Vocalizations and Hearing
As the infant develops, it is important for the clinician to assess the
type and frequency of vocalizations. Clinician often
use standardized screening tools which are available to assess developmental
milestones. Failure to meet developmental milestones in this area may
be indicative of oral-motor, auditory, and/or cognitive difficulties that
may ultimately affect communication development. Most infants should "coo"
at around three months and use various cries for different needs. Strings
of "babbling" sounds are usually heard by age six to seven months.
Infants typically are capable of expressing emotion by age seven months
by squealing and/or laughing. By approximately the eighth month, babies
should begin imitating the speech sounds of significant persons in their
environment. By twelve months of age, the infant should pay more attention
to speech, make simple gestures (such as shaking head), use expressive
"jargon", say "mama" and/or "dada", try
to imitate words, and use short exclamations. Licensed speech/language
pathologists can evaluate theses areas of infant development from birth.
Hearing is the most missed disability and clinical assessment
of communication is paramount in infants and young children. The Joint
Committee on Infant Hearing and the U.S. Public Health Services for Healthy
People 2010 recommend that babies be identified by 3 months of age and
receive intervention and amplification by 6 months of age. Excellent documentation
regarding the efficacy of early amplification (Yoshinago-Itano, Sedey,
Coutler, & Mehl, 1998) showed that those who are identified and receive
intervention before 6 months of age develop significantly better speech
and language skills than those who are identified and receive intervention
after 6 months. Infants as young as 4 weeks of age can be fitted for hearing
aids.
Hearing problems may be suspected should any of the following occur:
the infant fails to move his/her eyes toward sounds or speaker; is unable
to respond to changes in voice tone (e.g., loud /angry vs. soft/gentle);
does not notice toys that make noise or music; does not react to loud,
sudden noises in the environment; or fails to develop imitative sounds.
Some infants with hearing problems may coo like other infants, but at
about eight months sound production may diminish and the infant may fail
to or be delayed in putting consonants and vowels together into utterances.
Clinicians should gather information about the infant's communication
abilities through observation, interaction, medical history and gathering
parent/caregiver report information. Parent/caregiver report of the child's
typical performance in the home is of great importance, since many children
become quiet in the clinic setting. When communication concerns are discovered
through the screening process, or through review of medical history (e.g.,
hearing test prior to hospital discharge around the time of birth) or
through clinical observation, a follow-up plan should be made to address
the child's needs.
For more information, you may visit the American Speech-Language-Hearing
Association online at http://www.asha.org/default.htm
Batshaw, M.L., & Shapiro, B.K. (1997). Mental retardation.
In M.L. Batshaw (Ed.), Children with disabilities (pp. 339).
Baltimore, MD: Paul Brookes Publishing.
Yoshinago-Itano, C., Sedey, A.L., Coutler, B.A., &
Mehl, A.L. (1998). Language of early and later-identified children with
hearing loss. Pediatrics, 102(5), 1168-1171.
Also taken in part from the American Academy
of Pediatrics online medical library, retrieved 12/07/04 from http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZWKQVIQDC&sub_cat=105