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Why do hospitals, schools and pediatricians screen for hearing loss

What are school hearing screenings?

Screening programs are developed and used to identify individuals who are likely to have a specific condition.

• In this case, we are talking about hearing screenings!

• School-age hearing screenings are an integral tool in identifying children with hearing loss who were not identified at birth, lost to follow-up, or who developed hearing loss later.

• A hearing screening is a simple “pass” or “fail” test. 

• Its purpose is to determine if a child has normal hearing or not. 

• It consists of a series of beeps or tones, played through headphones, at the limit of normal range to see if the child is able to hear them.

• The child responds by raising their hand if the tone was heard across different pitches, and for each ear.

Purpose of a school hearing screening:

• A hearing screening can detect potential hearing loss

• The screening places a child into either a “normal hearing” group or “possible hearing loss group”

• This would lead to a recommendation for further testing to rule out presence of hearing loss

• School hearing screenings can pick up hearing losses that are missed at birth

• Newborn hearing screenings that are done at the hospital do not reliably rule out potential mild hearing losses

When should we screen?

• School districts have timelines set in place for when students will be screened: 

• Children who are entering school (Kindergarten, 1st grade in some places)

• Children in K-3 (annual evaluations at these ages)

• Children in 7th grade

• Children in 11th grade

• Children who have failed a grade

• Children with speech/language delay

• Children entering a special education program

Who Else Should We Screen?

However, there are other times outside of routine school hearing screenings when a child should have their hearing screening: 

• Concerns about hearing, speech language or learning

• Family history of delayed or late onset hearing loss

• Signs of syndromes that include hearing loss

• Craniofacial/ear abnormalities

• Persistent ear infections for more than 3 months

• Head trauma and loss of consciousness

• Ototoxic drug exposure (harmful to hearing)

•  Noise exposure

What is Considered a “Pass”?

• Each tone is presented to the child 3 times at 20 dB HL, which is the cutoff loudness level to be considered within the range of normal hearing. 

• If a child hears it at least 2 out of 3 times, he/she passes at that frequency, or pitch. 

• If the child passes at all frequencies, then the child passes the screening.

What is Considered a “Fail”?

• If a child does not respond to one or more of the tested frequencies at a level greater than 20  dB HL, it is considered a “failed” hearing screening

• The child “fails” the screening even if only one ear did not hear the tones at this level

If the Child Fails the Screening, What Happens Next?

• The child should be re-screened, either:

• On the spot

• On another date (should be within 24-48 hours after the first screening)

• Another type of screening tool may be used to compare to results from the first screening

• The child may be referred to an Ear, Nose & Throat doctor (ENT) or an Audiologist for a full hearing test

• Parents should be notified about results from the screening either by mail or over the phone

Consequences of Missed Hearing Loss:

• Impaired hearing is a primary health condition, just as impairment of any sense organ.

• Sensory deprivation results in restricted or non- development of the central auditory nervous system.

• Communicative: Compromised speech-language development.

• Social/Emotional: Family will use ineffective communication behaviors, experience frustration, and misinterpret the child’s behaviors and might experience guilt and anxiety when the hearing loss is diagnosed.

• Cognitive/Academic: Negative effects on vocational and economic potential and contributions to society.

What is EVA Enlarged Vestibular Aqueduct

What is an Enlarged Vestibular Aqueduct (EVA)?

 The vestibular aqueduct is a bony canal that begins inside the temporal bone and travels

within the inner ear to deep inside the skull

 Running through the aqueduct is a fluid-filled tube called the endolymphatic duct, which

connects the inner ear to the endolymphatic sac

 The role of these two structures is to maintain a normal ion concentration

 Some believe that the vestibular aqueduct is mature at birth, while others believe it

continues to grow postnatally until about age 3-4

A vestibular aqueduct is considered enlarged if it is greater than 1-1.5mm. Usually, when the

aqueduct is enlarged, the endolymphatic duct and sac are large too. This causes the regulation of

cochlear fluid and ion concentration to be disrupted

EVA & HEARING LOSS

 EVA can occur in isolation, but also can co-occur with congenital disorders such as

Pendred syndrome, CHARGE syndrome and Branchiootorenal syndrome

 EVA can lead to both hearing loss (most likely sensorineural) and balance issues

 It can be identified with a CI Scan or an MRI

 There is no “cure” for EVA, but hearing aids are most commonly used to manage hearing

loss associated with it

 Vestibular therapy can be beneficial to those who have balance problems due to EVA

EVA & CONTACT SPORTS

 Those with EVA may be at risk for progressive hearing loss, in which the hearing can

gradually or rapidly decrease or fluctuate over time

 Head injury or barotrauma increase the likelihood of progressive hearing loss

 People with EVA are *strongly advised* to avoid contact sports such as football and

soccer, as well as wear helmets when engaging in activities that put them at risk for head

injury

Contact us for more information on EVA!

What are vestibular disorders

Vestibular Disorders

How does my ear affect my balance?

 The Organ for Balance, or the vestibular system, lies within the inner ear

 It consists of three fluid-filled loops call the semicircular canals

 The fluid within the canals changes in response to head motion

 Our vestibular system, eyes and proprioceptive system help us move our bodies within

space and maintain our balance

Vestibular conditions can be caused by:

 Changes in medication

 Poor circulation of the ear

 Movement of “ear crystals” within the semicircular canals

 Infections

 Debris in the semicircular canals

 Traumatic brain injury

Symptoms of a vestibular disorder:

1. Falling, swaying or tilting

2. Vertigo

3. Floating feeling

4. Feeling off-balance

5. Leaning to one side

How do I test for a vestibular disorder?

