Frequently Asked Questions

Q:
What indicators of hearing should I watch for in my child?

A:
Hearing is critical for developing speech and language. Even before a child begins to talk they are hearing speech around them and starting to learn to understand what the people around them are saying. What children hear affects their babbling. Research has shown that infants initially babble sounds used in many different languages but after a few months, their babbling changes so they are only using sounds that they hear. Children who hear Chinese make different sounds than children who hear English. This makes it clear that children are using the sound around them as soon as they are born. It is critical that children hear from birth. Parents know their children best and are in the best position to observe development.

Checklist:

• By 2-3 months a child should be comforted by mother's voice
  
• By 3 months a child should smile when spoken to
  
• By 6 months a child should be beginning to babble
  
• By 12 months a child should be saying his first word

If you have any question about your child's ability to hear, arrange to have your child's hearing tested.

Hearing should be screened at birth and 2-3 times a year during the first few years of life and yearly throughout school years. This may be done in the pediatrician's office or at school. If there is a real question about hearing, a child should have a diagnostic evaluation and not a screen.

The hearing screening is only the first step. If a screening reveals that your child may have hearing loss, the next step is to schedule--and keep--an appointment for a follow-up examination with an audiologist. An audiologist is a health professional who conducts a series of tests to determine whether your child has a hearing problem and, if so, the type and severity of that problem. To do so while your child is still an infant will help you make sure that he or she develops the necessary language skills to be successful--with family and friends, at school, on the job, and in all other life activities.

Q:
Why is a follow-up examination necessary?

A:
A follow-up examination with an audiologist can help in many ways. Audiologists can identify the kind of hearing loss a child has and sometimes the cause. The audiologist also may recommend further medical attention, such as a visit to the otolaryngologist. An otolaryngologist is a physician specializing in ear, nose, and throat disorders who can determine the cause of a hearing loss as well as possible treatment options. If a hearing problem exists, the audiologist, otolaryngologist, pediatrician, or other professional who works with your child will point you to the various intervention services that can help you. The term intervention refers to the different steps that families can take to overcome communication barriers caused by a hearing loss. For example, you may be referred to a speech-language pathologist or a teacher who is experienced in working with deaf or hard-of-hearing children. You also may learn about special tools to help your child make use of what hearing she or he has as well as tips on how to best communicate with your child.

Q:
When should I have the follow-up examination performed?

A:
If your child did not pass the hearing screening, you should schedule the follow-up examination immediately. The most important period in which a child learns language is during the first six months. If you suspect that your child has a hearing loss, you should schedule an appointment with an audiologist before your child reaches three months of age. Ask the hospital or facility staff who conducted your child's screening to provide you with contact information for one or more certified pediatric audiologists. They may be able to help you schedule an appointment. You also can obtain a list of certified audiologists from the following web sites: American Speech-Language-Hearing Association at www.asha.org or American Academy of Audiology at www.audiology.org. By the time your child reaches six months of age, he or she should be using hearing aids and receiving some form of intervention services.

Detailed information can also be found on the American Speech-Language-Hearing Association's web site at www.asha.org/public/hearing/testing/. Topics covered include risk factors, screening techniques and follow-up testing for infants and toddlers, preschoolers and school age children.

Do persist and ask questions! You know your baby best!

Q:
What exactly is “hearing loss?”

A:
There are four main types of hearing loss:

• Conductive: Hearing loss is caused by a problem in the outer ear or middle ear. Conductive losses usually affect all frequencies to the same degree. These losses are not usually severe.
  
• Sensorineural: Hearing loss is caused by a problem in the inner ear or auditory nerve. A sensorineural loss often affects a person's ability to hear some frequencies more than others. This means that sounds may be appear distorted, even with the use of a hearing aid. Sensorineural losses can range from mild to profound.
  
• Mixed: A combination of conductive and sensorineural losses.
  
• Central: Hearing loss caused by a problem along the pathway from the inner ear to the auditory region of the brain or in the brain itself, not by problems in the ear.

Q:
What caused my child’s sensorineural hearing loss?

A:
In some cases, the cause of deafness is easy to determine.

Heredity, high fevers, illnesses such as meningitis, drugs which can cause hearing loss (ototoxic drugs), and complications during pregnancy or childbirth are some common caused of deafness.

In many other cases, the cause is more difficult to determine. There might be several factors that contributed to the hearing loss. Perhaps there is no apparent reason for deafness. In such cases, the cause of deafness is listed as unknown.

Q:
Can my child’s nerve loss be cured?

