When a child is born with a hearing impairment, it can be overwhelming for the parents. It may also be a little sad for parents who are hearing themselves; long years of raising a child with whom you can’t share a key sense of the world may feel daunting. The fact that it can also open up a flood of other lovely, unique experiences is often clouded by initial doubt.

In many Western countries, where there are sophisticated support networks for hearing-impaired people, parents do not approach deafness as a problem in need of fixing; their children can live completely fulfilling, enriching lives surrounded by communities and networks that support them. But unfortunately, in places where resources for hearing-impaired people are woefully inadequate, parents struggle to help children who will seemingly be at a disadvantage throughout life. Early detection and therapy can bolster your child’s language skills to match hearing children and give them an edge in a world too often stacked against them. Read on to learn more about raising a baby with a hearing impairment.

EARLY DETECTION

Hearing impairment can happen to any baby for many reasons – from genetic factors to premature birth – and it’s an important sense to gauge. Most hospitals and speciality clinics in India offer a test at birth that can determine hearing loss, such as the otoacoustic emissions test (OAE), auditory brain stem response (ABR) and auditory steady state response (ASSR). These non-invasive procedures can effectively gauge and diagnose hearing loss in newborns, making early intervention a possibility. While these tests is standard protocol at major urban hospitals, they are not always administered in smaller clinics. Some reports estimate that only 38% of Indian babies are screened for hearing loss at birth.

Yet not all hearing impediments present at birth, and these tests don’t always accurately capture impeditments, so this makes parental vigilance especially important. While most parents know to observe their baby’s language development, not all connect it to hearing. But observance is critical to detecting a hearing impairment early enough – within the first one to three years – for your child to develop typical language skills, says Dr A Ravi Kumar, head of the ENT, head and neck surgery department at Sri Ramachandra University Hospitals in Chennai.

If your baby doesn’t turn his/her head in the direction of any sound, if they don’t even stir when you call out to them in their sleep, if they don’t begin to babble by the end of 2 months and if they cannot seem to notice the difference when a sudden, loud sound erupts in a quiet setting — these are warning signs. If by 9-12 months, the child doesn’t respond to his or her name or doesn’t talk, then you’ll know that further testing and intervention is required.

EARLY THERAPY

Once diagnosed, immediate therapy can help bolster the impaired sense.

“Babies with a profound hearing loss can learn via listening alone and can talk like other children their age provided they receive treatment early, i.e., as close to birth as possible,” says Shefali Shah, a listening and spoken language specialist (LSLS) and founder-director of Sound Steps, which specialises in auditory-verbal therapy for children.

Specialists like Shah begin working with hearing impaired babies from the moment they’re diagnosed, helping them learn to talk, sing, play and read. On Shah’s staff, an audiologist (a professional trained to identify hearing loss early, to assess the extent of the condition and who helps plans rehabilitation for each patient) facilitates the treatment. Speech and language therapists help hearing impaired children mouth the words more effectively, developing their communication skills.

Shah’s centre, as well as many others, are equipped with counsellors and psychologists. They assess the treatment and help parents cope with any emotional difficulties that they may be facing when it comes to administering care.

TECHNOLOGICAL HELP

In today’s wired world, it’s no surprise there’s technology that can help hearing impaired children experience sound. For children whose hearing impairment isn’t severe, hearing aids may be helpful. Modern versions are small, easy to secure and more effective; but they shouldn’t be bought over the counter or without the guidance of an expert. And they shouldn’t take the place of therapy, says Vidhya Ramkumar, a senior lecturer and audiologist at Sri Ramachandra University in Chennai.

“Children at this stage (1-3 years) should be encouraged to listen and respond based on what they hear and not what they see,” Ramkumar says. She also advises parents and caretakers not to use sign language at this stage, so as not to build a reliance on visual cues over sounds. Still, children must be introduced very gently to even basic sounds most hearing people take for granted, like pouring water or a whirring fan.

For babies with severe hearing loss related to inner ear damage, hearing aids will likely be ineffective. Instead, a device called a cochlear implant, surgically inserted in the cochlea, or, inner ear, may be helpful. The implant bypasses the damaged cochlea and relays auditory messages directly to the brain. While this may restore hearing – though not necessarily in the way hearing people experience the sense – there are serious considerations: The recovery period is difficult for young patients, as is dealing with unfiltered and perhaps unwanted sounds.

LIVING WITH HEARING IMPAIRMENT

Therapy and technological aids are just small parts of supporting children with hearing loss. What goes on in the home has a profound affect as well.

“All parents need to know that noisy homes make it difficult for babies – and indeed even those with normal hearing – to pay attention and engage in any activity,” Shah says.

Noises compete for our attention, and for kids with hearing aids or cochlear implants, chatter from a TV or the whir of an appliance can easily drown out important sounds like a parent’s voice. In fact, Shah stresses that noisy homes are ill-advised even for families with hearing babies.

“High noise levels weaken attention spans and sustained over time, can lead to permanent hearing loss even in babies who were born with normal hearing,” Shah says.

Noise isn’t the only distraction. Hearing impairment can also affect depth perception, so keeping your home free of clutter, clunky furniture and staircases can help prevent injury and be more comfortable for your child.

The same is true at school as it is at home. Just how small class sizes have been shown to benefit hearing children, smaller and quieter classrooms are recommended for hearing impaired children as well.

“Children benefit greatly from being allowed to sit within the first three rows, in the middle block, so that they are always close enough to the teacher and that the sound signal reaches them clearly,” Shah says.