The baby has hearing impairment, how to find and intervene early?

When does the newborn have hearing?

It used to be thought that all newborns were born deaf. However, with the development of science, research shows that the fetal auditory receptors are basically mature when the fetus is 6-7 months old, and ultrasound imaging can observe that the fetus will blink when stimulated by external sound. Normal newborns are born with auditory orientation.

Is hearing impairment common in infants?

Hearing loss is the most common congenital birth defect in the world, and the incidence of permanent hearing loss accounts for about 20% of all birth defects, ranging from one thousandth to three thousandths. Hearing impairment in infancy will cause devastating damage to the baby's language learning in the future, resulting in the baby being deaf and dumb.

How do parents find their baby's hearing impairment as soon as possible?

The infant's early hearing ability is as follows

After birth 1 month: sudden sound stimulation will cause startle reflex, blink reflex, awakening reflex and sucking reflex. When crying or dancing, the baby will stop the current behavior when he hears the sound. When shaking the sounding toy near the ear, the baby will occasionally turn his face slowly.

2 months after birth: when stimulated by loud sounds during sleep, jumping, blinking, trembling hands and feet may occur. When talking to the baby, he can pronounce vowels such as "uh-oh".

3 months after birth: when you hear voices during sleep, you may have actions such as eyelid closure and finger clenching. The sound of TV can make the baby turn his head or roll his eyes. I feel uneasy when I hear a quarrel, and I feel happy when I hear ridicule and music.

5 months after birth: I can turn my head to look for the alarm clock in my ear and distinguish the voices of my parents and acquaintances. Afraid of sudden vocal stimulation.

6 months after birth: Talk to him or sing, and he will look at you with his eyes and track the sound source. Can quickly find the place where the sound is made.

If you have normal hearing, you should be able to understand some simple languages at the age of one, such as come, hug and goodbye. When you are older, you will imitate adults and say some simple words. At the age of one and a half, he will correctly point out his five senses or familiar objects according to language instructions.

How to check the baby's hearing impairment?

Hearing screening mainly includes two screening methods: otoacoustic emission and auditory brainstem evoked potential.

1. otoacoustic emission

It refers to the phenomenon that the normal cochlea will emit sound after receiving external sound stimulation, and this sound will be transmitted to the external auditory canal through the ossicular chain and periosteum.

This spontaneous sound can be recorded by an instrument to evaluate the function of the cochlea. Because the instrument needs to record tiny sounds, the otoacoustic emission examination will be affected by environmental sounds, the state of external auditory canal and the degree of cooperation of the subjects. For babies, this test is more accurate in quiet sleep, which can avoid the interference of children's crying and swallowing on the experimental results.

It should be noted that otoacoustic emission can only evaluate the function of cochlea, but not the function of auditory nerve. However, because of the simple operation and wide popularity of the experiment, the first hearing screening was mostly for this project.

2. Auditory brainstem evoked potential examination

Sound stimulation is given to children with instruments, and then the bioelectrical activity of children's auditory nerve activity is recorded through electrode patches attached to the skin of children's heads, so as to evaluate the functions of auditory nerve and auditory nucleus of brain stem.

This test is also better when the child is sleeping quietly. Examination will not be interfered by external auditory canal, and it is one of the routine items for diagnosing hearing impairment.

The defect of auditory brainstem evoked potential is that it can reflect the high-frequency hearing threshold, but it is easy to miss the low-frequency hearing threshold.

Conclusion: Otoacoustic emission can well screen the defects of low-frequency hearing threshold, so the combination of otoacoustic emission and auditory brainstem evoked potential can comprehensively grasp the hearing situation of children.

The American Academy of Pediatrics also emphasized the necessity of newborn hearing screening.

When will the baby have a hearing screening?

Normal newborn: hearing screening is generally carried out 48 hours after birth to before discharge. If the first screening fails or is not carried out, it needs to be re-screened 42 days after birth.

Children who fail to pass the re-examination: 3 months after birth, they need to be referred to the hearing-impaired clinic designated by the provincial health administrative department for further diagnosis.

How to treat the results of hearing screening?

As parents of newborns, you need to remember to check the hearing screening result form issued by the doctor when you leave the hospital, which will write the screening results and the time and place of reexamination, and follow the doctor's advice to reexamine in time.

1. False positives may appear in the initial screening.

The failure rate of newborn hearing screening is 15%-20%, but don't worry, most babies are normal. False positive results may be caused by amniotic fluid, fetal fat and other residues blocking the neonatal ear canal, environmental noise interference, middle ear lesions and other reasons.

Failure to pass the first screening does not necessarily mean hearing impairment, and it needs to be screened again to be clear.

