Daycare Dilemma: A Cesspool Of Germs Affecting Hearing And Non-Hearing Kids.

By Ronald Kennedy

February 12, 2023

Children Are Susceptible Too Many Illnesses In Day Care.

If your child is deaf or not, why are parents not being more cautious in regard to classroom environment?

The number of children, hearing and non-hearing, spending time in day care grows each year. Health officials have estimated that approximately two-thirds of all preschool children and three-quarters of all school age children need some sort of child care while their parents work.

With this rise in day care usage comes and increased risk of illness to the children who participate.

Young children in this setting are as twice as likely as those in home care to contract an illness that last more than 10 days, causes a fever of at least 102 degrees for three or more days, or requires medical attention.

So asking school health officials, “Why my child get sick in daycare?” is a legitimate question any concerned parent would ask. For a variety of reasons, germs easily spread from child to child in the close quarters of the day care setting.

Among the most common are:

• Giardia lamblia
• Shigella
• Salmonella
• Escherichia coli
• Entamoeba histolytica
• Adenoviruses
• Rotavirus
• Herophilus influenzae
• Streptococcus pneumoniae

A friend of mine Dr. Stanley Schuman, of the medical University of South Carolina, blames day care centers for “outbreaks of illness – diarrhea, dysentery, giardiasis, and epidemic jaundice – reminiscent of the pre-sanitation days of the 17th century.

A study published in 1984 revealed that children in daycare centers were more than 12 times as likely to be infected with Herophilus influenzae type b. Another showed that day care children are 15 to 20 times more likely to contract giardiasis than

children under maternal home care.

Researchers at the University of Alabama found that 59 percent of day care children were shedding cytomegalovirus. Cytomegalovirus (CM) was found on toys and other items frequently handled by children in the day care center.

Based on antibody testing, it was estimated that between 70 and 100 percent of day care children were infected with CMV.

A study reported in the American Journal Of Public Health in 1988 compared children raised at home, raised in another home, and placed in nursery school or day care.

The investigators in this study found that, compared to children reared at home, children in daycare spent 30 percent more sick days in bed, while those raised in another home spent 19 percent more sick days in bed.

A variety of infectious organisms have been isolated from day care workers and children. Infants and toddlers in daycare has to be specially cared for and protected as much as they could from germs.

 

Children in day care were also likely to spend more time in hospitals than children raised at home.

It was also determined by specialist in the field of infections and hearing loss among young children, that when they compared the rate of otitis media in children minded exclusively at home with those spending time in day care centers, they found the occurrence of otitis media to be significantly higher.

A 1988 report in the Journal of Pediatrics revealed that hospitalization for myringotomy and tube placement occurred in 21 percent of the children in day care compared with only 3 percent of those in home care.

Day care is here to stay. Many families require two incomes in order to survive. Certainly, many single parents would find it impossible to work or go to school without available day care for their children. Even the federal government has expressed its need to have mothers in the workforce.

Public Officials Work To Rectify Health Issues

However, the health implications of the growing day care situation are enormous. Public health officials are working to stem the rising tide on infections in day care children.

At this stage there seems to be little progress. Some have recommended mass immunization of day care children, but this carries with it a host of social, philosophical, and medical implications.

Parents and day care providers should be aware of things they can do to reduce the spread of infectious diseases. For parents, it is necessary to be aware of times when your child should be kept out of daycare.

For providers, it is important to know which children should be excluded or sent home. These are only first steps since the nature of the day care environment contributes to the spread of illness among children.

Recognize that otitis media is not considered a communicable disease in the strict sense. A number of studies have shown that otitis media occurs more frequently in day care children than in children minded at home. Yet, many of the conditions that predispose children to the development of middle ear effusion are considered communicable.

The following guidelines are useful in determining when to exclude children from day care. Children who have the following symptoms should be excluded from the child care setting until 1) a physician has certified the symptoms are not associated with an infectious agent or the child is no longer a threat to the health of other children at the center, or 2) the symptoms have subsided.

For the mildly ill child, exclusion should be based on whether there are adequate facilities and staff available to meet the needs of both the ill child and other children in the group.

FEVER: Axillary or oral temperature: 100 degrees F. or higher, or Rectal temperature: 101 degrees F. or higher; especially if accompanied by other symptoms such as vomiting, sore throat, diarrhea, headache and stiff neck, or undiagnosed rash.

