BEGINNINGS provides informational, emotional and technical support to families of children who are deaf or hard of hearing, deaf parents of children who hear well and professionals serving those families. BEGINNINGS uses an unbiased approach to meeting the diverse needs of families. Our staff provides resources and referrals to parents and professionals. More detailed information is available within this web site. A brochure detailing our services is also available.
BEGINNINGS is a non-profit organization. Our services are free to parents and professionals residing in the state of North Carolina. We also provide literature and videotapes for which there may be a charge to families or professionals elsewhere.
In some cases, the cause of a child’s hearing loss may be easy to trace. There may be a family history of deafness, a congenital condition, an illness, accident or a prescribed medication that may be responsible for the hearing loss. In many cases, however, there may be no obvious reason for the hearing loss. Parents must come to understand that it is likely that the cause of the hearing loss may never be determined.
BEGINNINGS is a strong proponent for the Universal Screening of all infants for hearing loss. Many birthing facilities in our country have currently adopted this philosophy. The two most frequently used measures for testing infants are the Auditory Brainstem Response (ABR) and Otoacoustic Emissions (OAE’s). Both measures can be conducted while an infant is sleeping and require no response from the infant. The ABR monitors brain activity (much like an Electroencephalogram, or EEG). It records specifically the brain activity that occurs in response to sound. OAE’s are a quick, non-invasive probe measure that determines cochlear, or inner ear, function.
There are two distinct types of hearing loss, conductive and sensorineural. A conductive loss is the disruption or mechanical blockage of the movement of sound waves from outside the ear to the inner ear. This occurs in the outer and/or the middle ear. Many conductive hearing losses can be treated and eliminated with medication or surgery. There are also occasions when a problem in the middle ear cannot be corrected. Bone or conduction hearing aids and other assistive devices can assist in these cases.
A sensorineural hearing loss is one that occurs in the inner ear. Some or all of the hair cells in the cochlea may be damaged or not completely formed. In addition, it is also possible that the auditory nerve from the cochlea to the brain may be damaged or not completely formed. This type of loss is not reversible. In some cases, a surgical procedure called cochlear implantation may be appropriate. Otherwise, appropriate habilitation or rehabilitation involves hearing aids and other assistive devices. Please visit our Assistive Technology page for more information about this topic. As a general rule, sensorineural hearing loss does not improve over time. Some sensorineural hearing losses do become worse as children get older. Some “progressive” hearing losses are genetic in nature and there is no way to stop the process. You may wish to speak to your ENT or otology physician regarding medical technology to slow the process. There are some hearing losses that fluctuate, although these are not very common. Children must be monitored very carefully during the first few years of life to determine the stability of their hearing loss. Your child should always be retested if you suspect a change in his/her hearing ability.
A child who is deaf can learn to speak. With the use of powerful hearing aids and/or cochlear implant and speech therapy, a deaf child can learn to produce speech. Some of the methods discussed on our Communication Methodologies section focus on speech production more than others. Please read the descriptions of the five different methodologies to help you decide which method meets the needs of your child and family.
Typically, there are various options available to meet a child’s educational needs. The law mandates that public schools are responsible for providing a free and appropriate public school education for all students regardless of disability. School districts are required to educate students in the least restrictive environment with the related services necessary for the student’s success. Many students who are deaf or hard of hearing can be fully mainstreamed with few or little related services. Some counties/states will have what is referred to as “cluster programs”; this is where classes for students who are deaf or hard of hearing are located in specific schools. Students can be placed in an environment with a teacher of the deaf and hard of hearing and deaf and hard of hearing peers and also participate in a regular school setting. Another option for families is a school for the deaf. Most schools for the deaf now offer different communication options from which families can choose.
Communication with your child should be a top priority. There are five communication methodologies that are currently being used to teach children who are deaf and hard of hearing. We recommend that parents learn about these methods and view programs in which they are used. Please visit our Communication Methodologies section to get more detailed information.
