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In the first few years of life, hearing is a critical part of kids' social, emotional, and cognitive development. Even a mild or partial hearing loss can affect a child's ability to develop speech and language properly.
The good news is that hearing problems can be overcome if they're caught early — ideally by the time a baby is 3 months old. So it's important to get your child's hearing screened early and checked regularly.
Hearing loss is a common birth defect, affecting about 1 to 3 out of every 1,000 babies. Although many things can lead to hearing loss, about half the time, no cause is found.
Hearing loss can occur if a child:
Newborn hearing screening identifies most children born with a hearing loss. But in some cases, the hearing loss is caused by things like infections, trauma, and damaging noise levels, and the problem doesn't emerge until later in childhood. Researchers believe that the number of people who have hearing loss doubles between birth and the teen years. So it's important to have kids' hearing checked regularly as they grow.
Your newborn should have a hearing screening before being discharged from the hospital. Every state and territory in the United States has now established an Early Hearing Detection and Intervention (EHDI) program; the program identifies every child with permanent hearing loss before 3 months of age, and provides intervention services before 6 months of age. If your baby doesn't have this screening, or was born at home or a birthing center, it's important to have a hearing screening within the first 3 weeks of life.
If your baby does not pass the hearing screening, it doesn't necessarily mean there's a hearing loss. Because debris or fluid in the ear can interfere with the test, it's often redone to confirm a diagnosis.
If your newborn doesn't pass the initial hearing screening, it's important to get a retest within 3 months so treatment can begin right away. Treatment for hearing loss can be the most effective if it's started before a child is 6 months old.
Kids who seem to have normal hearing should continue to have their hearing evaluated at regular doctors' appointments. Hearing tests are usually done at ages 4, 5, 6, 8, and 10, and any other time if there's a concern.
But if your child seems to have trouble hearing, if speech development seems abnormal, or if your child's speech is difficult to understand, talk with your doctor.
Even if your newborn passes the hearing screening, continue to watch for signs that hearing is normal. Some hearing milestones your child should reach in the first year of life:
As your baby grows into a toddler, signs of a hearing loss may include:
Conductive hearing loss is caused by blockage in the transmission of sound to the inner ear. Ear infections are the most common cause of this type of hearing loss in infants and young children. This loss is usually mild, temporary, and treatable with medicine or surgery.
Sensorineural hearing loss can happen when the sensitive inner ear (cochlea) has damage or a structural problem, though in rare cases it can be caused by problems with the auditory cortex, the part of the brain responsible for hearing. Cochlear hearing loss, the most common type, may involve a specific part of the cochlea such as the inner hair cells, outer hair cells, or both. It usually exists at birth, and can be inherited or come from other medical problems, though sometimes the cause is unknown. This type of hearing loss is usually permanent.
The degree of sensorineural hearing loss can be:
Sometimes the loss is progressive (gets worse over time) and sometimes unilateral (one ear only).
Because the hearing loss can get worse over time, audiologic testing should be repeated later on. Although medicines and surgeries cannot cure this type of hearing loss, hearing aids can help children hear better.
Mixed hearing loss happens when a person has both conductive and sensorineural hearing loss.
Central hearing loss occurs when the cochlea is working properly, but other parts of the brain are not. This rarer type of hearing loss is more difficult to treat.
Auditory processing disorder (APD) is a condition in which the ears and brain cannot fully coordinate. People with APD usually hear well when it is quiet, but cannot hear well when it is noisy. In most cases, speech-language therapy can help kids with APD.
Several methods can be used to test hearing, depending on a child's age, development, and health status.
During behavioral tests, an audiologist carefully watches a child respond to sounds like calibrated speech (speech that is played with a particular volume and intensity) and pure tones. A pure tone is a sound with a very specific pitch (frequency), like a note on a keyboard.
An audiologist may know an infant or toddler is reponding by his or her eye movements or head turns. A preschooler may move a game piece in response to a sound, and a gradeschooler may raise a hand. Children can respond to speech with activities like identifying a picture of a word or repeating words softly.
If a child is too young to get behavioral hearing testing, or has other medical or developmental problems to prevent this type of test, doctors can check for hearing problems by looking at how well the ear, nerves, and brain are working.
For this test, tiny earphones are placed in the ear canals and small electrodes (sensors which look like small stickers) are placed behind the ears and on the forehead. Usually, clicking sounds are sent through the earphones, and the electrodes measure the hearing nerve's response to the sounds.
Young infants under 6 months can sleep for the entire test, but older infants may need sedation for this test. Older cooperative kids can do this testing in a silent environment while they're visually occupied.
