate. Some audiologists have "lending libraries" of equipment that families can try before they buy. (See treatment options for examples of devices/equipment.)


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What causes hearing loss in children?


Hearing loss can be inherited (passed on in families), or it can be caused by illness or injury. In some cases, the cause of hearing loss is not known. About 90% of babies born with hearing loss are born to hearing parents.

Sometimes an illness a mother has during pregnancy can cause deafness or hearing loss in the baby -- for example, rubella (German measles).

Other things that can cause hearing loss after the baby is born are head injuries or infections (such as meningitis, measles or chickenpox). Some medicines, such as the antibiotic streptomycin, can damage a child's hearing. Ear infections may cause temporary hearing loss. Multiple, untreated ear infections can cause permanent damage. And very loud noises such as from an explosion can cause temporary or permanent damage to your child's hearing.


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Is there a cure or treatment for hearing loss?


There is no cure for a sensorineural hearing loss. But there are treatment options and devices you can choose to use to help your child with hearing loss. The Individuals with Disabilities Education Act (IDEA) ensures that children with hearing loss receive free, appropriate early intervention programs from birth to age 3 and until age 21.

Types of Hearing Devices:
  • Hearing Aid: These amplify (make louder) sounds. Depending on your child's diagnosis and needs, a hearing aid might help. Babies as young as four weeks old can be fitted with hearing aids. A baby, of course, can't tell you how well a hearing aid is working or change settings. A growing child will need to have more hearing tests and new hearing aids (to fit size and hearing needs).

    You perhaps can get help paying for your child's hearing aids. Some private health care plans cover the cost. Medicaid will pay for hearing aids and services for children who qualify.


  • Cochlear implants: These are different from hearing aids and intended to make up for damaged or non-working parts of the inner ear, not just to make sounds louder such as a hearing aid. Hearing through a cochlear implant sounds different from normal hearing, but it allows many to hear well enough in person and over the phone. The big difference between hearing aids and cochlear implants is that an implant needs surgery to be put in.

    Cochlear implants usually help adults or older children who have lost all or most of their hearing later in life. Young children also can be helped. The best age for implantation is less than 3 years old. Most young children who receive implants are between 12 months and 6 years old.
Auditory/Oral:
These programs teach children to use whatever hearing they have with hearing aids or cochlear implants along with speech reading (also called lip reading, described below) and learning to speak. This option doesn't include using of any kind of sign language. This option prepares the child to work and live in a society where most people can hear.
  • Speech reading or lip reading: This is learning to see what people are saying by seeing what they say, even if your child can't hear it. Many deaf or hard-of- hearing people become excellent lip readers. Thus, your child can understand people who do not know sign language. It also helps your child to develop spoken language skills. Children who can see and understand how speech is produced can speak better themselves.
Auditory-Verbal:
Here, your child and family work one-on-one with a therapist who teaches your child to rely on hearing helped by hearing aids or cochlear implants. This differs from auditory/oral because the child doesn't use speech/lip reading to help or any kind of sign language. The therapist and your family work with your child to teach advanced listening skills. This treatment option helps your child adjust more quickly and better to a regular classroom.

Cued Speech:
This teaches your child and your family to uses speech/lip reading and signed cues to understand speech. Unlike sign language, there are only eight hand shapes to learn --each used to show the child which consonant (letters of the alphabet that are not an "a", "e", "I", "o" or a "u") the speaker is using. It is only used with consonants that are hard to tell apart from lip reading such as "p" and "b" or ones that don't use the lips to pronounce such as "k." This is used with children who don't have very much hearing, even when using such devices as a hearing aid.

Total Communication:
Called "total communication" because it combines many different styles, this includes a type of sign language called SEE (Signed Exact English). It is not a language, but it does follow some of the same rules as English or American Sign language. It is easier and faster to learn. This method also uses finger spelling, speech/lip reading and hearing devices. Using all these different things helps your child to learn to talk out loud.

American Sign Language (bilingual/bicultural):
This is based on the idea that sight is the most useful tool a person with hearing loss has to communicate. Sign language uses hand and finger shape, position and movement as well as body movements and face expressions. Here American Sign Language is used. Different sign languages are used in different countries or areas.

Deaf children born to deaf parents who already use sign language learn to sign naturally just as hearing children learn to talk. American sign language becomes a first language and English a second language. Nine out of ten children who are born deaf have parents who can hear. Hearing parents who choose to learn sign language often learn along with their child. Click on this website for more information on sign language: http://www.nidcd.nih.gov/health/hearing/asl.asp

Augmentative and Alternative Communication:
This means ways other than talking to send a message from one person to another. We all use this approach sometime. For example, if you are trying to speak with someone in a noisy room where you cannot hear each other, you will use more facial expressions, hand gestures or even writing.

Some special augmentative tools are made for people with hearing losses. Communication boards (sometimes called language boards) are one example. Objects are represented by pictures, letters, words, sentences, symbols or a combination of these. Computerized devices are an advanced form of communication board that can speak in response to typing or pushing buttons on a keyboard Don't worry if your child can't type or push buttons; there are other ways to make the boards work.

For more information on communication boards and alternative ways to communicate, see this website: http://www.asha.org/public/speech/disorders/Augmentative-and-Alternative.htm


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Who are some professionals my child may need to see?


