hardofhearingchildren.com by PAM Candlish MLS
"What did you say?" "Eh?" "WHAT did you say?" "MM?" "WHAT DID YOU SAY?" oh "PARDON ME!"

Baby's Hearing

Hearing Tests for every Baby

A baby's hearing can be tested by an audiologist using a variety of objective tests in a matter of minutes. The skill of the audiologist is the interpretation of the test results.

My Grandson's hearing test in October 2000.

I expected the hearing testing protocol to be in place in the hospital where my daughter gave birth. However the hospital had bought a machine, and planned to use a nurse to do the hearing tests on babies. I was relieved that the hospital had not done the hearing test, and "using up" his hearing test because this should be done by an audiologist. My son who has hearing problems was also born in this hospital 16 years ago. The hospital has never exhibited the slightest knowledge of hearing problems. This is probably why they figured a nurse could do hearing testing.

We went to a hospital which had a hearing test for babies in place because of an intensive care ward. The audiologist placed Jonathan on a pillow on my daughter's lap. I am not going to tell you the audiologist's name because he has a magic trick of rubbing a baby's head to put it to sleep for eight hours. Then the audiologist gently attached little electrodes to Jonathan's head and sent sound through his ear. As you can see from the picture, Jonathan was not disturbed at all. 

My son Reid was with Jonathan and his parents, as well as me. Originally the audiologist was going to leave me in the waiting room, until I explained that I was the grandmother who knew about hearing, and arranged the test... and I wanted to take pictures for the web site.

I never cried when I was told Reid had hearing problems, but I had to retreat to the hall when I heard that the baby's hearing was normal, because I didn't want Reid to think his problems were such a big deal. 

Subsequent expectable Language did not develop well in my Grandson. 

At age 15 months, he was sent to another audiologist which took a long time, and which required external funding from a charitable source to pay for children's audiology where he lives which otherwise costs $75, money which most parents do not have. Testing in the sound field reveals a mild conductive hearing loss and fluid in his ears. Now he is waiting for months to see an ENT. He is the focus of Healthy Babies program, but it is still too slow because months and months of language development in its natural pace is going by. 

Problems of Missing years of hearing

The difficulties which we had with regressing language to compensate for two years of missed hearing were great. The only parents, in the 1980's when Reid was a baby, who managed to get hearing problems diagnosed in infancy were parents on their second child with similar problems. They knew who wasted their time saying "no" or "wait for some magic development." They had more self confidence, and more knowledge.

I felt the issue of newborn hearing tests was so important, that I mentioned it in most chapters of the manuscript which became Not Deaf Enough. Most of the people reviewing the manuscript, authorities in the field, noted to me that it was impossible to test a baby's hearing.

Traditional Medical Model of Newborn must Change

The medical model of a newborn child was based on a long-standing theory that newborns were blind, deaf, and insensate, and therefore untestable. As babies started meeting Mom and Dad in the delivery room, the parents could see that the child was not blind or deaf at birth, most of the time. Frankly the doctors looked stupid telling us that babies could not hear.

Our GP tested Reid's hearing by clapping his hands in front of the baby's eyes, looking for a startle reflex. When the baby startled, he was presumed to hear. Eventually Ross came along and requested a tool for the job. A tuning fork was sounded behind the baby's ear. When he did not pay attention to the sound, he was referred to a ENT. 

This is a copy of a letter which I am sending to the Ontario Minister of Health concerning newborn hearing testing in my local area. It would be a good thing to send similar letters to the authorities if you suspect things are not up to scratch where you live.

November 2, 2000

To:Elizabeth Witmore
Ontario Minister of Health,Queen's Park

Dear Ms. Witmore:

I was pleased that $7million has been put into the health care system to test newborn hearing.

Locally my first grandchild was born, in an urban Hospital,three weeks ago. The hospital had bought a hearing testing machine but did not have an audiologist to use it.

We have been visited by the Healthy Babies Healthy Children program from Wellington County.

Locally hearing screening is at age three years 6 months. I was told that the public health department was thinking about running a hearing screening at 18 months. So what are they dong with the money for newborn hearing testing?

My grandchild has already had a hearing test because I have a child who has little hearing and I know the hell his life has been locally. I would take the grandchild to the US if that was necesssary to get a hearing test done.

I think the healthy babies program needs more professional support and consultation from younger and passionate professionals. It is clear to me that the implementation of this program is being blocked by a tradition myth that newborns cannot hear, see or feel. I have read philosophy and understand that the concept is very ingrained, and very wrong.

My grandchild, and every other newborn baby in the province has the right to hearing, either using ears which we know work, or using hearing aids. The only way this can happen is if the hearing testing happens to every child born, as soon as possible.

The newborn hearing test must be administered by an audiologist, not a nurse. I would suggest you consult with an audiologist...

 

The Ontario Minister of Health never answered my letter so I sent an email to the Premier complaining about the local hearing screening continuing to be set at 3 years 6 months through the Healthy Babies, Healthy Children program. This is the Premier's response.