Normal hearing has a certain appearance when test results are measured on a chart. Because of this, a normal ABR suggests that a baby's inner ear and lower part of the auditory system (brainstem) are working normally for typical speech. An abnormal ABR may be a sign of hearing loss, but it may also be due to some medical problems or measurement problems.
This test is similar to the ABR, though an infant usually needs to be sleeping or sedated for the ASSR test.
Sound passes into the ear canals, and a computer picks up the brain's response to the sound and automatically decides whether hearing loss is mild, moderate, severe, or profound. This ASSR test has to be done with (and not instead of) ABR to check for hearing.
This test is similar to the ABR, and uses the same tiny earphones and small electrodes. This CAEP test allows the audiologist to see if the pathways from the brainstem to the auditory cortex are working properly. The audiologist may recommend a CAEP test for some specific types of hearing loss. This test can be done at any age and does not require participation from the child.
A sleeping infant or an older child who may be able to sit quietly can do this quick test. A tiny probe is placed in the ear canal, then many pulsing sounds are sent and the probe records an 'echo' response from the outer hair cells in the inner ear. These recordings are averaged by a computer.
A normal recording suggests that the outer hair cells are working well. But in some cases, a hearing loss may still happen if other hearing pathways are not working normally.
Hospitals use ABR or OAE to screen newborns. If a baby fails a screening, the test is usually repeated. If the screening is failed again, the baby is sent to an audiologist for a full hearing evaluation.
Tympanometry is not a hearing test but a procedure that can show how well the eardrum moves when a soft sound and air pressure are introduced in the ear canal. It's helpful in identifying middle ear problems, such as fluid collecting behind the eardrum.
A tympanogram puts the tympanometry results into a graph. A 'flat' line on a tympanogram may indicate that the eardrum can't move, while a 'peaked' pattern usually suggests that the ear drum is moving normally. Doctors who do this exam should also do a visual ear examination and see the ear drum.
The MEMR (also called acoustic reflex test) tests how well the ear responds to loud sounds by evoking a reflex. In a healthy ear, this reflex helps protect the ear against loud sounds. Free online slot games to play now.
For the MEMR, a soft rubber tip is placed in the ear canal. A series of loud sounds are sent through the tips into the ears and a machine records whether the sound has triggered a reflex. Sometimes the test is done while the child is sleeping.
A pediatric audiologist specializes in testing and helping kids with hearing loss and works closely with doctors, teachers, and speech/language pathologists.
Audiologists have a lot of specialized training. They have master's or doctorate degrees in audiology, have performed internships, and are certified by the American Speech-Language-Hearing Association (CCC-A) or are Fellows of the American Academy of Audiology (F-AAA).
While medical treatments and surgery can help people with certain types of hearing loss, hearing aids are the main treatment for sensorineural hearing loss. The most common type of hearing loss involves outer hair cells that do not work properly. Hearing aids can make sounds louder and overcome this problem.
A hearing aid has three basic parts: the microphone, amplifier, and receiver. Settings can be customized to make certain sounds louder.
Some hearing aid styles are worn on the body while others fit behind the ear or in the ear. If regular hearing aids can't be used — as in certain types of conductive hearing loss — specialized hearing aids that attach to the skill bone can send sound waves directly to the cochlea.
No single style or manufacturer is best — your doctor will help you choose a hearing aid based on your child's needs. Most kids with bilateral hearing loss (in both ears) wear two hearing aids.
Because they are so technology-heavy, hearing aids are expensive. Unfortunately, health insurance companies do not usually cover hearing aids, although several states now require that insurance cover at least part of their cost. Talk to your child's doctor to look for financial assistance options for hearing aids.
A specialized amplification device called an FM system (sometimes called 'auditory trainers') may help kids in school. These systems have a microphone that a teacher can speak into and a receiver help by the child, which can send the sound to the ears or directly to a hearing aid. They can work well in the classroom to improve hearing in group or noisy environments and also can be fitted for personal or home use. Other assistive listening or alerting devices may help older kids.
In addition to hearing aids or FM systems, hearing rehabilitation may include auditory or listening therapy and speech (lip) reading. Technology is improving all the time, so ask your doctor about newer tools available to help aid a child's communication.
A cochlear implant is a surgical treatment for hearing loss; this device doesn't cure hearing loss, but is a device that gets placed into the inner ear to send sound directly to the hearing nerve. It can help children with profound hearing loss who do not benefit from hearing aids.