2. The initial screening has passed, but there are high-risk factors.

If the initial screening passes, but the child has high risk factors, annual hearing screening is needed within three years after birth. Some hearing impairments do not appear until after the neonatal period, so regular check-ups are needed.

3. Pay attention to observation through screening.

What should the baby do with hearing impairment?

If you feel that your baby is slow to respond to sounds or won't start talking, you need to see a doctor in time to check if there is any possibility of hearing impairment. It is best to start early intervention for hearing impairment within 6 months after birth, help children hear the sound through hearing AIDS, cochlear implants, vibrating sound bridges and other means, and then achieve the goal of being deaf but not dumb through professional language rehabilitation training.

How to protect your baby's hearing?

1, don't let the baby lie down to feed.

The baby's eustachian tube is straight, and it is easy to choke when lying down and nursing. Milk will choke into the eustachian tube and enter the ear cavity, causing otitis media. Not only does rhinitis choke the baby, but oral diseases can also easily lead to otitis media. Otitis media is very common in infants and is also an important factor that hurts the baby's hearing.

2. Don't just pick your baby's ear.

Many mothers see earwax in their babies' ears, and they can't stand the itching, so they have to clean up their babies. In fact, there is some earwax in the baby's ear, which is actually very beneficial. It can effectively protect the baby's eardrum and reduce the impact of strong sound on the baby's eardrum. And the right amount of earwax can also prevent foreign bodies and flying insects from entering the baby's ears.

Don't force the baby to take medicine.

It's hard for the baby to eat bitter and astringent medicine. Therefore, we often see parents holding the baby's nose with their hands and forcibly filling the baby with medicine when the baby is crying. Forced drug infusion will cause drugs to choke into the eustachian tube, causing otitis media, and the consequences are almost the same as choking milk.

4. Don't abuse antibiotics for your baby.

Newborns are very weak in resistance and immunity, so they are easily infected with diseases. Parents will give their children various antibiotics in order to make them recover soon.

Some kinds of antibiotics, such as aminoglycoside antibiotics (gentamicin, kanamycin, streptomycin), have great damage to nerve cells in the ear, and even a little carelessness will lead to deafness, which is called ototoxic drugs.

Step 5 avoid domestic noise

Family noise, which may be a problem that parents easily ignore. According to the test, the noise generated by the TV set at home can reach 60 to 80 decibels, the washing machine is 42 to 70 decibels, and the refrigerator is 34 to 50 decibels. In addition, indoor knocking and loud family quarrels are all within the scope. Hearing loss is gradual and not easy to be found, while domestic noise has the characteristics of long-term and concealment. Therefore, the harm of family noise to baby's hearing damage can not be ignored! It is recommended not to turn on the noisy equipment at home at the same time, and avoid keeping the baby in a noisy environment for a long time to avoid the common noise pollution sources in life.

As a non-specialist doctor, I have no specialist experience, but I can start with the baby's hearing development and show parents how to find out whether the child has hearing problems. The following information will be collected:

First, the baby's hearing development law

(1)0 3 months

There is still amniotic fluid residue in the middle ear of newborn babies, which can be completely absorbed after a few days. At this time, the baby can't hear the faint sound, but can hear the loud sound.

If the sound above 60 decibels suddenly appears, the baby is easily frightened, and will tremble, blink, frown, bend his forearm quickly, clench his fist, cry, gasp or even stop eating.

(2)4-6 months

The baby began to recognize his mother's voice. When talking to your baby, he may look at you with his eyes, or he may concentrate on your voice and stop other actions, turning his head to the sound source to show his perception of familiar sounds.

(3)7 1 1 month

Babies can actively turn their heads to the direction of sound source, that is, they have the ability to distinguish the direction of sound. When they hear their mother's teasing voice, they will laugh, and some babies will even follow their mother's instructions and do corresponding actions.

In life, some behaviors of parents will affect the baby's ears, and even the baby will be deaf. Let's see:

Blow your nose too hard.

Small things like pinching your nose may also cause your baby to be deaf. Many parents hold their baby's nostrils with their thumb and forefinger, and then let the baby blow hard. This behavior may cause bacteria in the baby's nasal cavity to invade the tympanic cavity due to pressure, thus affecting hearing. The child's ears will feel blocked, but it may lead to ear pain and hearing loss. In fact, the correct way to blow your nose is to press the child's nose first, then blow out the secretions inside, and then blow out the nose by pressing the other nose.

Excessive ear pulling

It is common for parents to pull out their babies' ears. Just a reminder, it's easy to find out the problem by picking your baby's ears. You know, it is very important for parents to pull out their children's ears. Many mothers like to pick out their babies' ears, such as using hairpins, matchsticks and wooden sticks. Parents' casual behavior will lead to germs entering the baby's middle ear cavity, leading to middle ear cavity infection, and serious tympanic membrane perforation. Children's ears should be properly cleaned, but attention should be paid to tools. Don't use hard and unclean things. It's best to do it under the guidance of a doctor.

