Your baby’s first year sets the tone for their Listening and Spoken Language (LSL) journey.
With LSL and the right hearing devices, even your baby who is deaf or hard of hearing can go from making gurgling sounds to saying their first words, like mama and dada.
Keeping your baby’s hearing devices on and working during all waking hours is one of the most important actions you can take to help their development. Learn about your baby’s hearing and what you need to know about their devices and audiology appointments.
Since your baby can't tell you whether their hearing devices are working each morning, you'll need to take action. Take five minutes at the start of each day to do a device check so your baby can hear all the sounds of speech. These checks are important because you can confirm that your baby's hearing devices are providing complete speech information to their brain and that they're noticing and actually listening to that speech information.
Use a battery tester to see that the battery is fully charged and always replace low batteries.
Your audiologist can provide you with a listening tube, a handy tool to let you listen to the sound from the hearing devices.
Learn how to perform the Ling Six-Sound Test. You'll produce specific speech sounds to see how your baby reacts without being able to see your mouth. These six sounds represent all the frequencies or pitches of speech. This quick at-home check will confirm your baby is hearing, responding, and identifying these sounds. Put your baby's devices on and then use a normal conversational voice to say these speech sounds:
You'll become the expert on how your baby responds to sounds. Take note of sounds your baby doesn't respond to and share with your professional team.
Our handout explains more about daily listening checks for babies.
Traditionally, remote microphone (RM) systems have been used for school-age children in a classroom setting, but they're not just for school. RM systems, specifically the personal-worn FM systems, can help infants and babies too. They allow your baby to hear you more clearly — whether it's at home, in the car, in a stroller, at the store, or in the park.
An RM system can solve any problems of background noise and distance from the person talking, which means using one can increase the number of words your baby hears. It can also improve the quantity and quality of the information that reaches your baby's brain. Most hearing technology can easily accommodate an RM system. Talk to your pediatric audiologist to see if your baby's hearing aid or cochlear implant comes with a mini-mic accessory, and ask how and when to use both devices together.
Every moment your baby is awake their hearing aids should be on and working properly. In their first year, babies are awake for an average of 7-10 hours every 24 hours. Take advantage of every minute. Babies with typical hearing can hear the sounds around them all the time, even when sleeping. Your baby needs those same opportunities. Research shows babies who wear their hearing aids for 10 to 12 hours per day make the most progress in learning to listen and talk.
Keeping baby hearing aids on little ears can be tricky but you can try:
Most babies go through a phase of pulling their hearing aids off. But if your baby insists on pulling their devices off frequently, there could be an underlying problem, like earmolds that don't fit anymore, hearing devices that aren't working properly, or ear infections causing discomfort. Share all of your concerns about hearing device wear time with your LSL professional and your pediatric audiologist.
The Children’s Hearing Aid Retention Project has more information about keeping hearing devices on young children.
After diagnosis, you'll see your pediatric audiologist often. You'll have regular appointments to monitor your baby's hearing through testing, adjusting their devices, and fitting them for earmolds.
Your pediatric audiologist may suggest additional testing or appointments if your baby needs it. When your baby has an audiology appointment, schedule your next appointment before leaving the audiologist's office.
In your baby's first year their ears will grow very quickly, which means they'll need new earmolds to keep up. If your baby is fit with hearing aids within their first few months then they'll need new earmolds even more often. As your baby gets older, they won't need new earmolds as much, about every four to six weeks. Your commitment to keeping their earmolds fit for their ears will pay off. The quality and fit of the earmolds are critical for your baby's brain to access all the sounds of speech.
Sometimes hearing aids aren't enough and can't provide your baby with all the sounds of speech. If this is the case, your peditatric audiologist may recommend different devices, like a cochlear implant. If your goal is for your baby to listen and talk, cochlear implants may be your next step on your LSL journey.
Today, babies as young as nine months old, or younger in special cases, can get cochlear implants. Research shows that babies who are implanted before they turn one year old have better language outcomes. If cochlear implants are recommended for your baby, talk to your audiologist about early implantation.
“If a child has no response on their ABR hearing test...then the overwhelmingly high likelihood is that the child will make the best progress with a cochlear implant.”
If your baby has been approved for cochlear implants, it may feel like a waiting game but there's so much you can do. It's important to continue all of the routines you've established to teach your baby to listen and talk. This means keeping their hearing aids on during all waking hours, using LSL strategies and techniques in your routines, and talking to your baby with a focus on listening.
Often, babies who are cochlear-implant candidates have some access to sound in lower frequencies that provides important language information, such as:
Your baby's brain can have access to this information if they wear their hearing aids while awake and you continue to talk, read, and sing to them. This will give your baby a head start on listening when they receive their cochlear implants.
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Remember, you’re not alone on this journey. Thousands of parents have been in your shoes. Find other parents who can share from experience, offer encouragement, and help your family reach your LSL goals.
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