An audiologist may perform a videonystagmography (VNG) to test for certain vestibular

conditions. This gives the audiologist information about how the vestibular portion of the inner

ear is functioning. The patient wears goggles to monitor eye movements. The patient will

perform several tasks, including following a moving target on a screen, moving their head and

body in various positions, and having warm and cool air put into the ear canal. During these

tasks, the audiologist monitors eye movements and attempts to simulate dizziness to determine

the potential source of symptoms.

What happens next?

Depending on the results of the testing, an audiologist may refer for vestibular therapy.

Sometimes, the audiologist may refer to a specialist, such as an Ear, Nose and Throat physician

or a neurologist to determine if additional testing is warranted. In certain cases, home exercises

may be recommended to alleviate dizziness symptoms.

Who benefits from using custom musician ear plugs

WE MAKE CUSTOM MUSICIAN MONITORS!!

Q: What are musician monitors?

A: Musician earplugs and in-ear monitors are used for musicians and sound engineers to protect

their ears when performing or when exposed to high levels of sound pressure

Q: How do custom musician plugs differ from conventional ear plugs?

A: Conventional earplugs muffle speech and music; additionally, conventional earplugs reduce

more sound in the high frequencies than low and mid frequencies, which makes speech and

music sound unnatural and distorted. Custom earplugs allows for speech and music to sound

natural, preserving the distinct quality and richness of speech and music, but it is ensured to be at

a safer volume level.

Wearing in-ear monitors allows for musicians to hear themselves play music while still

protecting their hearing.

Musicians are not the only professionals who use musician plugs or in-ear monitors:

Aircraft:

 Crew

 Flight instructors

 Passengers

 Pilots

Athletics:

 Athletes

 Coaches

 People at sporting events

Construction:

 Carpenters

 Equipment operators

 Road builders

 Steel workers

Emergency vehicles:

 EMTs

 Highway patrol

 Firefighters

Industrial:

 Factory workers

 Shop teachers

 Students

 Supervisors

Leisure:

 Concerts

 Nightclubs

 Noisy restaurants

Medical-Dental:

 Dentists

 Hygienists

 Technicians

 Surgeons

Motor Sports:

 Motorcyclists

 Pit crews

 Race car drivers

 Spectators

Music:

 Concerts

 Marching bands

 Musicians

 Night clubs

Others:

 Delivery drivers

 Markey traders

 Night club staff

 Truck drivers

Celebrities with Hearing loss

CELEBRITIES WITH HEARING LOSS

1) Stephen Colbert: Colbert is deaf in his right ear as a result of surgical removal of a tumor

when he was a child. Colbert initially wanted to be a marine biologist, but the damage to

his ear would not allow him to scuba dive.

2) Steve Martin: The actor utilizes hearing aids to manage hearing loss and tinnitus. Martin

reportedly has hearing damage as a result of noise-induced hearing loss after being too

close to a loud gunfire on the set of “The Three Amigos” without wearing hearing

protection.

3) Katie Leclerc: The actress, who played a deaf teenager on the TV show Switched at

Birth, was diagnosed with Meniere’s disease, which causes fluctuating hearing loss,

ringing in the ears, aural fullness, and vertigo.

4) Whoopi Goldberg: The TV personality reportedly has low-frequency hearing loss, which

creates difficulty hearing vowel sounds like “a” and “e” that produce the energy of sound.

Goldberg has attributed her hearing loss to many years of listening to loud music without

hearing protection. She currently wears two hearing aids and is vocal about her hearing

journey.

5) Halle Berry: Berry has stated that she has a significant degree of hearing loss as a result

of a head injury.

6) Lou Ferrigno: The bodybuilder and actor has had profound hearing loss since the age of

three. He wore many hearing aids over the years, but due to his impaired word

understanding, was ultimately a Cochlear Implant recipient. Ferrigno has stated that the

CI has helps him hear “s” sounds and ambient noises that he was previously not able to

hear.

7) Derrick Coleman Jr: The football player has had known hearing loss since the age of

three due to a hereditary condition. He reportedly wears pantyhose underneath his helmet

to keep his hearing aids protected from moisture and prevent feedback!

Protecting your hearing aids in the Summer time

The summer is the riskiest time of year for hearing aids!

Hearing aids can:

• Get lost on days at the beach

• Be forgotten about when jumping into the pool

• Clogged with sand

• Moist from sweat

Here are some tips to protect your hearing aids during these summer months!

1) Keep up with daily cleaning!

 Use the brush to clean hearing aid microphones

 Wipe down the hearing aids using a microfiber cloth

 Change wax filters when necessary

2) Use a drying kit or desiccant to place next to your hearing aids at night

3) Place your hearing aids inside nylon sleeves to protect them from moisture

4) Remember to place your hearing aids in a portable pouch before going in the pool or onto

the sand. Don’t put them in your pocket!

5) Use an otoclip to clip your hearing aids to your shirt while playing sports

6) Visit your provider to have your hearing aids cleaned and checked to make sure they are

working properly for those summer activities!

Enjoy your summer!