Language & Speech Development Of Normal Hearing Children:
Newborn – 1month
Pay attention to people's voice
Jumps or blink to loud sound
Smile when you talk
1-3 months
Head will rotate in the direction of the sound
Listen to music
Express their emotions and needs with crying, cooing, facial expressions and body movements
4-7 months
Turns towards voices or sounds
Seem to like a musical toy
Respond to the call from others
Start babbling
8-12 months
Listen when people talk
Understand things like “no”, “bye bye”
Like copying sounds
1-2 years
Can distinguish object names and body parts
Understand and follow simple instructions
Listen to simple story and songs
Usually understand nouns firstly and learn verbs later
2-3 years
Understand and follow simple instructions
Can differentiate common items and the name of the picture
Find you when you call from another room
Understand most of what you and teachers say
Can answer simple question-食-糖」
Like books, story-time and able to answer questions after being read to
Symtoms of Children Hearing Loss
Clinical studies consistently show that even minimal hearing losses would lead to significant negative impact on the children’s speech and language development. In addition, children with hearing loss often do not appear to understand what is being said and frequently require repetition during daily communications. They might sometimes be accused of "daydreaming," or "not paying attention". It is therefore important for parents to observe their children's behavior and look for signs and symptoms of possible hearing loss.
Following are the signs and symptoms that should make you suspect that your child has a hearing loss::
Difficulty locating sounds
Turning head to one side when listening
Lack of response to soft speech or when called from a distance
Heavily rely on lip-reading in conversations
Inappropriate responses to questions or unable to follow instruction correctly
Asking for repeats
We provide the following two tests as part of the Newborn Hearing Screening service at Phonak:
Applicable: 0 to 6 months of age;
Test Time: 1 hour
Automated Otoacoustic Emissions (AOAE)
OAEs are measurable sounds emitted when the cochlea is stimulated with clicks or tone stimuli. The OAEs are recorded via a probe assembly with a microphone, placed in the infant’s external ear canal. OAEs provide information about the integrity and function of the outer hair cells of the cochlea when the middle ear has been shown to be free of effusion.
Automated Auditory Brainstem Response (AABR)
Compared with OAE, AABR technology is sensitive to auditory neuropathy spectrum disorder, and with a higher level of accuracy. It is an electrophysiological measure of neural responses to auditory stimulation. In AABR, broadband stimuli (click or CE-chirp) of a screening intensity level (e.g. 35 dB nHL) is presented to elicit neural responses from the auditory nerve to the brainstem.
We provide the following three tests that are commonly used in Newborn Diagnostic Audiological Assessment protocol:
Applicable: 0 to 12 months of age, or older child when needed;
Test Time: 2 hour
Tympanometry /Impedance Audiometry
Measures of middle ear function assist in the differentiation between conductive and sensory/neural sites. The measure for detecting middle ear dysfunction in infants under 6 months of age is 1000-Hz tympanometry.
Non-Sedated Auditory Brainstem Response (ABR)
ABR aims to estimate hearing sensitivity and to identify neurological abnormalities of the auditory nerve and the auditory pathway up through the brainstem. Electrodes are placed on the head, and auditory evoked potentials in response to sounds are recorded.
Auditory Steady State Response; ASSR
ASSRs are electrophysiological responses elicited by periodically repeated auditory stimuli. The purpose of ASSR is to estimate hearing thresholds. Frequency-specific modulated tones are used in ASSR to evoke neural responses that enable estimation of thresholds and form the foundation for determining hearing aid amplification characteristics.
Our Paediatric Audiological Services provided :
Visual Reinforcement Audiometry(VRA)
Applicable: age of 6-months to 3 years old
Purpose：Aims to assess the hearing levels of children through providing them with visual “reward”.
Procedure：Sounds of different frequencies are presented either via headphone or sound field speakers to the child inside the sound booth. The child is conditioned to make a head turn towards the direction of sound stimuli. Slides of animation will be then presented on display monitors as a visual “reward” to reinforce the child’s responses
Conditioned Play Audiometry (CPA)
Applicable: age of 2 to 5 years old
Purpose：Aims to assess hearing levels of children through a Conditioned Play Audiometry.
Procedure：Sounds of different frequencies are presented via headphone to the children inside the sound booth. The child is conditioned to perform a task with toys when a sound is heard, such as putting a block in a box to indicate that she/ he heard the sound.
Audiological Assessment
Applicable: above age of 6 years old
Include Pure Tone & Impedance Audiometry
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