Can my baby hear me? Common red flags according to our Audiologist

Having a total or partial failure to hear any sound may result in social seclusion, communication failure and even accidents. Now imagine your adorable newborn having this issue but unable to let you know their condition. Hearing loss at birth or also known as congenital hearing loss is prevalent in Malaysia of between 1 to 6 cases for every 1000 births.

“Congenital hearing loss can happen with risk factors and even without risk factors,“ said Dr Ahmad Aidil Arafat bin Dzulkarnain, an Audiologist at the International Islamic University Malaysia and also one of the Medical Advisory Board members for Mama Net, a locally flourishing educational parenting App.

Dr Aidil further elaborated that the risk factors often further categorized into environmental and genetic risk factors. Examples of the environmental factors are maternal infection during pregnancy (e.g. toxoplasmosis and herpes simplex), low-birth weight or premature birth.

While genetic factors affecting congenital hearing loss are babies with certain syndromes such as Alport’s, Down’s, Turner’s and Waardenburg’s syndromes. These genetic and environmental factors may cause alterations to the hearing system that later may impair the infants’ listening abilities and may cause difficulties for them to undergo normal speech and language development.

Further concern on this issue is the fact that 50% of the congenital hearing loss cases typically occur without any associated risks factors. This suggests that congenital hearing loss can happen in a child without any clear health issues or signs and can only be identified if proper hearing assessment is carried out.

As opposed to adults, infants who have hearing losses are not able to tell their parents on their hearing difficulties thus making hearing loss a hidden disorder. Often, parent has difficulties to notice the presence of hearing loss until the child gets older especially when they are unable to speak like other normal developing children.

“The ears and brain are inter-connected, and we hear through our brain from the message sent by our ears. Without sufficient “hearing experience”, the brain area that supports our hearing and listening skills will not be fully developed and this could lead to further deterioration of the brain to process sound if the intervention is delayed or too late,” he added.

Because of that, congenital hearing loss need to be identified as early as possible so that health professional support can be given straightaway.

Tips for parents to address congenital hearing issues

Firstly, get your child hearing to be tested by an audiologist or their team members as soon as the infant is born. Some private and government hospitals conduct universal newborn hearing screening (UNHS) program as an initiative to detect congenital hearing loss and would be a good platform for this purpose. Alternatively, you may get your child hearing to be tested at any audiology clinic as soon as you can.

Secondly, should your child be identified to have hearing loss, do not panic. Please follow the advice and intervention suggested by the audiologists or any health professional.

Thirdly, observe your child’s hearing, listening and speaking abilities to ensure that they are adequate for your child’s age.

Fourth, if you have concerns on their hearing, listening and speaking abilities, immediately seek for health professional’s help.

Because of that, congenital hearing loss need to be identified as early as possible so that health professional support can be given straightaway.

This figure summarizes the impact of hearing loss on a child. Primary causes of hearing loss may lead to secondary issues such as speech and language skills, followed by lower cognitive abilities and this will further impact the academic performance of the child.

The red flags of hearing loss for infants

No reactions to sudden loud noise for example firecrackers or thunderstorm
Not responsive to the parents’ voice
Not trying to search for sound especially in quiet environment
Speech and language milestone are left behind in comparisons to other peers
Could not utter first words after 12 months of age
Could not use two-word phrase by 24 months of age (e.g. “nak makan”)
Lack of babbling and cooing

Frequently asked questions from parents and caregivers

Can my child hear immediately after he/she is born?

Yes, without hearing loss, your child should be able to hear immediately after being born although their brain will continue to develop and mature as they grow older.

2.Why do I need to get my infant hearing tested at a very young age?

Because the probability of a child to be born with hearing loss is high. For every 1000 births, 6 babies are born with hearing loss.

3.Can you get your child hearing tested even though he/she is still a baby?

Yes, with current technology, your child’s hearing can be tested even at day 1 of their life.

4.I have preterm baby, can I get my child hearing tested?

Yes, the current technology allows preterm babies’ hearing to be tested as early as 26 weeks of gestational age.

5.I suspected my child to have hearing loss. To whom should I seek further advice?

You can set an appointment with an audiologist or get a referral from any medical practitioner for further referral to an audiologist.6.

6.My child is still unable to produce first words at the age of 18 months. I was informed by my relatives that their child was having the same situation previously but now she is becoming a successful lawyer. Should I get further audiological advice or wait for my child to catch up with her speech and language development?

Speech and language problems can be caused by many factors and one of them is hearing loss. Research have shown that not all child with speech and language problem can catch up in their development. Without early intervention, the risk for other problems will increase including (but not limited to) literacy, social interaction, attention, and behaviour issues. Because of that it is essential for you to see an audiologist to rule out hearing loss and at the same time get referred to speech and language therapist for further intervention.

7.My child has passed universal newborn hearing screening at birth. Is there any possibility for him to get hearing loss at later stage of life?

The possibility is still there as hearing loss can be acquired at later stage of life. However, by having your child hearing tested, you have at least ruled out the possibility of your child to live with hearing loss.

8.I suspected that my child may have hearing loss. What would happen if I delay seeking audiologist’s advice in regards to my child’s hearing?

Should your suspicion turns to be true, the delay in seeking advice and getting proper intervention may influence your child’s speech and language development. Researches have shown that children born with hearing loss will have better chances to develop appropriate speech and language milestones if the intervention takes place early especially before 6 months of age. Therefore, do not delay in decidi it may reduce the chances of your child to have a better future.