The Weekly HATCH
It's Okay to Ask Questions!
As parents, we sometimes assume that because someone is a professional, they automatically have the specialized knowledge our child needs. We may even feel uncomfortable asking about their qualifications. But asking questions isn't questioning someone's competence. It's making sure your child's team has the knowledge, experience, and resources to provide appropriate support.
Here are some great questions to ask a new provider:
What experience do you have working with babies and toddlers who have hearing differences?
Have you received specialized training in supporting deaf and hard of hearing children?
How do you stay current on research and best practices?
How will you collaborate with our child's other providers?
How will you include our family's goals, priorities, and observations in your recommendations?
You don't need to approach these questions like an interview or an interrogation. They can simply be part of a friendly conversation about your child's needs.
Remember, You Bring Expertise, Too!
One of the most important things to remember is that your child's providers aren't the only experts at the table. You are the expert on your child. Your audiologist may understand the audiogram, hearing technology, and access to sound. Your speech-language pathologist may understand language development and communication strategies. Your early intervention provider may understand developmental milestones and ways to support learning through everyday routines.
But you know your child's personality, interests, frustrations, strengths, and daily experiences. You know what happens during all those hours between appointments. The best outcomes come when professional expertise and family knowledge work together. A strong provider won't just tell you what to do. They will listen to what you notice, explain their recommendations in ways that make sense, welcome your questions, and work with you to make decisions that fit your child and family.
Learning Together Through Connection
During this week's Tuesdays@10, we gratefully welcomed Dr. Gabe Bargen, CCC-A/SLP. She walked families through the different tests audiologists use to evaluate hearing in babies and young children. Audiologists use different tests to look at different parts of that pathway. Each test provides another piece of information, helping the audiologist understand how your child's hearing system is working. Let's take a look at what those tests are and why they matter.
1. Otoscopy: Taking a Peek Inside the Ear
This is usually the first step in a hearing evaluation. The audiologist uses an otoscope, a small handheld instrument with a light, to look inside your child's ear canal and examine the eardrum. They are checking for things like earwax, blockages, and anything unusual that might affect the testing. This is especially important for children who wear hearing aids because earmolds can sometimes contribute to earwax buildup.
What parents should know: This test should not hurt, although your child may not particularly enjoy having someone look in their ears! Dr. Bargen emphasized the importance of the provider carefully bracing their hand against the child's head to prevent injury if the child suddenly moves.
She also shared a practical tip about earwax: use a soft washcloth to gently clean the outside of the ear, rather than inserting cotton swabs into the ear canal.
2. Tympanometry: Checking the Middle Ear
Have you ever driven up into the mountains and felt your ears pop? That feeling is related to pressure changes in your middle ear. Tympanometry helps audiologists understand how your child's middle ear is functioning. A small, soft probe is placed in the ear canal. The equipment gently changes the air pressure and measures how the eardrum responds. This test can help identify middle ear fluid, unusual pressure, or problems with eardrum movement.
What parents should know: Tympanometry does not tell us how well a child hears. Instead, it tells us whether the middle ear is allowing sound to travel through it efficiently. This distinction is important because middle ear fluid can temporarily make hearing more difficult. For a child who already has hearing loss, that additional reduction in access to sound can be especially significant.
3. Middle Ear Muscle Reflexes: A Tiny Protective Response
Remember when your doctor tapped your knee with a little rubber hammer and your leg automatically kicked? Your middle ear has a reflex, too! During this test, the audiologist presents a relatively loud sound and measures whether a tiny muscle in the middle ear responds.
This reflex is part of the auditory system's natural response to sound, and testing it can provide additional information about how the hearing pathway is functioning.
What parents should know: This test is not always necessary at every appointment. It is simply another tool audiologists may use to better understand your child's hearing.
4. Otoacoustic Emissions (OAE): Listening for Tiny Echoes
This is one of the tests many babies receive during newborn hearing screening. Inside the cochlea, the spiral-shaped structure in the inner ear, are tiny sensory cells called hair cells. Despite their name, they aren't actually hairs! When sound enters a healthy cochlea, the outer hair cells respond by producing tiny sounds of their own. These are called otoacoustic emissions, or OAEs. The audiologist places a small probe in the ear, plays sounds, and uses a sensitive microphone to measure those tiny responses.
What parents should know: OAEs provide information about how the outer hair cells in the cochlea are functioning. They do not measure the entire hearing pathway or tell us everything about what a child can hear. Because the responses are so small, a quiet child and a clear ear canal help the audiologist get accurate results.
5. Auditory Brainstem Response (ABR): Following Sound Toward the Brain
For many families, the ABR is one of the most memorable hearing tests. This is the test where your baby may have little sticky electrodes placed on their forehead and near their ears while they sleep. The electrodes measure the auditory system's electrical responses to sounds presented through small earphones. And here's something reassuring Dr. Bargen emphasized: Those electrodes do not send electricity into your baby. They simply record responses. An ABR helps audiologists understand how sound is traveling through the auditory pathway to the brainstem. It can also help estimate hearing levels, even when a baby is too young to respond to sounds by raising a hand or turning their head. These results are especially important when determining whether a baby has hearing loss and what hearing technology or other supports may be appropriate.
