The old adage that "the more things change, the more they stay the same" holds true in the field of pediatric audiology more than you might think. It was 30 years ago this May that I began working as an audiologist at Bellevue Hospital in New York City.

I loved my work there and primarily worked with children. It was at Bellevue that I first diagnosed a child with a profound hearing loss. He was about 2 ½ years old and was being evaluated because he hadn't started to talk. His parents previously had voiced some concerns to his pediatrician about his hearing, but they were told not to worry, that he seemed to hear just fine. Sound familiar? Ultimately, they found their way to my test booth and, unfortunately, they were right to be concerned.

To say that the child's parents were devastated would not be an exaggeration, and I clearly remember that one of the very first questions they asked was, "Isn't there any kind of operation that can help him hear?" My answer was, "No, I'm sorry, but there isn't."

Fast forward to today: the situation couldn't be more different. Universal newborn hearing screening is mandated in most of the 50 states, and in 2006, almost 96 percent of newborns were screened at birth. As we had hoped, the result is that hearing loss is diagnosed and intervention begins at younger ages than ever before.

At the Center for Hearing and Communication, it has become the routine rather than the exception to have quite a few very young infants being fit with amplification and already enrolled in our auditory-oral Parent-Infant Program. Most are developing spoken language at levels that are, for the most part, on par with their hearing peers; by age 3, they are entering mainstream preschool programs.

And today there is an operation that can help those with severe to profound hearing loss. The advent of the cochlear implant, when combined with intensive and high quality habilitation, has had a tremendous impact on the achievement levels of children with profound hearing loss. In general, technology for children with hearing loss is better than ever. There are tiny hearing aids that can be fit to tiny ears, with ample gain and output, without feedback, that can adapt to a changing hearing loss and changing listening situations to provide better access to sound than ever before.

What hasn't changed at all? The devastation that parents feel when they first learn their baby can't hear normally. Their world has crashed in on them. They have to learn about things they never even knew existed and often have to make very difficult decisions that will impact their child's life forever. They are overwhelmed by the diagnosis and the fact that early diagnosis and improvement in technology at this point in time doesn't offer them the comfort they need.

What is comforting to them is a knowledgeable and compassionate pediatric audiologist to help them along the way.

The pediatric audiologist is typically the first professional to give parents the news about their baby's hearing loss; the empathy and skill needed to do this in the best possible way has not changed. I truly believe that one of the most important jobs we have when dealing with families impacted by childhood hearing loss is helping them understand what they need to know at each step, through the initial days of the diagnosis and beyond. We need to know how to help them see that "their baby will be okay," that they have a team of professionals who will help them and their baby and, perhaps most important, that they can learn what is needed and ultimately be the team leader for their child.

So whether you've been in the field for years and years and are excited by how much has changed or are just starting your career and are grateful that you have so many new tools to use, remember you play a pivotal role in the success of families living with childhood hearing loss.

Laurie Hanin, PhD, CCC-A, is executive director of the Center for Hearing and Communication, formerly the League for the Hard of Hearing. She recently received the New York State Distinguished Clinician Award and has made frequent presentations at major conferences and conventions in addition to numerous television appearances as a leading expert in audiology, particularly on The Today Show. Contact her at lhanin@chchearing.org.