Chapter One Summary:
Cassie Logan and her three brothers (Stacey, Christopher-John, and Little Man) walk down a dusty road in rural Mississippi on their way to the first day of school in the fall of 1933. Stacey, aged twelve, is grouchy because he will be in the class taught by their mother. Christopher-John, aged seven, is a cheerful boy who keeps to himself. Cassie is annoyed that they must go to school on a 'bright August-like October morning' and is even more annoyed that they must wear their Sunday clothes and shoes.
Little Man is six years old. It is his first day of school ever, and he walks very slowly and carefully to avoid getting the dust from the road on his shoes or corduroys. Cassie tells him that he will make them late to school, and she drags her feet in the dust until Stacey yells at her to stop because they promised their mother that they would arrive neat and clean.
As they walk, the children pass an old oak tree that marks the boundary between their family's four hundred acres of land and the forest. The forest and the land beyond is part of Harlan Granger's ten-square-mile plantation. The Logans' land had once belonged to the Grangers. Cassie's grandfather bought the family's first two hundred acres in 1887, and after he paid off the mortgage on that land bought two hundred more in 1918.
Flyer mill 1 5. The Logans still have a mortgage on the second two hundred acres of land and have to pay taxes on all four hundred acres. In 1930, the price of cotton dropped, and the profit from their cotton crop could not pay the Logans' bills, so Cassie's Papa left to look for work. Every year, Papa works in Louisiana on a railroad, and is away from home from spring until the next winter.
Cassie remembers Papa telling her that the land is important because as long as she lives she will never have to live on anybody's place but her own. Cassie knows that the land belongs not only to her Papa but also to her brothers, their grandmother, their mother, and their uncle. Papa describes it as 'Logan land.' While Papa is away, Mama teaches school and Big Ma works in the fields.
Halfway to school, an 'emaciated-looking' barefoot boy named TJ and his brother Claude emerge from the trees and walk with the Logan children. TJ failed Mrs. Logan's class the previous year and will be in it again with Stacey. He tells Stacey that Mr. Berry and his two nephews were burned by some white men the previous night. Stacey says that Mr. Lanier had fetched Big Ma to help nurse Mr. Berry the night before. TJ knows about the burning because Mrs. Logan had stopped by to talk to his mother about it before school earlier that morning.
TJ is angry at Cassie for telling her mother who told his mother about him going up to the Wallace store to dance. He only escaped being whipped by telling his mother that he only went up there to follow Claude, who wanted to buy candy. Cassie knows that Claude was willing to take TJ's punishment because he is more scared of his brother than of his mother.
The children have to jump out of the way as a school bus rushes by and covers them with dust. Stacey explains to Little Man, who is furious, that the bus is only for white children and that they don't have a bus. A blond white boy named Jeremy runs out of the forest and starts walking with the Logans. He tells Stacey that his school has been going since the end of August. Cassie recalls that Jeremy has always walked with them to the crossroads in the morning and met them there after school. Other kids at his school pick on him because of this and he sometimes has red welts on his arm as punishment for associating with them, but he continues to meet them.
At the crossroads, some other white children rush past and Jeremy's older sister, Lillian Jean, yells at him to come with them. Cassie looks at the white children's building, Jefferson Davis County School, and notices that it has two school buses, a sports field, and the Mississippi flag with the emblem of the Confederacy on it. The black children turn east to head to their school.
They go to Great Faith Elementary and Secondary School, 'consisting of four weather-beaten wooden houses on stilts of brick, 320 students, seven teachers, a principal, and caretaker, and the caretaker's cow.' Most of Cassie's classmates are children whose families sharecrop on three nearby plantations. They start school late because their families need them to pick cotton until October.
Cassie walks slowly over to the building that houses the first four grades. Mary Lou Wellever, the principal's daughter says hi, and Cassie notices that she is wearing a new dress. Cassie looks at the other children wearing their Sunday clothes and knows that after today, they will come to school barefoot again until the roads freeze. She also sees Stacey's friend Moe Turner, who walks to school for three and a half hours from the Montier plantation.
Inside the school, Cassie sits with Gracey Pearson and Alma Scott, who say they would rather have Mary Lou sit with them. When the teacher, Miss Daisy Crocker, tells everyone to sit down, Mary Lou looks angrily at Cassie. The first and second grade teacher, Miss Davis, is in Jackson for a few days, so Miss Crocker temporarily teaches both classes.
Miss Crocker announces that they will all have books this year. Cassie has never had one of her own before and is excited until she notices that they are old and worn. She sees how excited Little Man is to get a first grade reader because he cannot see the cover. Cassie picks up her book and begins to read it until she hears Miss Crocker yelling at Clayton Chester (Little Man) because he has asked for a book that is not dirty.
