Developmental Hearing and Auditory Milestones. Presented by : Amy Packer & Marilyn Nelson

Transcription

1 Developmental Hearing and Auditory Milestones Presented by : Amy Packer & Marilyn Nelson

2 Today s Objectives: 1. The EAR and the Development of Hearing 2. The Developmental Urgency of Hearing 3. The Impact of Hearing Loss on Literacy

3 Newborn Baby Can Hear!!!! Baby Can hear at 20 weeks gestation At birth already has 20 weeks experience with mother s voice

4 Motherese Baby Archer: Smiles and reacts to his mother s voice

5 EAR Development in Utero 1

6 EAR Development in Utero 2

7 Parts of the EAR

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9 What could possibly go wrong? Complex Development Tiny Structures Expected to be Fully Developed by Birth

10 Underdeveloped Outer Ear May or May NOT have other parts of the ear: ear canal beneath the skin inner ear, cochlea auditory nerve

11 The linguistic genius of babies Pat Kuhl TED Talk Critical Time Period to learn language in Brain: birth to about 3 ½ years What if the Hearing Loss is not identified until after 6 months or even later?

12 EHDI Early Hearing Detection & Intervention Rationale - Today s Discussion How is it Done? NLSEC: Current Process is being Reviewed State Training at Metro ECSU in November Will be shared future Webinar

13 Hospital Hearing Screening ^ Quick ^ Non-Invasive ^ Reliable ^ Results in Referral for Diagnostic Audiologic Hearing Evaluation or PASS ^ Does not rule out minimal hearing loss ^ Does not IDENTIFY who may develop hearing loss after screening

14 Diagnostic Hearing Evaluation: Auditory Brainstem Response (ABR) Done while baby sleeps Non-invasive diagnostic hearing measure Obtains hearing levels each ear Reliable & objective Done at ANY AGE, easier with younger infants DON T WAIT TO TEST HEARING

15 Why is Early ID of Hearing loss Important? Hearing Loss is the Most Common Birth Defect Undetected Hearing loss has Negative consequences for a lifetime! Early intervention = Significantly improved outcomes!!!

16 Prevalence #1 Birth Defect 33 Babies Born every day PROFOUND HL ~ 1/1000 births 2-3 /1000 babies born with some hearing loss Until 1990s the 2-3 babies/1000 NOT ID d until 2 ½ or 3 Years old!!

17 Middle Ear Problems -What to do? Arrow indicates typical location of middle ear fluid Middle ear fluid can cause intermittent & fluctuating hearing loss educationally significant lasting 3 months or more Middle ear fluid is medically treatable and should be referred to medical clinic: preferably ENT & audiology

18 Carol Flexer Auditory Brain Development

19 Ears are only a way in to the BRAIN!!! FILTERS TO THE BRAIN: decreased hearing, not using hearing aids, cochlear implants or BAHAs, middle ear fluid, poor acoustic environment (TV on all the time), limited spoken interaction, ETC

20 1-3-6!!!! Guidelines Early Screening, Diagnosis, & Enrollment in Early Childhood Intervention ID Hearing Loss by 1 Month Hearing Aids by 3 Months Enrolled in Intervention by 6 months

21 Warning Signs of a Hearing Loss 3-4 months - does not turn head to sound 1 year- does not say single words: Mama Dada Responds to some sounds, not all Turns to visual stimuli only, not auditory only

22 Baby Fit with Hearing Aids

23 Baby Fit with Cochlear Implant

24 Internal Components Cochlear implant

25 BAHA: Bone Anchored Hearing Aid Another Way into the BRAIN!!!

26 Yoshinaga et. al Landmark Data Published in 1998 compared language development of children ID with hearing loss before and after 6 months Between months of age: ID BEFORE 6 months ~ Expressive language, vocabulary as peers ID AFTER 6 months ~ 20 month language age at months

27 Yoshinaga et al cont d. Gaps continue to widen: DEVELOPMENTAL EMERGENCY TO IDENTIFY HEARING LOSS AND INTERVENE BY 6 MONTHS OF AGE Data since 1998 continues to support Yoshinaga s findings

28 READING & LITERACY GAPS DEAF vs. HEARING DEAF- late ID, by age 18 reading level ~ 3rd grade level (even in 2014) HEARING/HARD OF HEARING reading level on par with peers with early ID and intervention

29 POTENTIAL LIFELONG NEGATIVE CONSEQUENCES: *Less Prepared for post secondary education *Less income earning potential *More likely to receive government assistance due to disabling condition of hearing loss *More likely to experience mental health crises, *more likely to have social challenges more likely to experiment early in life with risky behavior (drugs, alcohol, sex)

30 Take Home Nuggets: Early ID of Hearing Loss is Important! No such thing as a MILD hearing loss or Don t worry because it s only in 1 ear! Early Intervention is Critical for Child s Lifetime!

31 References & Resources: Alexander Graham Bell Association:

32 Guidelines for Pediatric Medical Home Providers: Principle Journal of Pediatrics, Volume 120, #4, 2007

33 ASHA Webpage asha.org Year 2007 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs Normal Developmental Milestones for Hearing, Speech, and Language

34 infanthearing.org National information site Minnesota EHDI, legislation etc.

35 THANKS FOR LISTENING!!!!