A:
At this time, there is no course of treatment or other medical procedure that will reverse or cure a sensorineural hearing loss or deafness. Research continues and you will want to stay in touch with your hearing professionals to learn all you can.

Q:
Will a hearing aid help my child?

A:
Most children with a sensorineural hearing loss are fitted with hearing aids right away. Only through ongoing and consistent testing can your child’s audiologist help you find the best aids and the correct setting for your child’s loss. Hearing aids do not cure a hearing loss. In most cases, children with hearing losses can learn to detect and discriminate the sounds of spoken language through hearing aids. This will help your child learn to communicate through speech and be aware of the sounds around him. If hearing aids have been recommended for your child, it is important that the aids are worn on a full-time basis, as soon as possible!

Q:
What is a cochlear implant?

A:
Cochlear implants may help some children with profound hearing loss who do not benefit from hearing instruments or FM systems. A wire containing electrodes is surgically placed into the cochlea (the organ of hearing). Sound is picked-up by a receiver which is implanted behind the ear in the mastoid bone. An externally worn receiver sends signals to the electrodes and this creates a sensation of sound.

Q:
Will a cochlear implant help my child?

A:
For the small group of deaf children who do not receive enough benefit from hearing aids, a cochlear implant may be recommended. You will need to work closely with your child's audiologist and doctors to find out whether or not your child is a candidate for this procedure.

Q:
How will my child learn to communicate?

A:
Bolesta utilizes a learning method called Auditory-Verbal Therapy. Auditory-Verbal Therapy teaches children to become skilled listeners using their cochlear implants or hearing aids, helping them to create the necessary tools for speech and language development. We do not teach sign language or lip reading. Our children learn to listen and speak rather than using visual communication methods.

Q:
What is Auditory-Verbal Therapy?

A:
Auditory-Verbal Therapy “teaches parents how to teach their child” to listen and speak. The child learns to listen and talk using hearing aids or a cochlear implant. The goal of this program is to have the child attend regular school and be integrated into hearing society.

Q:
Why choose the Auditory-Verbal approach for my child?

A:
A parent choosing the Auditory-Verbal Therapy approach for their child with a hearing impairment is a parent who prefers that their child learn to listen and speak. By choosing the Auditory-Verbal approach, a parent is making a choice for their child to live independently in a hearing and speaking world.

The goal of Auditory-Verbal practice is for children who are deaf or hard of hearing to grow up in "typical" learning and living environments that enable them to become independent, participating, and contributing citizens in an inclusive mainstream society. The Auditory-Verbal philosophy supports the basic human right that children with all degrees of hearing loss deserve an opportunity to develop the ability to listen and use verbal communication within their own family and community constellations.

The principles of Auditory-Verbal practice are (as shortened here): early identification and aggressive audiological management, seeking best source of amplification for the child as early as possible, attaching meaning to sounds and teaching parents how to make sound meaningful for their child all day long, helping the child learn to respond and to use sound in the same way that children with normal hearing learn, using parents as models for learning speech and spoken communication, helping the child to develop an inner auditory system so that they are aware of their own voice and will work to match their own voice with those they hear, knowing how children with normal hearing develop sound awareness, listening, language, and intellect and using this knowledge to help children with hearing impairments learn new skills, observing and evaluating the child's development, helping the child to participate educationally and socially with children who have normal hearing by supporting them in regular education classrooms.

Q:
What does the future hold for an Auditory-Verbal child?

A:
A bright future indeed! A recent study of 157 newly graduated men and women from Auditory-Verbal programs in the US, 94% who had a severe-to-profound hearing loss had this to say:

- 152 had completed high school
- 95% of those went on to post-secondary education
- 72% see themselves as part of the hearing world

Q:
Will my child go to a regular school?

A:
Yes!

Q:
I’m receiving conflicting information and feel overwhelmed. What should I do?

A:
The diagnosis of hearing loss is often a shock and may bring with it many difficult feelings. Parents often receive conflicting information from different professionals when a baby’s hearing loss is diagnosed. Sometimes parents are given several different diagnoses before the hearing loss is even confirmed. Once a diagnosis is made, parents start learning about the many communication approaches available, about amplification options and cochlear implants, and about services and educational programs. So remember, it may feel overwhelming at times!

Q:
How will Bolesta help my child?

A:
Our goal at Bolesta is to give your deaf or hard-of-hearing child the ability to live a normal, independent life in a hearing and speaking world. And we mean independent – free from the burden of being considered handicapped, or impaired in any way.

Through our individualized habilitation program, children learn to hear and speak normally – to use regular telephones, go to regular schools, and to just be regular kids!