Hearing in Infancy: The Development of Auditory Skills and the Audiological Evaluation

Among the most dramatic advances in the field of audiology has been the evolution of special testing techniques aimed at the infant from 0 to 24 months. Amid the urgings for early identification voiced by researchers and developmental experts (Mencher, 1977; White, 1975), there has emerged a ready supply of theoretical information and proven methods to accurately identify hearing loss close to birth. A survey of actual clinical practices, however, may reveal a discouraging gap between available knowledge and its application. Much time and effort may be expended in the evaluation of children eighteen months and older, yet the younger infant may receive only cursory and reserved attention (Simmons, 1980). Perhaps even we audiologists have fallen victim to the myth that evaluating babies is time-consuming, expensive, extraordinarily difficult, and fraught with uncertainty. Nothing could be further from the truth! While there are many areas of research as yet unexplored, we do possess sufficient developmental information and appropriate measurement techniques to identify hearing loss even in newborns. Beyond these basics, the clinician must be equipped with a sense of commitment and self-confidence which may be cultivated by study and practice. Thus, it would seem appropriate in any discussion of audiological evaluation to begin by reviewing some of the pertinent developmental data which lend validity to the assessment tools available and reveal the expected response. Strategies for successfully employing these techniques will be included, in the hope that it will become patent that prompt infant identification is not only desirable but imperative. The audiologist is in a unique position not only to perform the evaluation but to spearhead the effort to discover affected babies.