Babies with Hearing Loss Benefit from Early Intervention

When it comes to infants and hearing loss, early intervention makes all the difference, as numerous studies have confirmed. The process of acquiring language and vocabulary begins at birth, and hearing is fundamental to this process. Newborn hearing screenings are now standard practice in hospitals nationwide, a step which has helped greatly with early detection of hearing loss. But what comes next?

There are two vital steps that must follow a positive diagnosis of hearing loss in babies–evaluation by a specialist, and the beginning of treatment and interventions. A recent study carried out by Colorado University – Boulder has revealed that in nearly half of American families, the necessary steps after diagnosis are not being met, and the impact on language development in infants who are treated later is already apparent. 

Early intervention linked to vocabulary size

The CU Boulder study, funded by the Centers for Disease Control, is the first multi-state study to analyze the effectiveness of the Early Hearing Detection Intervention (EHDI) 1-3-6 guidelines. The guidelines, established 17 years ago by the Joint Committee on Infant Hearing, recommend that all newborns be screened for hearing loss within one month, those who test positive receive an evaluation by a specialist by three months, and those diagnosed with hearing loss get started with interventions (including family support services, listening and spoken language intervention, sign language instruction, cochlear implants or hearing aids) by the age of six months.

The study found that babies who received treatment earlier went on to develop a far broader vocabulary than those who were treated later. Researchers compared the number of words the children used either in spoken or sign language at different ages to the number of words used by their hearing peers. (Most children have around 600 words in their expressive vocabulary by 30 months.)

For a child with hearing loss, the equivalent vocabulary score would be 100. In children whose hearing loss had been treated early, according to the guidelines, the average score was 82, while those who were treated later scored below 70 on average. This is the lowest 10th percentile for vocabulary development.

Audiologist, research professor and lead author of the study Christine Yoshinaga-Itano commented on the results of the study: "We still have some work to do. Because the brain is so pliable in those early months, the sooner we can get them diagnosed and get them access to language, the more likely they will be able to develop on track with their peers."

A broader vocabulary was also seen in children who were born with more hearing, whose parents had a better education, or whose parents were deaf (and who already knew sign language or had other ways to communicate).

Why are so many infants not meeting the 1-3-6 guidelines?

Although about 96 percent of U.S. infants are now screened for hearing loss by one month, 

only 58 percent are meeting the 1-3-6 guidelines, according to the study, which looked at 448 children across 12 states. The children were ages 8 to 39 months, and had hearing loss in both ears.

Researchers noted a number of difficulties which prevent families from getting their infants the early hearing care they need. These include trouble with transportation, appointments, getting time off work, paying for hearing aids, and navigating the complex U.S. healthcare system.

The unfortunate effect of these roadblocks is that almost half of infants with hearing loss are developing language at a much slower rate, which according to researcher Yoshinaga-Itano, can create “an environmentally induced and preventable secondary disability, making children function much like children with cognitive delay.”

Yoshinaga-Itano went on to say: "We can't change how much hearing a child has at birth or the educational background of a parent, but we can develop better systems. Policymakers need to do whatever they can to make transitions from one step to another as seamless as possible so parents can meet the 1,3,6. And parents should know that there is an urgency to assuring that children who are deaf or hard of hearing have access to language as quickly as possible."

Visit Us at Orange County Physicians’ Hearing Services

At OCPHS, we provide hearing health care for the entire family. If you are concerned about your child’s hearing health or simply want to take an annual checkup, schedule a hearing test and appointment with us today.