Chattering Children

What happens at a hearing evaluation?                                         

Hearing Evaluation

1. Your child's hearing will be tested by an audiologist, who is a professional trained in hearing evaluation and management. Audiologists are certified by the American Speech and Hearing Association (Certificate of Clinical Competence or CCC-A) and may also be fellows of the American Academy of Audiology( FAAA). Before choosing an audiologist, make sure that the audiologist has adequate experience working with children.2. During the hearing evaluation the audiologist will determine if your child has a hearing loss and if so, the type and degree of hearing loss. A variety of tests may be used for this purpose. The important thing to remember is that the evaluation could span several sessions with the audiologist. It is important to use as many sessions as necessary to get an accurate picture of your child's hearing loss. 3. Your audiologist will record your child's hearing levels on a chart called the audiogram. The points on the audiogram represent the softest sounds your child responded to during the hearing evaluation. Make sure you understand the audiogram and what your child can and cannot hear.

What kinds of hearing aids are there?                                           

Amplification devices
Once the audiologist has determined the degree of hearing loss, the next step is to fit your child with hearing aids as soon as possible. Ideally, the hearing aids should help your child hear conversational speech at comfortable loudness levels. Usually, two hearing aids are recommended, to be worn on both ears. There are a variety of hearing aids available today (digital/analog, behind-the-ear/body worn/in-the-ear, etc.);  your audiologist is the best person to discuss which hearing aids are the most appropriate for your child. With a young child, it may take several sessions to fine-tune the hearing aids. It is important to realize that hearing aids will help the child detect sounds, but the child still needs to learn how to interpret those sounds in order to learn and use language. Listening is a learned skill and, in the case of a hearing-impaired child, is a process that requires therapy, time, and patience. It takes a normal hearing baby almost a year of listening before he/she uses single words. A child with a hearing loss requires at least as much listening time (after being fitted with hearing aids and consistently wearing them).If your child has a profound hearing loss, hearing aids may not  provide the amplification necessary for your child  to learn spoken language through listening. A trial period with hearing aids and intensive therapy that focuses on listening is necessary to evaluate how much benefit your child gets.  It is useless to wear hearing aids and not teach the child to listen. Many children receiving good benefit from hearing aids will often 'tune out' what they hear because they have not been taught what  sounds mean. This is why therapy isimportant. After this trial period, if the hearing aids do not provide sufficient amplification, your child may be referred to an implant center for a cochlear implant.

What modes of communication are available?                              

Choosing A Mode of Communication

When it comes to choosing how the child with a hearing loss will communicate, there are a number of options available. There is no single approach that works for all children. You should not decide on a mode simply on the basis of the 'potential' benefits alone, but consider a number of other important factors: What does the approach demand of you? Can you meet these demands? To what degree is the approach available where you live? If it is not available where you live, how much effort can you afford or are you willing to put forth to access services (e.g., drive 100 miles, relocate, etc.). Are you prepared to work with the school system to get necessary services --- and fight for your child's rights when necessary?The bottom line is that you need to do a fair amount of research before you can make an informed decision. The following is a brief description of the major communication options.1. Auditory-verbal: This approach is not just a technique but a way of life. It trains the child to use his/her hearing alone to learn how to listen and speak. The child progresses through the normal developmental stages of listening and communication development. Two key tenets of this approach are i) parents are the primary teachers for the child, and ii) children using this approach are mainstreamed into regular preschools and classrooms from the beginning. This approach is very demanding on parents requiring hard work over the long haul. Parents are intimately involved in the therapy process. Typically, therapy is available at nonprofit clinics or from private therapists. Auditory-verbal therapists are certified worldwide by Auditory-Verbal International. 2. Auditory-Oral : This approach uses listening and speech reading ("lip reading") as avenues to develop verbal communication. Children are often placed in special classes that focus on verbal communication until they are ready to enter a mainstream education environment. Typically, services are obtained through public schools which may have special self-contained 'oral' classrooms, or special private schools for the deaf. 3. Cued Speech: This is a system of hand cues used in conjunction with verbal communication to help a child understand spoken communication. The hand cues differentiate elements of speech that look the same when you speech-read. Parents need to learn and be fluent in the use of cued speech in order for it to serve its purpose. 4. Total Communication : A combination of sign language, gestures, speech reading, and verbal communication is used to develop communication skills. Parents are required to learn and be fluent in the sign language system being used with the child. There are a variety of ways in which this approach is implemented with varying emphasis on each component. Total communication option, in one form or another, is available at most public school programs. 5. Manual : This approach teaches the child American Sign Language as the primary language for communication, interaction and learning. Parents (and ideally family members) need to learn and be fluent in ASL. An important aspect of this approach is that it is rooted in Deaf Culture, which believes that deafness is not a disability but a characteristic that defines people of this subculture whose natural mode of communication is sign language. Many public school programs and state schools for the deaf offer manual option.Note:  The above gives some very basic information about the various approaches. You are advised to contact the respective advocacy organizations for more thorough information.