What Is Hearing Loss?
Kids who have hearing loss, or hearing impairment, have trouble hearing or understanding some or all sounds. This can happen when there is a problem with:
Parts of the Ears
Problems with one or more parts of the ears
Nerves
The nerves that send sound signals from the ears to the brain
Brain
The part of the brain that makes sense of these signals
Early detection and treatment of hearing loss is crucial for a child's language development, learning, and social skills.
What Are the Types of Hearing Loss?
Conductive Hearing Loss
This is caused by something that blocks sound from traveling to the inner ear. Sound is blocked or reduced before it reaches the inner ear.
Common Causes:
- • Ear infections
- • Ear wax buildup
- • Problems with the tiny bones of the middle ear
- • Fluid in the middle ear
- • Perforated eardrum
- • Foreign objects in the ear
Treatment: Many cases of conductive hearing loss can be treated medically or surgically, and hearing may be restored.
Sensorineural Hearing Loss (SNHL)
This happens when the inner ear (cochlea) or hearing nerves are damaged. This type of hearing loss is usually permanent.
Common Causes:
- • May run in families (genetic)
- • Part of a genetic syndrome
- • Certain infections that damage the inner ear or nerves
- • Medicines that damage the inner ear or nerves (ototoxic medications)
- • Exposure to loud noises
- • Head trauma
Treatment: Usually permanent, but hearing aids, cochlear implants, and therapy can help.
Mixed Hearing Loss
This is when a person has both conductive and sensorineural hearing loss. This means there are problems in both the outer/middle ear and the inner ear or hearing nerve.
Treatment:
Treatment addresses both types of hearing loss. The conductive component may be treatable, while the sensorineural component typically requires hearing aids or other assistive devices.
Central Hearing Loss
This happens when there is damage to the part of the brain that controls hearing. The ears may work normally, but the brain cannot process the sounds correctly.
Causes:
- • Brain injury
- • Stroke
- • Brain tumors
- • Neurological conditions
- • Developmental brain differences
Auditory Processing Disorder (APD)
This is when the ears and brain don't work well together. Kids with APD have normal hearing but something interferes with the way the brain recognizes and makes sense of sounds, especially speech.
Characteristics:
- • Normal hearing test results
- • Difficulty understanding speech, especially in noise
- • Trouble following directions
- • Difficulty distinguishing between similar sounds
- • Problems with reading and spelling
Treatment: Therapy focuses on improving auditory processing skills and using strategies to help with communication.
What Causes Hearing Loss?
Many things can lead to hearing loss, but often, no cause is found. Hearing loss is more likely if a child has certain risk factors or experiences.
Birth-Related Factors
- • Birth defects of the ears
- • Family members with childhood hearing loss
- • Born early (premature birth)
- • Stayed in the neonatal intensive care unit (NICU)
- • Newborn jaundice with a bilirubin level high enough to need a blood transfusion
Medical Conditions
- • Many ear infections
- • A perforated ear drum
- • Infections like meningitis or cytomegalovirus
- • Chronic middle ear infections
- • Certain genetic syndromes
Environmental Factors
- • Exposure to loud sounds
- • Head trauma or injury
- • Exposure to certain chemicals
Medications
- • Given medicines that can lead to hearing loss (ototoxic medications)
- • Certain antibiotics
- • Some chemotherapy drugs
- • High doses of certain medications
What Are the Signs & Symptoms of Hearing Loss?
It can be hard to tell if a child has hearing loss, especially in young children. Those with hearing loss may not respond to sounds or speech. Language development may be delayed.
Hearing Milestones in the First Year of Life
Talk to the doctor if your child does not reach these hearing milestones in the first year of life:
For Newborns:
- • Startling or "jumping" to sudden loud noises
- • Responding to sounds
By 3 Months:
- • Recognizing a parent's voice
- • Turning toward familiar sounds
By 6 Months:
- • Turning the eyes or head toward a new sound
- • Repeating sounds (like "ooh" and "aah")
By 12 Months:
- • Making babbling sounds
- • Responding to their name
- • Imitating words
- • Saying a few words, such as "mama" or "bye-bye"
Signs in Older Children
As your child gets older, signs of hearing loss may include:
Communication Issues:
- • Limited, unclear, or no speech
- • Not responding to conversation-level speech
- • Answering inappropriately
- • Not seeming to pay attention
Behavioral Signs:
- • Not following directions
- • Being easily frustrated when there's a lot of background noise
- • Needing a higher TV volume
- • Learning problems
Some hearing problems come on gradually after birth or show up later in life. If you are concerned about your child's hearing, talk to your doctor. Your child may need to see a hearing specialist called an audiologist for a complete hearing evaluation.