RESPIRATORY SYMPTOMS: Difficult or rapid breathing or severe coughing:

-child makes high-pitched croup or whooping sound after he coughs.

-child unable to lie comfortable due to continuous cough.

DIARRHEA: An increased number of abnormally loose stools in the previous 24 hours. Observe the child for other symptoms such as fever, abdominal pain, or vomiting.

VOMITING: Two or more episodes of vomiting within the previous 24 hours.

EYE/NOSE DRAINAGE: Thick mucus or pus draining from the eye or nose.

SORE THROAT: Sore throat, especially when fever or swollen glands in the neck are presented.

SKIN PROBLEMS: Rash – Skin rashes, undiagnosed or contagious. Infected sores – Sores with crusty, yellow or green drainage which cannot be covered by clothing or bandages.

ITCHING: Persistent itching (or scratching) of body or scalp.

APPEARANCE: Child looks or acts differently.

BEHAVIOR: Unusually tired, pale, lacking appetite. Confused, irritable, difficult to awaken.

UNUSUAL COLOR: Eyes or skin – yellow (jaundice), Stool – Gray or white, Urine – Dark, tea-colored.

These symptoms can be found in hepatitis and should be evaluated by a physician.

THE AUDIOLOGIST:

Educated professionals

An audiologist is a licensed and/or certified professional trained to identify and measure hearing loss, and to rehabilitate those with hearing or speech problems.

Audiologist are trained to determine where hearing loss occurs, and they can assess the loss of your ability to communicate.

Educational audiologist creates a strong connection their patients.

They pinpoint and identify issues in regard to Early Hearing Detection and Intervention process. You can just identify it as EHDI, for short.

Although loss can occur at any age, hearing difficulties at birth or that develop during infancy/toddler years, and not properly treated through the adult years can have serious consequences.

These medical people are complete professionals that perform their job well, but it’s not their job to teach sign language you or your loved ones.

School based audiologist are in a unique position to facilitate and support the developmental and educational management of individuals suffering from hearing loss.

Testing the patient’s middle ear function is important to the audiologist, for this may be the main issue that brings on other problems.

With proper hearing examination, treatment, education, and support, the individual should function as close to what a normal person should.

Audiologist who works for a special school has an ongoing responsibility and the opportunity to promote early detection and intervention of hearing loss.

The audiologist can recommend hearing aids and provide counseling and therapy to help you deal with hearing loss.

An audiologist is not a medical doctor, but may have a doctorate in audiology and thus be referred to as “DR.” An audiometrist is a person without a degree in audiology who has been given informal training in the administration of hearings test.

An audiometrist must work under the supervision of an audiologist or a physician.

They can neither diagnose hearing disorders nor interpret audio grams.

The definition of Audiology, also listed under IDEA (Individuals with Disabilities Education Act), is the responsibility to use his or her skills for the identification of people that are partially or fully deaf.

Screening activities are generally considered health initiatives rather than special education responsibilities.

AUDIOGRAM- An audio gram is a graph produced as part of some hearings test that can be used to represent at what level of loudness you can hear different frequencies.

The audio gram form is arranged so that octave and half-octave frequencies range across the top, with the frequency increasing from left to right.

The hearing-level scale on the left side of an audio gram shows the strength of the test sound in decibels (dB).

EHDI

Good news now being that thirty-eight states have Early Hearing Detection Intervention (EHDI) programs, which mandate that all newborns be screened for hearing loss before they are discharged from the hospital.

You should check within your own home state to find the proper facility and hearing aid that would cater to your special needs.

At any time during your child’s life, if you and/or your pediatrician suspect that she has a hearing loss, insist that a formal hearing evaluation be performed promptly.

Management of these screenings are usually the responsibility of the audiologist. This is to make sure all the appropriate procedures are followed and all screening targets are met.

Local clinical audiologist, EHDI personnel, and the special educational audiologist work hand-in-hand combating critical health issues in a child’s hearing development.

Although some family doctors, pediatricians, and well-baby clinics can test for fluid in the middle ear – a common cause of hearing loss – they cannot measure hearing precisely. Your child should go to an audiologist, who can perform this service.

He or she may also be seen by an ear, nose, and throat doctor (ENT; an otolaryngologist).

Normal hearing is initially needed to understand spoken language and then, later, to produce clear speech.

Consequently, if your child experiences hearing loss during infancy and early childhood, it demands immediate attention.

Even a temporary but severe hearing loss during this time can make it very difficult for the child to learn proper oral language.

