Growing up is quite the adventure, but with a hearing problem, it’s an adventure that’s hard to navigate no matter how courageous the spirit.

Even though it’s essential to social, emotional, and cognitive development, hearing is often a sense that’s overlooked medically. Early identification and treatment of hearing loss in children can lessen the negative impacts it will have on a child’s development, giving them the opportunity to live up to their full potential socially and academically.
 

Categories of Hearing Loss

Hearing loss can be measured in degrees, ranging from mild to moderately severe to profound deafness. Hearing loss in children typically falls into three main categories.

  1. The most common, conductive hearing loss, is associated with conditions in the external or middle ear that block the transmission of sound. These conditions can include ear infection, fluid in the ear, impacted earwax, a perforated eardrum, a foreign object in the canal, or birth defects that alter the canal. Many of these are treatable through minor procedures or surgery.
  2. Sensorineural loss, also known as “nerve deafness,” is the second type. This occurs when damage to the inner ear, or to nerve pathways from the inner ear, interfere with the brain’s ability to process sound. Most often, if a child is born with sensorineural hearing loss, it is congenital, meaning it was present at birth. It can also be caused by the use of ototoxic drugs (drugs that damage hearing) during pregnancy, a low birth weight, or treatments for a number of other medical conditions. Although there is no cure for this type of hearing loss, in most cases hearing aids and a family-centered care plan are effective treatments.
  3. Mixed hearing loss is a combination of conductive and sensorineural hearing loss, and it may include damage to the outer or middle ear as well as the inner ear or auditory nerve. Treatment options are based primarily on how much of the hearing loss is correctable through surgery, drugs, or other methods. The remaining hearing loss is usually treatable with hearing aids.

 

Symptoms of Pediatric Hearing Loss

Hearing loss can be difficult enough for adults to detect, let alone children, who aren’t always able to articulate the source of their difficulties in life. There are a number of signs to look for if you’re concerned that your child may be suffering from a hearing loss.
 

In Newborns/Infants

Your child’s communication skills begin developing as soon as they are born. A delay in the advancement of these skills is a red flag that something is not right developmentally. Look for these signs of hearing loss:

Difficulty Hearing/Understanding:

  • Not startling at loud noises

  • Not recognizing your voice

  • Not moving eyes in direction of sound

Difficulty with Speech Development:

  • Lack of babbling

  • Lack of crying for different needs

  • Doesn’t vocalize excitement or displeasure

  • Around 7 months to a year, hasn’t spoken one or two words

 

Toddlers

As with newborns and infants, a child’s difficulty with communication skills may be a sign of hearing impairment. As your child begins day care and/or preschool, any trouble they may have listening or communicating will become more prominent. Look for these signs of hearing loss:

Difficulty Hearing/Understanding:

  • Unable to point to different body parts when asked

  • Doesn’t enjoy being read to

  • Doesn’t understand action words like “run” or “sit”

  • Sits close to the television

Difficulty with Speech Development:

  • Unable to form simple sentences

  • Doesn’t ask “why?” or “what?” questions

  • Can’t answer “why?” or “what?” questions

  • Doesn’t use plurals or verbs

 

Young Adults

Teens today have quite a bit on their plates, and they typically aren’t educated about the possibility of loud noises permanently damaging their hearing. It is essential to protect their healthy ears, as hearing plays a critical role in their academic success, social standing, and future economic achievements. This age group is at a greater risk for high-frequency hearing loss because of lifestyle choices. Seeing their favorite artists in concert, playing music too loudly through headphones, attending loud sporting events, or hunting can all damage your child’s hearing irreparably if they’re not using proper hearing protection.

Look for these signs of hearing loss:

  • Turning up the television to an excessive volume

  • Saying “what?” frequently

  • Only responding when eye contact is made

  • Complaining of ringing in the ears or a dip in hearing ability

  • Withdrawing socially

If you believe your child is showing signs of hearing loss, please contact us today. As a certified location for infant hearing evaluations, we can properly determine your child’s hearing ability, regardless of age, and determine if there is a hearing loss. As a family-centered practice, we encourage your entire family, as well as your pediatrician, to be involved in all aspects of this process.
 

How is a child’s hearing tested?

There are several ways to test a child’s hearing. The method chosen is based upon age and ability.

Birth to 6 months

Screened at hospital before discharge or within 30 days using otoacoustic emissions (OAE) auditory brain stem response (ABR) or auditory steady state response (ASSR). These are referred to as electrophysiological tests. They are objective and do not require a response from the baby.


6 months – 2 years

Depending on the child’s age, either behavioral observation audiometry (BOA) or visual response audiometry (IVRA) will be used to assess hearing. Both of these test are conducted in the sound booth with the child seated on the parent’s lap. The chair is placed between 2 speakers from which a variety of sounds are emitted. In younger children we are looking for such things as a head turn or eye shift when sounds and speech are presented (BOA). In older children, we teach them to localize the source of the sound by reinforcing their responses using lights or toys (VRA). This engages the child and will often encourage them to respond to soft sounds.


2-3 years

At this age we begin play audiometry. The child wears headphones, so each ear is tested individually. The child is conditioned to drop a block in a box or place a ring on a stick every time a sound is heard. Ear specific information at soft levels can be obtained.


4 years and older

At this age, many children can be tested as an adult. In this case, they will raise their hand whenever they hear a sound, no matter how soft.

Frequently Asked Questions

How are earbud headphones harming my child’s (or my) hearing?
Earbuds allow us to listen to music anywhere, anytime, and for long periods of time. This is the perfect storm for hearing loss, as the decibel level (the sound pressure) and the length of listening time affect how much damage is done. Loud music destroys the fine hairs that stimulate auditory nerve fibers, which send signals to the brain to interpret sound. Sound becomes damaging at 85 decibels (the sound level of a bulldozer idling). Listen to your MP3 player at about 70% to avoid damage. Or try the 60/60 rule: Listen to your device at 60% volume for 60 minutes at a time.
How early can a child be diagnosed with hearing loss?
Most children receive their first hearing screening shortly after birth. All states have implemented newborn hearing screenings into hospitals and birthing clinics, and most screenings happen before the parent and child are discharged. If the child does not pass the test twice, they are referred to an audiologist for further testing.
How often should children have their hearing tested?
Your baby should have a basic newborn hearing screening performed before being discharged from the hospital. If your infant has not had this yet, it is important to have your child’s hearing evaluated, preferably within the first three weeks of life. Kids who seem to have normal hearing should continue to have their hearing evaluated at regular checkups. Typically, hearing tests are scheduled at ages 4, 5, 6, 8, 10, 12, 15, and 18.

What are some signs that my child has hearing loss?
Children who seem inattentive may be experiencing hearing loss. Other signs:

  • Infants and newborns may not startle at sounds or respond to whispers

  • Speech may be delayed or unclear

  • Turning up the television volume too high

  • Asking “what?” often
    • What should I do if I think my child has a hearing loss?
    The sooner the issue is addressed, the better the chances of successful treatment. If you believe your child has a hearing loss, please contact us for an appointment. Our practice provides family-centered treatment that focuses on thorough hearing testing, diagnosis, and follow-up appointments if necessary.
    What types of hearing loss are found in children?
    While the types of hearing loss in children are the same as in adults (conductive, sensorineural, and mixed), there are differences in what they are more susceptible to. For example, teens are at a greater risk for high-frequency hearing loss because of their lifestyle choices (loud concerts, music volume), while younger children may experience conductive hearing loss caused by otitis media or an ear infection. This is usually because the eustachian tube — the passage between the middle ear and the back of the throat — isn’t able to drain because of its shorter passage and horizontal setting.