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Phonemic and syllabic speech patterns are delayed even for children with mild to moderate HL 4-7
Unidentified children are at risk for delayed: 8
social use of language
Boys Town National Research Hospital
EHDI and the Medical Home Parent Groups Mental Health Hospital Screening Audiology Primary Provider Child/Family ENT Genetics EI Therapists 3rd Party Payors Deaf Community Interpreters Deaf Services
Listening to Parental Concern About Delayed Language Development Gravel & Vohr
Listening to parent concern about language development
Parent concerns about hearing, speech, language, or developmental delays are strong predictors of an actual problem.
Providers must avoid statements like “Babies develop at different rates. Lets take another look in about 6 months”
Myths about hearing and early speech language delay
We don’t have to worry because:
His older brothers and sisters talk for him
Boys develop speech much later than girls
Twins always have language delays
Grandma says that her Dad did not speak until he was 3 years old.
She has great motor milestones
I know he hears because he gets upset every time I turn on the vacuum.
It is important to respond to concerns about language immediately !
Most children with delays of speech and language respond to appropriate medical, audiologic, and/or educational interventions.
A successful early screening, identification, and intervention program will ultimately permit every child with HL to develop to his/her potential.
Characteristics of Children with Hearing Loss Site Rate Well Baby Nursery 1 per 1000 NICU 10 per 1000 Total population 2-3 per 1000 # infants ident annually US 8,000-16,000 Average career pediatrician 12 patients
Most Common Specific Environmental Risk Causes CMV > 1 risk factor Meningitis Perinatal Asphyxia Prematurity < 1500 g Ototoxic medications
Some Infants pass their hearing screen and have late onset hearing loss Some of these infants have a risk factor and some have no risk factor known to the family or physician.
This is ordered to rule out long QT ( Jervell and Lange-Nielsen )syndrome.
This syndrome may manifest itself with apnea, passing out episodes, or a history of sudden death in a relative.
Considerations in Determining the Appropriateness of Cochlear Implantation including Risks, Benefits & Timing
How is a Cochlear Implant Different From a Hearing Aid? Hearing Aid Cochlear Implant Acoustically amplify sound. Convert sound into electrical signals. Rely on the responsiveness of healthy inner ear sensory cells. Bypass the inner ear sensory cells and stimulate the hearing nerve directly.
What are the Candidacy Criteria for a Cochlear Implant?
Limited benefit from conventional amplification following a minimum of 3-6 months use
May be sooner following deafness from meningitis
Profound hearing loss: (sensorineural loss only)
Severe-to-Profound hearing loss
Motivated, involved family
Educational support to develop auditory skills
Who is a Candidate for a Cochlear Implant? Range of hearing for a cochlear implant candidate.
Similar to early amplification provision, children implanted at early ages with more experience tend to do better developing auditory skills and speech than older children who receive implants after greater period of deafness