Tuesday, April 30, 2013

Hearing Health

We are advised to schedule annual physicals, vision exams, dental exams and the list goes on, but why aren't we advised to have our hearing evaluated on a consistent basis?

Image Source: Wikipedia
Hearing tends to be the forgotten exam of health care, but it is an important step to take towards ensuring that all aspects of your health are being evaluated. We tend to pay attention to hearing only when it becomes a problem, but early intervention can be key to reducing the impact that hearing problems can have over the course of a lifetime. Our hearing can be greatly impacted by many health conditions such as diabetes or cardiovascular disease; monitoring hearing levels can provide insight into other potential health conditions that may not have been identified. Scheduling a hearing exam to establish a baseline measurement of your hearing is the first step, if your hearing is normal returning for an exam every 2-3 years may be good starting point. For those with an established hearing problem, it would be recommended to have an exam every year or follow the recommendations of your audiologist. Early identification and management of hearing problems should be a priority by making hearing exams a regular part of routine health check-ups.

Common Hearing Loss Myths

 "Hearing loss affects only old people and is merely a sign of aging."

Only 35% of people with hearing loss are older than age 64. There are close to six million people in the U.S. between the ages of 18 and 44 with hearing loss, and more than one million are school age. Hearing loss affects all age groups.

"If I had a hearing loss, my family doctor would have told me."

Not true! Only 14% of physicians routinely screen for hearing loss during a physical. Since most people with hearing impairments hear well in a quiet environment like a doctor's office, it can be virtually impossible for your physician to recognize the extent of your problem. Without special training, and an understanding of the nature of hearing loss, it may be difficult for your doctor to even realize that you have a hearing problem.

"My hearing loss is normal for my age."

Isn't this a strange way to look at things? But, do you realize that well-meaning doctors tell this to their patients every day? It happens to be "normal" for overweight people to have high blood pressure. That doesn't mean they should not receive treatment for the problem.

"The consequences of hiding hearing loss are better than wearing hearing aids."

What price are you paying for vanity? Untreated hearing loss is far more noticeable than hearing aids. If you miss a punch line to a joke, or respond inappropriately in conversation, people may have concerns about your mental acuity, your attention span or your ability to communicate effectively. The personal consequences of vanity can be life altering. At a simplistic level, untreated hearing loss means giving up some of the pleasant sounds you used to enjoy. At a deeper level, vanity could severely reduce the quality of your life.

"Only people with serious hearing loss need hearing aids."

The need for hearing amplification is dependent on your lifestyle, your need for refined hearing, and the degree of your hearing loss. If you are a lawyer, teacher or a group psychotherapist, where very refined hearing is necessary to discern the nuances of human communication, then even a mild hearing loss can be intolerable. If you live in a rural area by yourself and seldom socialize, then perhaps you are someone who is tolerant of even moderate hearing losses.

"Hearing aids will make everything sound too loud."

Hearing aids are amplifiers. At one time, the way that hearing aids were designed, it was necessary to turn up the power in order to hear soft speech (or other soft sounds). Then, normal conversation indeed would have been too loud. With today's hearing aids, however, the circuit works automatically, only providing the amount of amplification needed based on the input level. In fact, many hearing aids today don't have a volume control.

**From the Better Hearing Institute

Monday, April 22, 2013

New Horizons for Single Sided Deafness in Children

Single sided deafness is a difficult condition to treat in both children and adults. Single sided deafness has been traditionally treated with a CROS hearing aid (transmitter rests on the deaf ear and sends sound to the better ear via a wireless signal), BAHA (Bone Anchored Hearing Aid, which functions similar to a CROS, but requires surgery and sends the sound to the better ear via vibrations of the bone), and traditional hearing aids. Some patients respond well to these options, but understanding speech in background noise and determining where sound is coming from is always a challenge for these patients. Recent research using cochlear implants for single sided deafness has been surfacing and the benefits are very encouraging. In a recent study published in Otology and Neurotology, children were evaluated one year after a cochlear implant was placed in the worse ear. The results suggested improved speech understanding in noisy environments, better localization of sound and some benefits associated with being able to hear with both ears. For more information, please click on the link: http://www.audiology.org/news/Pages/20130328.aspx

Example of a cochlear implant (source: cochlear implant images on Google)

Thursday, April 18, 2013

Newborns and the Sound of Music

A great post by Marshall Chasin at HHTM:

Image Source: Wikipedia
"In an online version of the journal Pediatrics (http://pediatrics.aappublications.org) for April 15, 2013, more evidence was found that the sound of music could be beneficial for newborns. It was found that premature babies in the neonatal intensive care unit (NICU) who had respiratory difficulties did slightly better when presented with recorded sounds of what their mother’s voice would have sounded like in the womb. Similar findings were found whenever the mother or father sang to them. The heart rate of these infants slowed by 2-3 beats a minute while listening to these sounds.
Specifically, from data acquired at 11 NICUs that had music therapists employed, for 272 premature infants, over a two-week period, a number of vital signs were recorded. It turns out that the reduction in heart rate was the same whether the low-frequency sound was provided by a music therapist’s device or by the voice of the parents.
This is more evidence that music (singing) can be beneficial for even our youngest members of society. For years, parents have been told to talk to their unborn and newborn children in hopes of developing early bonds.

... "
Read the full post on HHTM: Infants and The Vowel U

Friday, April 12, 2013

Why do newborns need their hearing screened?

The early detection and intervention of hearing problems in a child is critical to that child's future success. Studies have shown that children with hearing loss who receive appropriate early intervention services by age 6 months usually develop good language and learning skills.

