Sounds of Silence

Anyone who has ever witnessed the miracle in which infants progress from mewling to “Mama” to “Mine!” knows how critical it is for youngsters to hear normally before they speak their first words. Indeed, many children who don’t talk by age two turn out to be deaf. The sooner their disability is discovered and treated, the less likely they are to fall behind in the development of important language and social skills. That is why a growing number of hearing specialists (audiologists) and parents are campaigning for mandatory screening of newborns for hearing loss.

Their appeal has registered in some powerful ears. To date, 22 states have passed legislation requiring at least partial screening programs. And last November the U.S. Congress okayed some federal funds for hearing campaigns. Part of the push stems from advances in technology that, among other things, allow children as young as two months to be fitted with hearing aids. But there are limits to the technology. One thing parents should realize before they start is that the screening tests are far from foolproof. A bad result doesn’t necessarily indicate a problem.

Audiologists estimate that 3 out of every 1,000 babies are born with some kind of hearing loss. Of those three infants, one is profoundly deaf. About half the time, doctors can identify a possible cause, such as a birth weight less than 5 lbs. or a family history of deafness. The rest of the time there is simply no clue as to why a newborn’s hearing may have been affected.

The screening tests work by introducing a sound into a baby’s ear and then measuring either the response of the ear’s internal mechanisms (the otoacoustic emissions test) or the electrical activity of the auditory portion of the brain (the auditory brain-stem response test). Just because a baby fails either test, however, does not mean there is a hearing problem. A temporary buildup of fluid in the ear canal or excessive noise in the nursery can skew the results. For this reason, says Sharon Fujikawa, director of audiology at the University of California at Irvine, hospitals should repeat the screening tests for any baby who doesn’t pass the first time before telling the parents to consult an audiologist for more thorough testing.

It’s at this stage that things get a bit complicated. Though 20 of every 1,000 babies fail the two-step screen, most prove on further examination to be just fine. Is it worth worrying 17 families of perfectly normal children–not to mention asking them to spend several hundred dollars on advanced tests–to identify three infants with hearing loss? On the other hand, what if you are the parent of a child whose disability might otherwise not be detected?

One thing is clear. Whether or not their children were tested at birth, all parents should be on the alert for possible hearing loss. Does your three-month-old daughter smile when you speak to her? Does your five-month-old like rattles? Being startled by loud noises doesn’t necessarily prove anything, since babies also pick up on vibrations.

Don’t forget the toxic effects of loud noises on you and your child. Turn down the TV and the stereo, and protect your ears while mowing the lawn and (I know this is a pipe dream) at rock concerts. The eyes may be the window to the soul, but the ears provide plenty of enrichment as well.

For more info, visit www.hearinghealth.net or time.com/personal Want to suggest a topic? Send e-mail to gorman@time.com