A hearing aid will not correct hearing in the same way that eyeglasses can correct vision. A sensorineural hearing loss usually involves some degree of sound distortion because of the nerve damage that has occurred. While a hearing aid can amplify the loudness of the sound, it is not able to clarify speech and other sounds and to eliminate distortion. Intensive intervention, including speech/language therapy and auditory training, must be in place for young children to learn to process or “make sense” of speech and other sounds. Please visit our Assistive Technology page for more information.
Babies begin developing the skills necessary for language as soon as they are born and possibly even in the womb. Research suggests that babies’ brains are actually “programmed” to learn language during a critical learning period, from birth to about three years of age. Research shows that when infants are aided early on they have the greatest chance of developing language skills comparable to their same-aged peers. Exposure to sound actually stimulates the development of the auditory neural synapses within the brain. If a child is unaided, it is important to begin using a visual form of language early on because, for these children, this type of stimulation encourages growth of the visual neural synapses in the brain.
Unfortunately, most insurance companies do not cover the purchase of hearing aids. There are many local, state, and federal funding programs available. Also be sure to consider local churches and civic programs as additional resources for funds.
There are many reasons why behind-the-ear, or BTE hearing aids, are more appropriate for children than smaller in-the-ear, or ITE hearing aids. Some of these reasons include: the power capability of BTE’s versus ITE’s, the durability of BTE’s, the ability to change an earmold for the BTE as the child grows, the compatibility of BTE’s with other classroom assistive technology, etc. For a more detailed explanation of what amplification is best for your child, contact your audiologist.
From a proactive and audiological standpoint, all children with permanent, sensorineural hearing loss should be properly amplified. There are cases, however, where hearing aids may not be appropriate. Some children with severe to profound hearing loss, bilaterally, may have a trial period with hearing aids and find that there is not sufficient benefit to wearing them. These children may be candidates for a cochlear implant. Other children may have conductive hearing loss that can be corrected or improved by surgical or medical intervention. These children may not be candidates for amplification but need to be carefully evaluated by medical professionals.
Children can be tested for hearing loss at ANY age. Many infants are tested within the first hours of life. There are numerous testing measures available to determine the hearing status of children of all ages.
Parents may ask their pediatrician or family physician for a referral to an Ear, Nose, and Throat or Otology practice. Most medical practices such as these have licensed Audiologists on staff, who can perform the testing. It is preferable to utilize the services of a Pediatric Audiologist. Additionally, many hospitals, teaching and general, have Audiology Departments. Licensed Audiologists are listed in the yellow pages and are generally willing to refer a child onto a Pediatric Audiologist if they are not experienced in working with children. Lastly, the American Speech Language and Hearing Association (1-800-638-8255 or ASHA) or the American Academy of Audiology (1-703-610-9022) will be able to assist you in locating qualified clinicians in your area.
Research based on adults with hearing loss has shown that those who have a hearing loss in both ears and wear only one hearing aid progressively lose much of their ability to recognize speech in the other ear. This phenomenon, called “auditory deprivation,” may be a physical deterioration, a psychological condition, or a combination of both. Studies have shown that the same loss of speech recognition occurs in children as well adults. As a result, binaural amplification is crucial to the proper development of speech and language skills in children with hearing loss in both ears. Binaural amplification is critical during the early years of speech and language acquisition, as well as in the classroom to combat the effects of noise, distance form the teacher, and poor room acoustics.
According to the 1997 reauthorization of the IDEA (Individuals with Disabilities Education Act), the IEP team must consider the following factors when developing a program for a child who is deaf or hard of hearing:
language and communication needs,
opportunities for direct communications with peers and professional personnel in the child’s language and communication mode,
academic level, and full range of needs, including opportunities for direct instruction in the child’s language, and
The schools must now take into consideration these factors, which include peer interaction in the child’s language and communication mode. This does not mean that the peer will also have a hearing loss but should be able to communicate in the mode of communication that is used by the child who is deaf or hard of hearing. Many parents choose to have their child in a setting where other students who are deaf or hard of hearing are also in attendance thereby allowing for friendships with other students who are deaf or hard of hearing to develop naturally.