What parents should know: Babies need to be sleeping during this test because movement creates interference with the tiny responses being measured. And as any parent knows, getting a baby to sleep exactly when you need them to is not always easy! That's why proper planning and preparation are important for this test.
6. Visual Reinforcement Audiometry (VRA): Turning Hearing Tests Into a Game
As babies grow, audiologists can begin using their developing abilities to participate in hearing tests. Visual Reinforcement Audiometry, often called VRA, typically begins around 5–6 months of developmental age, depending on the child. During this test, your baby may sit on your lap in a sound booth while the audiologist plays different sounds. When your baby hears a sound and turns toward it, they are rewarded with something interesting to look at, such as a lighted or animated toy. Over time, the audiologist uses this response to learn which sounds your baby can detect.
What parents should know: Your participation may be part of the process! You might be asked to hold a toy, help your child stay engaged, or simply provide a comfortable lap. And don't worry if your child doesn't perform perfectly. Audiologists who specialize in working with young children understand that babies and toddlers don't always follow the plan!
Understanding hearing tests isn't about becoming an audiologist. It's about feeling more confident at an appointment, knowing what questions to ask, and understanding how each piece of information helps your child's team support their development. A special thank-you to Dr. Gabe Bargen for sharing her expertise, her humor, and her parent perspective with our Tuesdays@10 families.
Kristi's Communication Corner
Hearing technology is a wonderful tool, and it has come a long way over time.
Today’s hearing aids and cochlear implants can provide amazing access to sound, but they work best when a whole team is involved, including families, audiologists, early intervention providers, and teachers. Everyone plays a role in making sure technology is well-fit for your child’s unique hearing needs.
For technology to truly support learning, children need access to sound across speech frequencies, full-time use, and a language-rich home environment filled with talking, reading, singing, and meaningful interaction. Children are capable of learning one language or multiple languages, and there are no limits to what they can achieve when they have strong support. The key is making sure all tools are fully activated so your child receives clear signals, consistent information, and rich communication every day. You are an essential part of this team, and your efforts make a real difference in your child’s success!
Kristina Blaiser, Ph.D., CCC-SLP, is the Director of Early Intervention Integration at the HATCH lab and a Professor of Speech-Language Pathology at Idaho State University.
BEWARE! It's the time of year when I tell a very spooky tale...
When my daughter was about two years old, I picked her up from her wonderful daycare. As I was giving her greetings and snuggles, I noticed that the battery door on her little pink hearing aid was open... and empty! I said, "Mary, where is the battery?" and she responded, "In my mouth".
You can imagine the immediate terror I felt. Batteries are highly toxic, and after searching all over the little room without finding it, we went directly to the ER. They laid my little girl on a table under an X-ray machine, and it didn't take a radiologist to tell me that the glowing dot in her tummy was the battery. The doctor said, "Well, the good news is that it made it past her esophagus, where it can get caught up. " "Okay", I said. "But, will we have to make sure it works its way out naturally in three days, or will we have to find it and take it out before it starts to erode." "Okay", I said. "That means you will need to search her poop to find it." "Oooookayyyyyyy", I said.
Each day, I gloved up and checked her poopy diapers. And because I am not a monster, I told her daycare that if there was a poopy diaper while she was there, "call me and I'll run over from work and do the searching."
On day three, I started to get really worried. If it didn't come out, my little girl would have to have surgery, and that was terrifying. That afternoon, I got a call from the daycare. I rushed over, gloved up, and searched. Eureka!! It had come out. I was so happy and grateful. And I'm sure it was a ridiculous and disgusting sight to behold.
When we got home, I soaked the battery in a cup of bleach and cleaned it sufficiently before placing it in a little baggy and saving it in Mary's special things box. I will never let her forget this scary story! And I hope you don't either. Make sure to lock those battery doors on your child's hearing aids!!
Text HEAR to 274 448!
The HEAR program is a specialty track within Lantern’s larger network, specifically designed for families of children ages birth to 3 years with suspected or confirmed hearing loss. Messages are a mix of information and encouragement, delivered once per week for 6 months. The program is available in English and Spanish.
We are HATCH Family Support, which is the family-to-family support arm of the HATCH (Helping Adults Talk to Children) lab at Idaho State University. Co-Directed by Kristina Blaiser, Ph.D., CCC-SLP, a professor in Communication Sciences and Disorders and years of experience teaching language strategies to the families of young children who have a hearing difference, and Kat Ross, a parent of a child with a hearing difference and years of experience in family-to-family support in Idaho. We provide family centered, statewide outreach, support, and evidence-informed resources to families who have children identified with a hearing difference.
Kristina Blaiser, Ph.D., CCC-SLP
Director of Early Intervention Integration
(208)859-0703
Kat Ross, Parent
Director of Family Support
(208)407-3726