Little Man takes the book back to his desk, but when he opens it, sees something inside it that makes him throw it on the floor and stomp on it. Cassie looks inside her book and sees columns listing the book's condition and the race of the student for every year from 1922-1933. This is the first year that the book's condition is listed as 'very poor' and the first time that the race of the student is listed as 'nigra' instead of 'white.' As Miss Crocker is about to take the switch to Little Man, Cassie explains that her brother can already read and shows the teacher why he was angry. Miss Crocker tells Cassie that the books says 'nigra' because that's what she is and orders her to sit down. Cassie tells Miss Crocker she doesn't want her book either. Miss Crocker takes the switch to both Little Man and Cassie.
After class, Cassie is determined to tell Mama the story before Miss Crocker does, but accidentally bumps into the principal, Mr. Wellever, and receives a long lecture from him on watching where she is going. When she gets to her mother's classroom, she sees Miss Crocker showing her the book that Little Man broke. Miss Crocker cannot understand why the children got so upset about what was written in the inside cover. Though Mama says that Miss Crocker had the right to punish them for disobeying, she clearly doesn't agree with her. Mama trims brown paper to the size of the page and glues it over the inside covers of her children's books. Miss Crocker is shocked that she would 'damage' county property, but Mama says she is going to do it to all the seventh graders' books the next day. Cassie can tell that her mother understands, and sneaks away.
Analysis:
This chapter provides an introduction to the social and historical structure of black life in the South in the 1930s. The educational system functions as a microcosm in which the reader can see the greater inequalities in society reflected in the differences in schooling available to black and white children. The black children must walk for an hour (or in Moe's case, three and a half hours) to get to school, while the white students have school buses that will drive them directly there. The physical ease with which the white children attend school reflects their greater access to education. Cassie personifies one of the two buses as 'our own tormenter.' The bus is a tormenter not only because it sprays them with dirt as it passes but also because in doing so, the bus illustrates society's that they are somehow inferior to, or dirtier than, the white children.
Similarly, the physical differences in the structures and appearance of the schools demonstrates the cultural and physical divide which separates black and white society in the 1930s South. The white children's school is named after Jefferson Davis, the president of the Confederacy. Cassie notes that the Mississippi flag 'waving red, white, and blue with the emblem of the Confederacy emblazoned in its upper left-hand corner' flies over the white school. This flag is a symbol of segregation and oppression. Flying over the white school, the flag's presence illustrates that the 'ideals' of the Confederacy, including oppression of blacks, still exist many years after the Civil War.
Cassie notes that the Mississippi flag flies above the American flag. The positioning of the flags illustrates the domination of racist Jim Crow ideology over the more inclusive American ideal of equality. 'Jeremy and his sister and brothers' can 'hurr[y] toward those transposed flags' because they represent a system which will allow them power and success, but the black children must turn away and head in the opposite direction.
Play total rewards. The incident with the schoolbooks demonstrates the ability of the children themselves to recognize the system of symbolic as well as actual oppression. Little Man lives up to his name in that he is far more perceptive than the teacher, Miss Crocker, in reading the deeper meaning behind the columns in the front cover or his book. The equation in Cassie's book of 'very poor' and 'nigra' illustrates not only the county's contempt for black children's educational needs but also reminds the reader that characters like TJ and Claude, who have no shoes, or like the Logans, whose father must work away from home for months to afford taxes and a mortgage, are poor as a result of discrimination.
Cassie recognizes the power of language more clearly than Miss Crocker does. Miss Crocker attempts to push her students into action by making them respond in unison to her. Cassie's refusal to respond to Miss Crocker's request that she 'share, share, share' comes in part because she recognizes the futility in saying something that you don't mean. 'I never did approve of group responses,' she thinks. Cassie also fails to respond because she is thinking of something more meaningful: the burning of the Berrys.
Furthermore, Cassie recognizes the danger inherent in the abuse of language. She says 'S-see what they called us,' when showing Miss Crocker the book, assuming that the teacher will think the labeling as wrong as she does. Miss Crocker, who later urges Mrs. Logan to make the children accept the way things are, cannot contemplate any means of resistance because she accepts the labels given to her by the whites in power. By accepting the racial title written in the book, she also accepts a type of subordination.
Chapter Two Summary:
Big Ma watches as Cassie balances halfway up a pole in the cotton field. She, Christopher-John, and Little Man are all picking the last of the cotton at the tops of the plants. (Stacey is too big to climb the poles now.) Big Ma tells Mama that they have picked enough for the day.
