Prenatal smoking linked to hearing loss

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Throw away those cigarettes, pregnant moms! As if there aren’t tons of other reasons that smoking while pregnant is bad for your unborn child, now a recent study published in the Journal of the American Medical Association for Otolaryngology found that kids whose moms smoked while they were pregnant were three times more likely to have mild hearing loss than their peers whose moms didn’t smoke. Read the article from USA Today here. It’s hard enough getting kids to listen, parents–don’t make it worse!

Marching band a threat to hearing?

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Thanks to all of the studies that have been done on the effects of loud music on hearing, researchers have discovered that even playing in the school marching band may be hazardous to your hearing. Ask your audiologist about musician’s plugs, which are specialized earplugs that can be worn while playing an instrument. They come with removable sound filters that allow kids to “turn down the volume” while still hearing all of their fellow musicians and staying in key. Check this article out from USA Today.

My child’s been diagnosed with hearing loss…..what do I do now???

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This is a question I’m sure every parent whose infant or child has been diagnosed with hearing loss has asked. The diagnosis itself can seem so overwhelming, along with the very important choices you’ll be asked to make for your child in what will seem like a very short period of time. The state of Minnesota has put together one of the most amazing brochures I’ve ever seen for parents of children newly diagnosed with hearing loss. In a step-by-step format, this online pamphlet will help guide you through the process of getting the services and help you will need. Most states will have something similar to Minnesota, so contact your state Department of Health to see what they can offer you.

Parent Roadmap

What’s auditory processing disorder?

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Auditory processing disorder (APD) is when the brain has a problem comprehending the signal that is sent to it. It’s “what we do with what we hear”. There are two parts to hearing. The first is detection, the ability to simply hear a sound and let someone know that you heard it. The other part is processing, the brain’s ability to make sense of the sounds and words that come to the auditory part of the brain.

Auditory processing disorder is hard to diagnose because most of the time audiological test results are normal. Sometimes speech understanding tests can indicate poorer word discrimination scores than would be expected with normal hearing.

Signs your child may have an auditory processing disorder are:
Difficulties hearing in background noise
Difficulty following directions
Difficulty localizing where sounds are coming from
Short attention span
Asking for repetitions of speech even when it’s quiet

Auditory processing disorder is usually evaluated using a special group of listening tests involving words and sounds. It’s important to have a regular audiological evaluation first to rule out hearing loss. The audiologist that evaluates your child for APD will choose specific tests based on your child’s history and areas of concern. The testing can sometimes take 1-2 hours and may need to be split up into a couple of visits. He or she will then review the results of the testing with you after they are completed and evaluated and offer suggestions for helping your child. Suggestions can range from special seating in the classroom to an “FM” system or to a computerized therapy program to help your child strengthen his areas of difficulty.

FAQ on Earmolds

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Q: What’s an earmold?

A: When your infant or child is fit with hearing aids, they will need to have an earmold made. An earmold is a custom-made earpiece that will connect to his/her behind-the-ear hearing aid and will fit into your child’s ear.

Q: Okay. I’ve never seen an earmold before. What do they look like?

A: Good question. Earmolds are usually made of a hard acrylic or a soft silicone material. They can come in many different styles. The style is usually determined based on several factors, such as the size and shape of your child’s ear or ear canal and the severity of their hearing loss. Your child can help choose the color of the earmolds, which can be made with colored glitter or single/swirled colors.

Q: Awesome. Do I just pick those up at the drugstore? Where can I get earmolds?

A: Earmolds have to be custom made so they’ll stay in your child’s ear, so they have to be specially ordered, usually from an audiologist.

Q: If the earmolds are custom-made, how does the audiologist know the shape of my child’s ear?

A: You’re right. Every child’s ear and ear canal are unique. Even your child’s two ears can be very different from each other! The audiologist will need to make what is called an earmold impression of your child’s ear(s). An impression is a silicone model of the ear and ear canal. The factory will either make a cast or use a computer scan of the impression to build the earmold.

Q: How is an earmold impression made? Will it hurt my child?

A: It does not hurt at all! Here’s a step by step process on how impressions are made so you will know what to expect.

1) The audiologist will use an otoscope to look into your child’s ear. This allows her to check for wax blockages or to see if there is anything medically going on in the ear that would make taking an impression unsafe. In those cases, wax will have to be removed or your child will need to be medically cleared by a physician before impressions can be made.

2) The audiologist will use a small pen-shaped object with a lighted tip called an earlight to place a small piece of cotton into the ear canal. This is done to ensure the ear canal is completely blocked so that the impression material cannot go too far down into the canal or adhere to the eardrum. The cotton will have a string attached to it in case it needs to be removed before the impression is taken. The sensation experienced by most during this process is a tickle!

