Hearing loss is one of the most common issues found at birth and, luckily, one of the most treatable according to Akron Children’s clinical audiologist Allison Harris.
“Speech and hearing are interrelated,” she said. “When children can’t hear, whether it’s due to middle ear fluid or permanent cochlear or nerve damage, it can impact them both cognitively and developmentally.”
As 1 of 5 audiologists in the hospital’s rehabilitation department, Allison sees inpatients and outpatients for hearing and central auditory processing tests, sedated hearing tests in the OR, and hearing aid fittings and evaluations.
Hearing aid fitting and evaluation
On this particular day, 9-year-old Ethan and his dad, Joe, are seeing Allison for a hearing aid check. Ethan was diagnosed with a mild hearing loss at birth and has worn hearing aids since he was 6 months old.
Having worn an older, bulkier model with bright blue ear molds for years, Ethan recently took a break from wearing his aids until he got a more discreet looking pair that sit directing behind the ear.
“When he was in kindergarten kids asked a lot of questions about them,” said Joe. “They were just being curious kids. Now his friends are used to seeing them, but there is still a social stigma. His new pair blends well with his glasses and hair and they are less noticeable.”
Allison escorts Ethan and Joe to one of the department’s soundproof booths to check how well he’s hearing different frequencies with his new aids. She asks him a series of questions including how much he’s been wearing them and whether he thinks he is hearing better at school.
“These should make school easier for you,” she said. “School is hard enough; you shouldn’t have to work to hear.”
Joe has been pleasantly surprised with how the new aids have impacted their home life as well.
“I can tell he hears me more, especially when he’s not looking directly at me,” he said. “He doesn’t listen to the TV or computer nearly as loud anymore.”
Allison leaves the booth and watches through a window as she administers the hearing check.
Ethan misses only a few words and Allison moves on to checking how well he’s hearing frequencies.
“We test pitches that are important for understanding speech,” she said.
Joe sits quietly in the room with his eyes closed.
“I close my eyes and make a conscious effort to not react to the noises so I don’t inadvertently assist him,” Joe said.
Allison adds background noise to the booth to make it a little harder for Ethan to hear her. She runs through the tests for the second time to double check and make sure he wasn’t guessing on any of the sounds.
“Ethan is doing really well,” she said. “He can hear my voice when it’s soft, which he couldn’t do without the aids.”
After finishing in the booth, Allison takes Ethan and Joe to the hearing aid room to get Ethan some new domes (the small, plastic bell-shaped piece at the end of the tube that’s inserted in the ear).
With no use for Ethan’s old hearing aids, Joe donates them back to the hospital to be used as loaners for kids whose own aids are being repaired. On average, a pair of hearing aids cost $5,000 and is not covered by most insurance plans.
“We are very lucky to have insurance that covers 80 percent of hearing aids,” Joe said. “Not everyone does, so if this helps someone in some small way I am happy to do it. Kids outgrow their aids about every 5 to 7 years so it adds up.”
The hospital is a provider with the Ohio Hearing Aid Assistance Program, which assists low-income families whose children have permanent hearing impairments to purchase hearing aids.
Allison’s next patient is 2-year-old Leon, who was admitted for failure to thrive, dehydration and croup. Born prematurely, Leon was referred for an infant therapy evaluation and Allison is doing his bedside hearing check.
The 5-minute test consists of a tympanogram to check for fluid in the middle ear and to see how the eardrum moves, and an otoacoustic emissions test to check the function of the hair cells in the inner ear when 2 tones are played.
Allison explains to Leon’s parents that he passed in one ear but not the other.
“I’d like to do a full hearing evaluation before he’s discharged,” she said. “It would involve doing behavioral testing in the soundproof booth to see how he responds to auditory stimuli.”
For kids who aren’t capable of sitting still in the booth and participating – often very young children or those with autism – Akron Children’s is one of a few places that offers sedated hearing tests.
“For sedated testing the child is asleep and we place ear phones in the ears,” Allison said. “We then use electrodes to measure the brain stem’s response to sound.”
Allison admits it can be challenging to deliver the news of a hearing loss to a family who had no idea anything was wrong.
“I try and help them understand the degree of the loss and the next steps we need to take,” Allison said. “That’s when it’s nice to be a part of a team and work with other disciplines like physical, occupational and speech therapy, so we can collaborate on the best course of treatment.”
Her favorite part of the job is doing hearing aid fittings on kids who have never worn them before.
“It’s moving to see their faces light up when they can finally hear,” she said.
Allison considers herself lucky to have landed the position right out of grad school in 2013.
“I was a patient at Akron Children’s when I was diagnosed with diabetes as a child,” she said. “I’ve spent a lot of time here and it feels like the place I was meant to be.”