Hearing loss can present a major developmental issue in childhood. Thus, newborn infant hearing screening has been mandated for over a decade now. The goal of this screening process is to identify affected children as early as possible so that proper interventions can be started at an appropriate age.
With a failed hearing screen, infants are typically referred for a confirmatory test. This test is called an ABR test (auditory brainstem response testing). Most children initially identified will go on to have normal hearing. In affected children, however, the ABR will help your providers determine the type and severity of the hearing problem.
Conventional amplification via hearing aids is typically the first step in management. This process can typically started around the age of a few months. Also, the hearing levels of the ABR will be confirmed with behavioral testing first possible at the age of about 7-9 months. Over this entire period, the entire team will continue to watch whether the child will meet developmental milestones or not. These data in combination with the properties of the hearing loss will help conclude a final hearing decision, which is made ideally around the age of one year. Specifically, in the setting of a severe enough hearing loss combined with a lack of proper developmental progress, cochlear implantation will be considered. This includes placement of a stimulating electrode inside the cochlea, which will then bypass the natural hearing mechanism. Mostly, children with cochlear implants can enter the hearing world and proceed into a mainstream educational setting. However, cochlear implantation has to be performed at an early age to ensure proper development of the central mechanisms that process acoustic information and thus help to develop our ability to speak.