Your child may need to see many different health care specialists. For example:

Pediatrician: A doctor who specializes in treating children. The word "pediatric" in front of a professional's title means he or she works with children.

Pediatric audiologist: A professional trained to test for and treat hearing loss and related problems, including vestibular (balance) disorders and tinnitus (ringing in the ears).

Pediatric otolaryngologist: A doctor who specializes in treating conditions of the ears, nose and throat in children.

Pediatric speech-language pathologist: A therapist who evaluates and treats communication disorders (problems with speech) and swallowing problems. A speech-language pathologist is sometimes called a speech therapist or speech pathologist.

Auditory/verbal therapist: A therapist who teaches children ways to communicate by helping them build good listening skills and using hearing devices. The therapist also helps the family to learn how to work with a child at home to build listening and speaking skills.

Social worker and counselor: A professional who provides counseling and emotional support for the child and family and may help coordinate services, too.

Care coordinator: An individual responsible for organizing the details across agency lines and serving as your contact to help you and your family get services and assistance.

Early childhood special educator/special-education teacher: A teacher trained to work with your child, focusing attention on your child's development and working with you to learn techniques that benefit your child.


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What are some websites where I can learn how to help my child?


Alexander Graham Bell Association for the Deaf and Hard of Hearing http://www.agbell.org This is one of the world's largest membership organizations with information focused on hearing loss.

National Institute on Deafness and Other Communication Disorders Information Clearinghouse http://www.nidcd.nih.gov This website provides health information, fact sheets and publications for families.

Hearing Loss Association of America http://www.hearingloss.org Information, fact sheets and research on hearing loss.

National Association of the Deaf http://www.nad.org News, research and policy issues about hearing loss and deafness.

HandSpeak™ http://www.handspeak.com This fun and interesting website shows sign language in motion. Click on the word and it displays the hand movements.

Hearing Exchange http://www.hearingexchange.com For parents of hearing-impaired children and the professionals who work with them.

DB-Link on Deafness and Blindness http://www.tr.wou.edu/dblink/index.htm National Information Clearinghouse for children who are deaf and/or blind.

Open Directory Project - Links on Hearing Loss
http://dmoz.org/Health/Conditions_and_Diseases/Communication_Disorders/Hearing/Deafness/ Links to various websites with information on a variety of topics (parenting, feelings, support groups, technology, education) related to hearing disorders.

National Institute on Deafness and Other Communication Disorders, National Institutes of Health http://www.nidcd.nih.gov/health/hearing/coch.asp Information on cochlear implants.

Sign With Your Baby http://www.signingbaby.com Information on learning and using sign language with your baby.

March of Dimes http://www.marchofdimes.com/pnhec/4439_1232.asp Quick reference and fact sheet on hearing loss.

NICHCY Deafness and Hearing Loss http://www.nichcy.org/pubs/factshe/fs3txt.htm A quick fact sheet from the National Dissemination Center for Children with Disabilities.

Early Steps http://www.cms-kids.com/EarlyStepsHome.htm Search Florida's Early Intervention Program home page for resources for parents.

Teachnology: The Web Portal for Educators http://www.teach-nology.com/teachers/special_ed/disabilities/hearing This website provides links to excellent resources on hearing losses for teachers.

Gallaudet University http://www.gallaudet.edu This school in the Washington, D.C., area serves undergraduate university students who are deaf or hard of hearing.

Florida School for the Deaf and Blind http://www.fsdb.k12.fl.us The Florida School for the Deaf and the Blind is the state's public school for eligible hearing and visually-impaired students, pre-school through 12th grade. There is no cost to families for tuition for eligible Florida residents. Founded in 1885, the school awards standard and special diplomas and prepares its graduates for a wide range of professional careers and trades. Each year, 70% of the graduates continue their education at colleges, universities and technical training centers.

Family Guide To Assistive Technology (online publication) http://www.pluk.org/AT1.html by Katharin A. Kelker, Roger Holt and John Sullivan (2000). This guide helps parents learn about how assistive technology can help a child. Parents can better meet their child's needs if involved in selecting and planning assistive technology choices.

American Speech-Language-Hearing Association http://www.asha.org is the main website for audiologists, speech-language pathologists and speech, language and hearing scientists to get certified and remain current in their fields. It also helps parents search for a professional.

American Academy of Audiology http://www.audiology.org Fact sheets for parents.


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What are some books to help my family and I learn more about hearing loss?


Books for parents:


Can't Your Child Hear? A Guide for Those Who Care About Deaf Children by Roger D. Freeman, Clifton F. Carbin and Robert J. Boese.

You and Your Deaf Child: A Self-Help Guide for Parents of Deaf and Hard of Hearing Children by John W. Adams.

Kid-Friendly Parenting With Deaf and Hard of Hearing Children: A Treasury of Fun Activities Toward Better Behavior by Daria J. Medwid and Denise Chapman Weston.

Books for children:

Jordan Has a Hearing Loss by Jillian Powell and Gareth Boden.

A Button in Her Ear by Ada Bassett Litchfield.

Elana's Ears, or How I Became the Best Big Sister in the World by Gloria Roth Lowell and Karen Stormer Brooks.


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