Whadyasay? Texas Babies With Hearing Loss In Need of Early Intervention

"Your turn," a new mother directs from across the room to her sleeping partner. She has just fallen asleep after three hours of pacing the floor with a colicky baby, head drooped gratefully against the luxurious papasan cushion, when, it seems only moments later, he awakens again. "He couldn't possibly be hungry," she mumbles before slipping into an exhausted sleep. "At least he has a healthy set of lungs."

Ah, yes. The joy of a new little life welcomed into an awaiting mother's arms - An iconic moment. We sigh collectively, as a culture enthralled with babies. The subsequent crying, screaming, and frustratingly sleepless nights are all just a part of the process, we say. Nothing could be more precious. Finding out something is wrong, then -- that "baby" is not as healthy as we'd like him or her to be -- can be just as devastating as the birth was joyful.

In Texas alone, two infants are born everyday with some type of hearing loss; that's twice the number of those born with genetic and metabolic disorders identified by blood screens. One in one thousand children in the United States will be welcomed into the world clinically deaf, and one in one hundred will show some level of hearing loss. What may be one of the most frustrating aspects for parents is that most cases occur with no apparent accompanying explanation. Ninety percent of deaf children, in fact, are born to those with no hearing impairments whatsoever.

Since 2001, hearing tests for newborns have become mandatory in forty states and are commonly administrated in the other ten. Before this, children with hearing loss often went undiagnosed until at least two years of age, when important developmental milestones were not reached. The Texas Early Hearing Detection and Intervention (TEHDI) Program, instituted in 1999 by House Bill 714, is a universal newborn hearing, screening, tracking, and intervention program requiring certain hospitals and birth facilities to offer newborn hearing screening tests (NBHS). The program, which is covered by many health insurance policies, is currently being implemented in 196 Texas facilities, focusing mainly on those counties with a population of 50,000 or more. Facilities across Dallas, Houston, Austin, and the rest of the state are slowly adhering to protocols, and new, improved statistics on diagnosis and intervention are hoping to be confirmed within the next several years.

Even with proper diagnosis, however, treatment can be difficult. Thirty-four percent of parents with newborns who do not pass the initial screening do not return with their children for follow-up examinations. This could be due to denial, or many physicians' "wait and see" approach, as only twenty-five percent of those infants who get to the second stage of testing actually require intervention. Some babies that fail initial tests, for instance, may show signs of hearing -- such as responding to human voices -- later on. Many medical practitioners, however, believe second screenings are just as crucial as the first ones -- even if the baby's chances of needing treatment are statistically low.

"Without early treatment, these children [with hearing loss] will not have a good communication system in place," said Dr. John Greinwald, pediatric otologist at the Cincinnati Children's Hospital Medical Center. "This can result in a number of learning and behavioral problems. We need to identify children early and provide them with hearing tools and training by the time they are six months."

The fear is that without early detection and treatment, children with hearing impairments will fall far short of their potential. Studies indicate that hearing loss, if detected and dealt with properly before six months of age, will not significantly slow language development. With the assistance of quality intervention programs, deaf children maintain language function equal, or nearly equal to, their cognitive abilities up to the age of five.

Anne Oyler, audiologist for the American Speech, Language, and Hearing Association, agrees with the need for early detection. "More than ninety percent of what babies learn is from incidental listening. If a child is not fitted with hearing aids until two, that is when he or she will have to start learning what sounds are. If we catch kids in the first few months, we don't see delays and they do beautifully."

For as low as Texas ranks in health care -- in fact, the worst in the nation for the rate of uninsured adults, at twenty-five percent -- at least new parents in the state can be assured that their babies are, most likely, being properly screened for hearing impairments. "By getting them early enough, we can change lives," said David Brown, the director of audiological research at Cincinnati Children's Hospital Medical Center. One less worry for new, excited, and anxious parents, after all, is one less worry.

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