Excessive noise

According to the survey, many children suffer from hearing diseases because of noise pollution. Children often study or live under noise, and their hearing will gradually decline. High decibel noise is an important factor in the formation of children's hearing diseases. Parents should create a quiet family atmosphere for their children's health. If there is noise around, remember to take it away or cover your ears in time.

Do not pay attention to protect your ears when swimming.

Now, many children begin to learn to swim. However, because the water in the swimming pool is unclean and the child's resistance is poor, such water can easily cause otitis media after invading the ear. Therefore, if parents want to take their babies swimming, they should take measures to protect their ears.

Using the wrong medicine

Some drugs can also affect children's hearing, such as antibiotics such as kanamycin and gentamicin. If the child is allergic, it is likely to have an impact. Don't use drugs blindly!

From birth to 3 years old, the baby will have a physical examination 8 times a week. In fact, the physical examination is not mysterious, just to check the baby's growth progress and ensure the baby's healthy growth.

Heart to heart lunar calendar lists the main contents of each physical examination for novice parents, so that many parents can preview in advance at home ~

"The first physical examination (42 days after birth) at this time, the child's physical development has the following characteristics: vision: it can see larger objects, and the eyes are easy to follow the one-way movement of the flashlight. Limb: its forearm and calf always like to be in flexion, with two small hands holding fists.

"The second physical examination (when the baby is 4 months old) movement development: I can support the head. You can look up on your stomach and make a 90-degree angle with your shoulder blades. When you stand upright, two legs can support your body. Vision: the eyes can follow the moving pen, and the head also rotates. Listening: When you hear a voice, you will show an attentive expression, and people will try to turn to the speaker when talking to him. Oral cavity: At this time, the child's salivary glands are developing, and saliva often flows out of the mouth. Blood: The 4-month-old child has ingested the trace element iron brought by his mother. If you don't pay attention to the intake of iron in your daily food, you are prone to anemia. Children should eat more iron-rich foods such as egg yolk, pork liver soup and liver mud. But you can't eat iron drugs. The third physical examination (when the baby is 6 months old) movement development: you can turn over and sit, but you still can't sit steadily. I will reach for what I want and stuff it in my mouth. Vision: The body can rotate with the head and eyes, and can stare at bright targets and toys for about half a minute. Listen: Pay attention and look around for a new sound source and turn to the place where the sound is made. Teeth: Some 6-month-old children may have two teeth, while others don't. We should give them more hard solid food, such as dry bread and biscuits, to practice chewing, grind the molar bed and promote tooth growth. Due to the stimulation of teething, saliva secretion increases, and the phenomenon of drooling will continue and worsen, and some children will bite their nipples. Blood: After 6 months, the hematopoietic substances obtained from the mother are basically exhausted. If it is not supplemented in time, anemia will easily occur. It is necessary to analyze the cause of anemia, whether it is caused by diet or disease. Correct anemia as soon as possible. Observe whether the child's face, lips and skin mucosa are pale at home. If so, anemia should be considered and further examination should be made in the hospital.

"The fourth physical examination (when the baby is 9 months old) movement development: I can sit firmly, sit up and lie down from the lying position, climb back and forth flexibly, and stand by the railing. Both hands can knock the building blocks flexibly. Thumb and forefinger can pick up small things harmoniously. Vision: You can see a line on the screen. The visual acuity is about 0. 1. Teeth: The eruption time of children's deciduous teeth is mostly 6-8 months. The formula for calculating children's deciduous teeth is: 4-6 months less. Pay attention to protecting your teeth at this time.

"The fifth physical examination (baby 1 year old) movement development: At this time, the child can stand up by himself, walk with things, climb the steps with both hands and feet, and poke points or roads on paper with crayons. Vision: You can hold your parents' fingers, nose, hair and eyes. Most of them will fondle toys or stare at nearby objects. Hearing: You can turn around or look up when calling him. Teeth: According to the formula, 6~8 teeth should be produced. The eruption time of deciduous teeth should not exceed one year old at the latest. If the child teeths too late or the order of teething is reversed, it is necessary to find the reason, which may be caused by calcium deficiency or hypothyroidism.

"The seventh physical examination (when the baby is 2 years old) movement development: can walk very steadily, can run, and can go up and down the stairs alone. Can string beads together and draw circles and straight lines on paper with crayons. Urine and urine: teeth can be completely controlled: there are 20 deciduous teeth, so pay attention to protecting teeth at this time. Listening: I have mastered about 300 words and can speak simple sentences. If the child can't speak at the age of 2, he should go to the hospital for hearing screening.