Newborn on yellow blanket being attended to by a nurse
Image source: Wikipedia
Some parents think they would easily be able to tell if their baby cannot hear. However, this is not always true. Babies may respond to noise by startling or turning their heads toward the sound. This does not mean they have normal hearing. Most babies with hearing loss can hear some sounds but still not hear enough to develop full speaking ability.

Your baby will have the best chance for normal language development if a hearing loss is discovered and treatment begins by the age of 6 months.

So how exactly do you test a baby's hearing?

The 2 primary methods are:

  • Automated Auditory Brainstem Response (AABR)—This test measures how the hearing nerve responds to sound. Clicks or tones are played through soft earphones into the baby's ears. Three electrodes placed on the baby's head measure the hearing nerve's response.
  • Otoacoustic Emissions (OAE)—This test measures sound waves produced in the inner ear. A tiny probe is placed just inside the baby's ear canal. It measures the response (echo) when clicks or tones are played into the baby's ears.
Both of these tests only take a few minutes and can often be performed while your baby is sleeping or lying still. Depending upon where your child is delivered, one or both of these tests may be performed.

If you have any concerns about your child's hearing or delays in speech/language development, be certain to follow-up with your pediatrician and get a referral to a licensed audiologist.

Tuesday, April 9, 2013

Jacob's Ride: Cross-Country Tour to Fund Hearing Devices

A 24-year-old hearing-impaired baseball fan from Annapolis, Md., hopes to raise $1 million to help others facing hearing loss, so they too can experience in what he calls his “miracle,” the cochlear implant performed at The Johns Hopkins Hospital in 1999 that restored much of his hearing when he was 10 years old.

The young pizza baker, Jacob Landis, is placing a constructive hold on his college plans while he combines his passion for America’s national pastime with his love of bicycling so that he can give back to people like him. His personal mission: to raise funds while bicycling to all 30 Major League Baseball stadiums during the 2013 season.
Image Source: Wikipedia
All told, Landis’ charity bike ride will take six months, and cover more than 10,500 miles in 175 days, he says. His million-dollar goal is designed to benefit those who need financial support to purchase a cochlear implant, or other kind of hearing-assist device, including hearing aids. Landis says that modern hearing devices like his, recently upgraded to include a remote-controlled computer that rests behind his ear, in addition to language rehabilitation therapy, needed especially by children, can cost upwards of $100,000, a sum he knows is beyond the health insurance coverage and resources of many families.

Donations to Jacobs Ride can be made through his website, www.jacobsride.com, his Facebook page, and through text message and mobile phone announcements at all stadiums he visits, as well as with bike team sponsorships and fund-raising events planned along the ride route.

All proceeds will benefit The Gift of Hearing Foundation in Narragansett, R.I.; The Listening Center in the Department of Otolaryngology – Head and Neck Surgery at the Johns Hopkins University School of Medicine in Baltimore, Md.; the Mayo Clinic in Rochester, Minn.; and the J.W. Pickle Foundation in Nashville, Tenn.

“Hearing loss is a prevalent medical condition with serious psychosocial consequences for many as 32 million infants, children and adults in the United States,” says Howard Francis, M.D., an associate professor of otolaryngology – head and neck surgery at Johns Hopkins and director of The Listening Center. “Jacob’s Ride is important to raising awareness about the condition and, I think, in celebrating his success in overcoming a debilitating condition that restricts achievement and social connection in the hearing world. I can only hope that many other people will be inspired by his young spirit and courage in what will certainly be a physically grueling and emotionally taxing national tour.”

For additional information, please go to:
http://www.facebook.com/home.php#!/JacobsRide2013?fref=ts http://www.hopkinsmedicine.org/otolaryngology/specialty_areas/listencenter/ http://www.hopkinsmedicine.org/otolaryngology/our_team/faculty/francis.html

Wednesday, April 3, 2013

Know the Signs: Infants & Hearing Loss

If you have concerns about your child's hearing, schedule a follow-up appointment with an audiologist to have his or her hearing checked again.

a baby getting a hearing screening
Image Source: Infanthearing.org
Audiologists are the primary healthcare professionals that evaluate, diagnose, treat and manage hearing loss and balance disorders in children and adults.

An infant with normal hearing should be able to do the following*:

Around two months of age:

  • Startles to loud sound
  • Quiets to familiar voices
  • Makes vowel sounds like “ohh”

Around four months of age

  • Starts babbling
  • Looks for sound sources
  • Makes squeals and chuckles

Around six months of age

  • Turns head toward loud sounds
  • Begins to imitate speech sound
  • Babbles sounds like “ba-ba”

Around nine months of age

  • Imitates speech sounds of others
  • Understands “no-no” or “bye-bye”
  • Turns head toward soft sounds

Around 12 months of age

  • Correctly uses “ma-ma” or “da-da”
  • Gives toy when asked
  • Responds to singing or music

*Source: American Academy of Audiology

Monday, April 1, 2013

Nearly half say cost a barrier to services

In a recent survey, half of parents (47%) indicate hearing aid cost was a barrier to getting the necessary services for their hearing impaired child. This was highlighted as a critical issue due to so few insurances plans providing coverage for hearing aids and that frequently those that do provide coverage don't provide an adequate amount.

Image courtesy S. Miles at FreeDigitalPhotos.net

Quotes from parents involved in the study:

"The reason for the huge gap between diagnosis and obtaining hearing aids was because it took me that long to save enough money to buy them"
"We have good private insurance... [but] the coverage for hearing aids is miserable--$500 every three years"

"..by the time he's in college we'll have invested $20,000."

 "I'm angry that our child cannot get help from our insurance company [for a condition] that affects his physical, academic, social and emotional health!"

"Can't get hearing aids due to the cost, they aren't covered by anything"


Barwick, K, Muñoz, K, & Blaiser, K. (2012). Parent's Experiences With Pediatric Hearing Aids. ASHA Leader.