May 14, 1998 By Victoria White
GAINESVILLE, Fla.---In their first months of life, babies drink in the details of their surroundings and begin to learn language from their parents' soothing chatter. But for some, such words literally fall on deaf ears, though years may pass before someone recognizes it.
The result? Severe delays in learning to communicate and lost opportunities for expanding the brain's potential at a critical time of growth, University of Florida experts say.
In an effort to diagnose hearing loss in infancy, UF audiologists this summer will begin screening all newborns at Shands HealthCare's Gainesville-area hospitals for possible problems. The University of Miami is launching a similar program.
The project, partly state-funded, was approved by the Legislature this year to weigh the costs and benefits of universal newborn hearing screening. UF audiologists hope the program will pave the way for Florida to join a handful of other states in requiring screening, which is recommended by the National Institutes of Health and the Centers for Disease Control.
"Many people think it is easy to tell if a baby can hear or not, but without the right tests, it's not," said Joseph Kemker, chief of audiology in the UF College of Health Professions' department of communicative disorders. "Some infants appear to be reacting to a sound when they are actually responding to something they have seen or felt. And some children can hear a little bit, but not enough to understand language. As a result, many hearing problems are not identified until children are 2, 3 and even 4 years old."
Early identification has taken on added significance in recent years as technological advances have improved the ability to detect problems in infants. Treatment options also have expanded, and brain research continues to highlight the importance of early learning and language development as the foundation for successful education.
"Extensive research tells us that if children with even mild hearing problems do not receive special treatment before the age of 6 months, they can fall permanently behind in speech, language, social, cognitive and emotional development," Kemker said.
Since 1985, Florida has required that all newborns with any risk factors for hearing loss be screened. Such risk factors include a family history of hearing loss and low birth weight. But many children with hearing problems have no obvious risk factors. If universal screening were instituted in Florida, experts predict an additional 570 babies with some hearing loss will be diagnosed annually.
Jake Jernigan of Tallahassee was 21 months old before his severe nerve deafness was diagnosed. His mother, Jodi Jernigan, had suspected it much earlier, but health professionals reassured her that nothing was wrong. "If I had known at birth that Jake was hearing-impaired, I think he would be a lot further along. I feel like a lot of the things I did with him when he was a baby didn't help him, because he couldn't hear anything at that point," she said.
Jake now is able to understand some speech, thanks to a cochlear implant. The surgically implanted device bypasses the damaged parts of the auditory system by sending electrical signals directly to the auditory nerve, which carries the signals to the brain for interpretation.
"His speech is coming slowly, but he can hear most everything," she said.
When Jake's younger brother Jordan was born, the Jernigans had him screened immediately. The 18-month-old has been wearing hearing aids for more than a year. "It was devastating to have a second child with a problem, but a relief to know that early what we were faced with," Jernigan said.
During the next 20 years, a statewide infant screening program would be expected to save $25 million by avoiding costs for intensive special education and therapy programs for children whose hearing loss went undetected too long, Kemker said.
The direct costs to provide these hearing tests average $50 to $80--a charge insurance companies likely would cover if evaluations are mandated by the state. The charge would translate into an annual cost of 72 cents per policyholder, Kemker said.
UF audiologists plan to use the otoacoustic emissions test in the pilot project. The test involves inserting a probe into the ear, transmitting a sound, then assessing the reaction of the ear's hair cells as the sound travels through the auditory system. The painless procedure takes just a few minutes.
Babies who fail the screening will receive more extensive tests and be referred for treatment.
In addition to Kemker, others at UF who will participate in the screening program include Alice Holmes, associate professor of communicative disorders, and Emily Tuttle McClain, a clinical audiologist.
The University of Florida and University of Miami pilot programs were sponsored in the Florida House of Representatives by Rep. George Albright, R-Ocala. The pilot programs were approved in the annual appropriations bill and signed into law by Gov. Lawton Chiles.
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