For the sake of the child’s overall development, it is crucial that hearing impairment is diagnosed as early as possible. Changes and advances over the last 15 years mean that we are now well on the way towards universal hearing screening for newborns. As a result, the age of the children with whom education professionals and therapists are working is becoming progressively lower. Specifically, this means that children, who are hard of hearing or profoundly deaf, are diagnosed immediately after birth and receive their first hearing aids at around eight weeks, which thus marks the onset of early intervention.
It is therefore becoming increasingly necessary for professionals to acquire detailed knowledge in many areas: early-childhood communicational development, building the parent-child relationship, hearing and speech development, the role of play, and the child’s overall development.
Even in our work with infants under one year of age, individual children and their families are very different and must receive tailor-made help that takes account of these differences.
The diagnosis may come in many different ways:
Within these individual categories, too, we see a very wide range of different situations. If, for example, a sibling child is hearing impaired, many normal-hearing parents (note: 90 % of all parents of children with hearing impairment have a normal hearing) find it incomprehensible that fate has dealt them another cruel blow – the birth of another child with hearing impairment -, whereas others may have prepared themselves for the possibility that a further child could be affected. Hard of hearing or deaf parents, too, take the news in very different ways. This depends not least on how well they themselves manage to integrate their own hearing impairment into their everyday lives.
Parents of children with auricular (outer ear) malformations and hearing impairment are confronted with the problem immediately after birth and often face months of anxiety as to whether the child might not also have other malformed organs or developmental problems. There are families who have a stable social network, and there are also mothers or fathers who have to cope with the diagnosis – and get on with their daily lives – more or less alone. Many more examples could be given. However heterogeneous a group of early-intervention children and their families may be, and however differently families deal with the diagnosis of hearing impairment, the initial period with a new baby is a time of tremendous upheaval in any family.
The work of an early-years practitioner often involves an outsider coming into the home during a highly sensitive phase, where nothing is as it used to be. The family is still feeling their way with the new arrival, learning to integrate them into their lives and adjust to new daily routines. It is an emotionally charged time for everyone anyway, and then, to cap it all comes the diagnosis of hearing impairment: “The parents are in a state of emotional turmoil, facing feelings of guilt and a sense of duty, anxiety, and grieving, uncertainty and happiness” (Pöllmacher/ Holthaus 2005).
Work with infants with hearing impairment thus requires more than specialist knowledge of child development in the first year of life: these professionals also need to provide highly skilled guidance and an empathetic understanding of each family’s individual situation.