"The eighth physical examination (baby is 3 years old) movement development: I can control the balance of my body at will, complete jumping, kicking, crossing obstacles, taking the S-line and other actions, use scissors, chopsticks and spoons, stack paper and pinch colored mud. Vision: When a child is 3 years old, his vision reaches 0.5, which has reached almost the accuracy of an adult. At this time, the baby should have an eye check. About 3% of children in China suffer from amblyopia. Children themselves and parents are generally not easy to find. If you can find it at the age of 3, the treatment effect is the best before the age of 4, and you can still treat it at the age of 5~6. 12 is impossible to treat. Teeth: Doctors will check for dental caries and gum inflammation.

Give your baby a regular physical examination, not only can you know the child's nutrition and health care in time, but also can find the disease and treat it as soon as possible. Dear novice parents, don't ignore it!

I remember that the baby went to the hospital for vaccination one month later, and the doctor would say that he would have a physical examination. We were born in the province of women and children. At first, we didn't vaccinate in the community hospital. Be sure to see a doctor before vaccination in the provincial maternal and child pediatrics department. The doctor will ask about the child before opening the needle.

At that time, during the physical examination, the doctor would use various toys to observe Doby's reaction. One of them touches the bell in the right ear and the left ear, and the baby will hear the bell and turn his head. I think this should be a listening test. After the examination, the doctor will make a comprehensive assessment of the development and will tell you if there are any problems. I don't think this money can be saved in the past few months. If there is a problem, I will prescribe pre-treatment.

Oh! It seems that a special instrument has been made to measure it on the head, which should be the same. In short, various breast milk tests and so on. The big hospital is still very professional and very reassuring.

I didn't go when everything was normal. Sure enough, my runny nose didn't completely get better the other day. The little girl in the community hospital said that she could get a vaccine. As a result, she had a high fever the next day, and it would take a few days to get well. Doctors in big hospitals are quite strict about this.

If children have hearing problems, it will affect their language, intelligence and psychological development for a long time. If parents and teachers can find children's hearing problems early and take effective measures in time, such as clinical treatment, hearing AIDS or language training, they can effectively avoid or reduce children's obstacles in language, intelligence and psychology. Hearing experts at Ocean Voice believe that it is difficult for adults to find the early symptoms of hearing impairment because children are too young to express themselves. We once saw a child patient who was taken to see a doctor by his parents when he was 9 years old. Parents reported that they never knew that the child had hearing problems. In kindergarten, teachers report that children are slower than ordinary children. At that time, parents didn't realize that it was caused by the child's hearing loss. Parents didn't notice until the children themselves reported that they couldn't hear the teacher clearly. At this time, intervention measures will not only have discounts, but also have a great impact on children's learning. In fact, if there is a problem with hearing, it will also show some special signs of deafness. If parents or teachers can observe it carefully, it is easy to find it. The signs of these early hearing impairment are as follows: 1. Baby: 1-3 months: no response to sudden loud noise. 3-6 months: No sound source found. 6-9 months: Don't look at the people or things mentioned in the speech. 9- 12 months: I don't know how to follow an action instruction, such as: give me the ball. 12- 15 months: failed to say the first word, such as: father, mother, light, car. 15-1August: indifferent to your call in the next room. 18-24 months: failed to use two-word short sentences. 24-30 months: can speak words within 100. 30-36 months: can't use 4-5 word sentences.

Children with hearing impairment follow the policy of "early detection, early diagnosis and early intervention". The fastest stage of children's speech development is 0-5 years old, and time is the most precious for children. If you miss this time, your child's speech, breath and understanding will be irreparable. Early detection is very important for children's later speech rehabilitation. In order to solve this problem, the relevant policies issued by the state make newborn hearing screening a compulsory item. Hearing screening for newborns within 72 hours after birth has passed, and there is no need for reexamination. Later, parents watched their children's reaction to sound at home; If you haven't heard of it, go back for a visit in 42 days. If it still doesn't pass, it will take 3 months to re-test. If it still fails, it needs to be referred to a third-class hospital for further hearing examination. You need to make a diagnosis and take relevant intervention measures this morning. If you have severe hearing loss, you need to wear a hearing aid and implant a cochlear implant.

Parents can observe and judge and strive for early detection and early intervention.

The symptoms of early hearing loss are as follows: 1. Infantile period: 1-3 months: no response to sudden loud noise. 3-6 months: No sound source found. 6-9 months: Don't look at the people or things mentioned in the speech. 9- 12 months: I don't know how to follow an action instruction, such as: give me the ball. 12- 15 months: failed to say the first word, such as: father, mother, light, car. 15-1August: indifferent to your call in the next room. 18-24 months: failed to use two-word short sentences. 24-30 months: can speak words within 100. 30-36 months: can't use 4-5 word sentences.

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