Older children learn a combination of spoken and sign language. Written language also is very important because it is the key to educational and vocational success. You may ask, “Why deaf kids feel special?” It’s because of mainly all of the close and special care they receive.

Learning excellent oral language is highly desirable, but not all people who are born deaf can master this.

Sign language is the primary way deaf people communicate with one another and the way many express themselves best.

If your child is learning sign language, you and your immediate family also must learn it. This way you will be able to teach him or her, discipline them, praise them, comfort them and laugh with him or her.

You should encourage friends and relatives to learn to sign, too. Although some advocates in the deaf community prefer separate schools for deaf children, there is no reason for children with severe hearing impairment to be separated from other people because of their hearing loss.

WHEN TO CALL THE PEDIATRICIAN – WHAT TO LOOK FOR:

Hear are the signs and symptoms that should make you suspect that your child has a hearing loss and alert you to call your pediatrician:

• Your child doesn’t startle at loud noises by one month or turn to the source of a sound by three or four months of age.

• He or she doesn’t notice you until they see you.

• He or she concentrates on gargling and other vibrating noises that they can feel, rather than experimenting with a wide variety of vowel sounds and consonants.

• His or her speech is delayed or hard to understand, or he or she doesn’t say single words such as “dada” or “mama” by twelve to fifteen months of age.

• Your child doesn’t always respond when called. (This is usually mistaken for inattention or resistance, but could be the result of a partial hearing loss.)

• He or she seems to hear some sounds, but not others. (Some hearing loss affects only high-pitched sounds; some children have hearing loss in only one ear.)

• They seem to not only hear poorly, but also has trouble holding his head steady, or is slow to sit or walk unsupported. (In some children with sensorineural hearing loss, the part of the inner ear that provides information about balance and movement of the head is also damaged.)

INFORMATION REGARDING HEARING LOSS AS WE AGE:

• More than 28 million Americans have a hearing loss; 80 percent of those affected have irreversible and permanent hearing damage.

• More than one-third of the United States population has a significant hearing loss by the age sixty-five.

• Sixty percent of people with hearing loss are between the ages of twenty-one and sixty-five.

• Sensorineural damage (damage to the hair cells and cochlea caused by genetics or exposure to noise) is the largest, single form of hearing loss, affecting 17 million Americans.

• At least 15 percent of the United States population is affected by tinnitus.

• Persons older than fifty years of age are twice as likely to have tinnitus.

• Meniere’s disease causes bilateral hearing loss in 5 to 20 percent of cases.

• More than 75 percent of people with hearing loss could benefit from using a hearing aid.

Things to take into account regarding the aging population:

• Hearing loss can cause frustration; however, with education and proper attitude, the frustration and the disability can be lessened.

• Responsive and experienced hearing health care providers are worth their weight in gold.

• Family members, friends, and co-workers can provide a large measure of support, but they need to be educated to your needs and you to theirs.

• The market is full of assisting devices that should be explored and used.
• The technology used in hearing aids and assisting devices is burgeoning and improving.

We all need to communicate effectively, In order to do this, I have a few suggestions:

• Learn as much as possible about your own hearing loss.

• Learn what services are best provided by otolaryngologists, audiologist, and hearing aid specialist, and chose the professional who best provides the service you need.

• Together with your hearing health care specialist, evaluate hearing aids and get the one – two if recommended – that best meets your needs.

• Learn assertive techniques to use with family members and other people, such as “It would help me to understand you, if you faced me when you spoke” and “I can be a part of this conversation if only one of you speaks at a time.”

• Find some other sources of support, as well. It is important to meet other people with similar hearing losses, and these people may be found through membership in groups such as SHHH.

• Learn some basic sign language; if nothing else, learn the alphabet. On my friend’s trip abroad after he lost his hearing, he taught his daughter to finger spell the alphabet. She then helped him with foreign names when he was having difficulty understanding them.

• Find out which assisting listening and alerting devices can help you in various situations. Keep abreast of the latest technology, since it changes rapidly.

• Keep your expectations for improvement realistic.

• And more important than everything else, keep your sense of humor.

In Conclusion

A parent, now-a-day, can’t be too careful when it comes down to letting their children linger around other children for longer periods of time. With too many germs flying around these daycare, young children are constantly exposed to ‘unhealthy stuff.’

And remember, as a parent, always be aware of hearing issues with your child. If you feel something is wrong, take them to an ENT specialist as soon as possible.