From the top of her pole, Cassie sees Papa and another man coming down the road. The children rush over to hug them, and he says they're getting too big to call his 'babies' anymore. The other man with them is Mr. Morrison, who is very tall. He has burn scars on his face and neck, deep wrinkles, some gray in his hair, and 'clear and penetrating' eyes. Mama wants to know if something is wrong, but Papa avoids the question.
Mr. Morrison and the family walk into Mama and Papa's room, which doubles as a living room. Mr. Morrison looks around the room, the walls of which are covered with pictures of various family members, before sitting down in Grandpa Logan's rocking chair. Big Ma asks her son how long he will be home, and he tells her until Sunday evening. It is already Saturday. The children want him to stay longer, but he says that if he does, he will lose his job.
Papa says that he came home to bring Mr. Morrison, who is going to work in the house as a hired hand for room and board and a few dollars in the winter. He used to work on the railroad but cannot get work anymore. Mr. Morrison, whose voice is 'like the roll of low thunder' says he got fired from his job because some white men started a fight with him and he beat them up. They didn't get fired.
That evening, as they milk the cows, Cassie asks Stacey if Papa brought Mr. Morrison home because of the burnings. Stacey tells her not to worry about it. Cassie says she just wishes she knew more. Christopher-John, close to tears, says that he wishes that Papa could stay at home.
The next day, at church, Mrs. Lanier tells Big Ma that John Henry Berry died the night before. The deacons announce it as well, and the people pray for his soul and for his brother and uncle's recovery. After church, Mr. Lanier says that John Henry had a nice place up by Smellings Creek with a wife and six children and that 'they' have been after him since he came back from the war. Big Ma says he was just in the wrong place at the wrong time.
Mrs. Lanier says that Henrietta Toggins, who is related to the Berrys, was with them in John Henry's Model T when it happened. They had stopped for gas and some drunk white men came by and said: 'That's the nigger Sallie Ann said was flirtin' with her.' Henrietta made John Henry and his brother Beacon get in the car and drive off without filling up on gas. After they dropped her off at home, the three white men caught up with them and kept hitting the back of the car. Knowing he didn't have enough gas to get home, John Henry stopped at his uncle's. The white men dragged John Henry and Beacon out of the house and when their uncle tried to stop them, lit all three of them on fire.
TJ's father says that he heard that a boy was lynched in Crosston a few days ago. Mr. Lanier says that the worst thing is that no one can do anything about it. The sheriff called Henrietta a liar when she went to him, and now the white men who did it are bragging about the lynching, saying 'they'd do it again if some other uppity nigger get out of line.' Papa says that his family doesn't shop at the Wallace store. The room goes silent. After the Laniers and Averys leave, Papa tells the children that Mama has heard about other older kids going to the store to dance, buy bootleg liquor, and smoke. He says he does not want his children going there and says he'll 'wear [them] out' if they go there. The children agree not to go, knowing that Papa swings a mean switch.
Analysis: Indivisible (2019).
The power of language is once again prevalent in this chapter. The use of derogatory, racist terms and the act of racist hate-crimes are part of a continuum of power. In their society, the white men face no reprimand for calling Henry John derogatory names. This too-permissive atmosphere implicitly condones the growth of their hatred into physical action.
For this black community, language is both powerful, and, in their own mouths powerless. All the white men need to do to 'justify' their attack on the Berrys is say that Henry John was flirting with a white woman. This second-hand hearsay is the only reason that they appear to have for attacking the Berrys. Similarly, their later bragging and threats operate just as strongly as physical threats. At the same time, black language does not have the same power in white society. Henrietta's testimony is powerless to make the sheriff investigate. Truth, therefore, is an essentially meaningless concept in this society, where the power of language is determined by race rather than by validity.
Can you use excel on a macbook. The allusion to the novel's title functions as a means of foreshadowing Mr. Morrison's significance in the novel. His voice, Cassie notices, is like 'the roll of low thunder.' Understanding that Mr. Morrison may be in danger, the reader can equate the threat represented by the sound of thunder with the threat to Mr. Morrison. His presence in the story marks the first entrance of an outsider into the safety of 'Logan land' and suggests that, like thunder before lightening, Mr. Morrison's presence will herald dangerous changes.
Mr. Morrison's physical appearance is symbolic of his place in society. The scar on his face and deep lines show he has been literally, as well as economically, hurt by a white society that will dismiss a black man defending himself but will not fire his two white aggressors. Mr. Morrison's penetrating eyes demonstrate his spirit of resistance and his ability to see to the truth. His immediate explanation to Mrs. Logan of why he lost his job shows how highly he values the truth.
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