3) The audiologist will mix together two soft materials, which when blended will set up after several minutes to make a firm, almost rubbery material. He or she will then put the soft material into a large syringe and carefully inject the material into the ear canal. The most common sensation is a cool, sticky feeling when the material goes into the canal. The material will stay in the ear until it is firm enough to remove, which is usually about three to five minutes.

4) The audiologist removes the cast from the ear when it is done solidifying. They will then check the ear canal again using the otoscope to ensure all the material has come out of the ear and that everything inside the ear looks normal. The audiologist then fills out the order form and mails the impression(s) to the factory where they are made. Here’s a picture of what an earmold impression looks like after it’s done.

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Q: How long does it take to get the earmold?

A: It depends. Opting for rush service at the factory and/or FedEx-type delivery will shorten the wait time, although these services usually have added charges. The usual wait time is about 8-10 business days, sometimes sooner depending on how busy the factory is.

Q: How do the earmold and hearing aid fit together?

A: Another great question. Each earmold will have a tube attached to it. The tube goes through the front of the earmold and through the canal part of the earmold. At the hearing aid fitting, the audiologist will first put the earmold into the ear to check the fit and comfort of the mold. She will then hang the hearing aid over the ear and gauge where the ear hook of the hearing aid and the tube will meet. She will then trim the tube length and attach the hearing aid to the earmold tube. Sound can then travel from the hearing aid through the tube and through the earmold into the child’s ear. Here’s a picture of the earmold and hearing aid connected together.

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Photo credit http://www.hearingaidblog.com

Q: What if the earmold doesn’t fit the first time? Will we have to buy another one?

A: No. If the audiologist determines that the earmold does not fit right when it is first fit to the ear, most factories allow a window of a few weeks’ time for an earmold to be remade so it’ll fit better. Sometimes a small modification can be made to the mold in the office by the audiologist without having to send it back to the manufacturer. If the fit is totally unsatisfactory a new earmold impression made need to be taken to ensure the best fit accuracy.

Q: Clearly my child’s ear won’t stay the same size as they get older. Will more more impressions have to be taken in the future?

A: Yes. The ear generally keeps growing until mid to late adolescence. An earmold that is too small for the ear or doesn’t fit right can cause problems like discomfort, whistling feedback or even less amplification to the ear. The earmold material itself may shrink or discolor with time which can also cause a less than ideal fit. Earmolds will need to be remade more frequently in earlier years than later years.

Unilateral hearing loss

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A unilateral hearing loss is when your child has normal hearing in one ear and a hearing loss in the other ear. Because there is normal hearing in one ear, if the hearing loss occurs after the newborn hearing screening it may be years before it’s diagnosed, since many children appear to hear “just fine” most of the time. There are some signs to look for, though. According to the American Speech-Language and Hearing Association, children with a unilateral hearing loss may have difficulty localizing sounds, difficulty hearing in background noise, and hearing you from a distance or another room. Speaking to a child on their poorer hearing side may result in the child not hearing you at all or responding incorrectly.

It’s been shown through research that kids with unilateral hearing loss may be at a disadvantage over their normal hearing peers in the classroom. It’s not hard to see why. Most of us with children would agree that classroom settings have changed drastically since we were in school. Classrooms no longer have the orderly rows of years past; many of them have “pod” settings, consisting of small groups of desks pushed together, with some not even facing the teacher. There may not even be a true “front” of the classroom; many teachers walk around among their students while teaching or to help with group work, which may cause difficulty for the child if the teacher is on their poorer side. Many schools have “open” classroom construction, where their rooms may not have all four walls and/or a door, allowing background noise from other areas to filter in.

To learn about unilateral hearing loss and how it can affect your child, click here for more information.

What is an IEP?

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IEP stands for Individualized Education Plan. If a child is in school and is diagnosed with a hearing loss that would affect their school performance, an IEP is a document outlining the academic goals and services your child will have for that school year.

There are many professionals, along with you and your child, who will be a part of the IEP process. This group may include an educational audiologist, school principal, your child’s teacher, a special education teacher,the school psychologist and/or school social worker. The professionals involved will typically do classroom observations and/or administer standardized testing to assess your child’s current needs. This group will come up with your child’s plan, and you have the right to appeal the plan if you don’t agree with it. This will be done yearly, and goals/priorities may change as your child grows.

It’s very important to ask questions during the meeting if you have them to be sure you fully understand the process and the plan!

Coping with a Diagnosis of Hearing Loss

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It can be very hard emotionally to take in the diagnosis of your child’s hearing loss; parents and siblings can experience many different feelings when hearing loss is confirmed, all of which are normal and natural. Sometimes it’s easier to know that others out there have gone through the same range of emotions. Here is a wonderful article from the New York Times about a parent coming to terms with their daughter’s hearing loss.