Ontario "Healthy babies,Healthy children" program 

The Ontario "Healthy babies,Healthy children" program offers a hearing test at age three years six months, and they are proud of it. Of course if you wait until a kid is three and a half to test the hearing, and make the child wait for speech therapy after diagnosis, it is not necessary to provide speech therapy to any preschoolers. My son never made it through the waiting lists for speech therapy when he was a child. At that time the lack of speech pathologists was blamed on the scarcity. Why the public health unit had an ad in an English newspaper offering $14,000 for a speech pathologist to come to a remote village in Canada. When parents pushed for a speech pathologist, they were told "We are advertising the position and cannot fill it."

There is a new spirit in speech therapy which includes the first 6 months of life. This is a very good thing, and helps to push diagnosis of speech problems and hearing problems back to an earlier age.

You can help.

Please get "your" baby's hearing tested. It might be your child, or a grandchild, or a neighbour, a little nag, a little suggestion helps. If you do not having testing facilities locally which is often the case, figure out which hospital has the critical care unit for newborns, and phone to make an appointment with the audiologist. You do not need a referral.

-PAM Candlish April 2002

Copy of E-mail from me to CBC after Radio show on Newborn Hearing Testing in Ontario, Oct 11,2002

Hello, I have urged the Ontario Ministers of Health to move forward on identifying newborn children's hearing ability since 1984. Their responses have been wishy-washy, and not understanding how terrible and unecessary it is to have an unidentified hearing loss throughout childhood. Only one child in 1200 is profoundly deaf, the rest of the levels of hearing loss spread at an increasing rate to about 1 in 9 children with a mild hearing loss. Hearing loss is very common and generally ignored. 

The problem with the current program is that they are coming from identification of hearing loss by 5 years in pre-school screening run by local public health units. Only recently was this pushed back to 3 years. My son was born with a hearing loss in 1984, which we identified as parents by 5 weeks of age, and which took two sets of doctors, two audiologists two years after a birth which made the baby at high risk for hearing loss. The original manuscript for my book Not Deaf Enough was passed through Voice for Hearing Impaired Children in 1990, at Dr.Daniel Ling's recommendation, and they refused to publish it. The Manuscript then went to A.G.Bell Association for the Deaf in Washington and was passed around the greats of deaf ed. One constant theme was the need for universal newborn hearing testing, which was considered an impossible task. But I said it was so important, and they started to think that way too. So as a little Canadian mother living in rural Ontario, I am responsible for the notion and need of universal newborn hearing tests in the US. 

And I have my yearly letter to the Ontario Minister of Health. The biggest impedance to universal hearing testing was the fact that insurance companies would pay for remediation costs of hearing loss if it could be proved that there had been a delay in diagnosis which caused the condition to worsen. If the hearing loss was identified at birth, then the parents would have to foot the bills, which are huge. $14 million was put into the Health system in Ontario for newborn hearing identification. When my grandson was born in 2000, he had a hearing test by 14 days by my efforts and not the system in place in the hospital where he was born. Subsequently he became part of the Healthy Babies program in Guelph, who had 3 years as a goal in hearing loss identification and thought they were doing a good job because it was down from 5.

 I was shocked to hear that nurses were going to perform the hearing screening. Nurses know as little as doctors do about hearing loss. I think the companies supplying the equipment to the government indicated that anyone who could breathe could use it, but the task of identifying newborn hearing loss should be performed by an professional audiologist. It does not take too much skill to identify a deaf child, banging pots at home does fine. However identifying the other nuances of hearing loss is a very skilled technical job, and when you are at the audiologists for the test, you are ready to begin remediation with hearing aids right away. If a nurse is doing the screening, then more time passes before the child gets to an audiologist which is where the child must go if there is a hearing loss. 

At the same time that all this was going on, the Ontario Ministry of Health placed audiology as a paid OHIP service only if the audiologist worked under an Ear Nose and Throat doctor. Otherwise there is a $75 charge. Most parents, including my daughter in Guelph cannot afford to pay for audiology, and they managed to fund the cost of hearing identification for local parents in need. This search for funding also took more time. 

Audiologists have Masters or Phd's. They are the academic equivalent of a MD, not a dental hygienists. But the way the Ontario government is treating the audiologists, we are soon going to have a shortage of audiologists, just at the time that we realize that we need more. If I were starting out in audiology today, I would not practice in Ontario because of the government's lack of respect. The summer that newborn hearing screening was being developed, the audiologists were fighting their own battle trying to stay alive as a professional group. It was an expensive legal battle which they lost. 

The biggest problem is that the people doing the job are coming from a philosopy of "Can't do" I have experienced this during many hours of visiting with my grandson and the Healthy Babies program in Guelph. I am told in a bureaucratic way that such haste is unnecessary according to the rules, and that as a grandmother I have no call to input or criticize. Check out my website, Read my book, and you'll find I should be running the Newborn Hearing Screening program, because I would begin with "How can I help you?"

 PAM Candlish
 8174 line 8 RR 4 Kenilworth Ontario N0G 2E0 CANADA ph:519-848-3534