How Is Hearing Loss Diagnosed?
It's best to catch hearing problems early, because treatment is more successful if it starts before a child is 6 months old. That's why every newborn has a hearing screening test before leaving the hospital.
Newborn Hearing Screening
If your baby doesn't have a screening before going home, or was born at home or a birthing center, get their hearing checked within the first 3 weeks of life.
Important Notes:
- • Not passing a hearing screening doesn't mean a baby has hearing loss
- • It does mean that the baby should be retested as soon as possible
- • Ideally, retesting should occur within a month of birth
- • If hearing loss is found then, treatment should begin right away
Ongoing Hearing Screening
Kids with typical hearing should continue to have their hearing checked at their regular checkups.
Screening Schedule:
- • Hearing screening tests are usually done at ages 4, 5, 6, 8, and 10 years
- • Screening during preteen and teen years
- • The doctor will also check hearing any other time there's a concern
- • Regular screenings help catch problems early
Comprehensive Hearing Evaluation
If there are concerns, your child may need to see an audiologist (a hearing specialist) for a complete hearing evaluation.
What an Evaluation Includes:
- • Detailed hearing tests
- • Assessment of different types of hearing loss
- • Evaluation of hearing at different frequencies
- • Tests to determine the degree of hearing loss
- • Recommendations for treatment
How Is Hearing Loss Treated?
Treatment depends on the type of hearing loss, what caused it, and how bad the hearing loss is. Children with permanent hearing loss should be seen by a team of specialists that includes an audiologist, ear, nose, and throat (ENT) doctor, speech-language therapist, and education specialist.
Hearing Aids
Hearing aids make sounds louder. Babies with permanent hearing loss who get hearing aids before 6 months of age have a better chance of improving their language development.
Key Points:
- • No single style or manufacturer is best for every child
- • Your audiologist will help you choose based on your child's needs
- • Most kids with hearing loss in both ears wear two hearing aids
- • Regular adjustments and follow-up are important
Benefits:
- • Improves access to sounds
- • Supports language development
- • Helps with learning and communication
- • Early fitting (before 6 months) is ideal
Frequency Modulation (FM) Systems
An FM system helps reduce background noise and makes a speaker's voice louder. This is especially helpful in classrooms and noisy environments.
How It Works:
- • The person talking (like a teacher) wears a tiny microphone and a transmitter
- • The transmitter sends an electrical signal to a wireless receiver
- • The child wears the receiver either on the ear or directly in a hearing aid
- • It's portable and can also be used at home or other places where there is a lot of background noise
Cochlear Implants
Cochlear implants may help children with severe hearing loss when a hearing aid can't. This surgically placed device bypasses the parts of the ear that are not working properly.
How It Works:
- • Surgically placed device
- • Bypasses damaged parts of the ear
- • Stimulates the hearing nerve directly
- • Requires surgery and follow-up care
Outcomes:
- • With training and therapy, kids can learn to hear and speak well
- • Requires intensive therapy and support
- • Best outcomes with early implantation
- • Ongoing adjustments and support needed
Hearing Habilitation and Rehabilitation
Hearing habilitation helps children born with hearing loss learn how to listen and communicate. Kids who lose their hearing when they are older also learn these communication techniques through what's called hearing rehabilitation.
Communication Methods:
- • Auditory-verbal therapy (AVT)
- • Speech therapy
- • Speech (lip) reading
- • Learning American Sign Language (ASL)
Team Approach:
- • Your audiologist and doctor will work with you
- • Find the best way for your child to communicate
- • May use one or multiple methods
- • Family involvement is crucial
The Importance of Early Intervention
Even mild hearing loss can cause problems with speech, language, learning, and social skills. That's why babies and toddlers with hearing impairment should be enrolled in early intervention, a service that offers free therapy in each state to children who qualify.
Early Intervention Services:
- • Free therapy services in each state
- • Available for babies and toddlers with hearing loss
- • Services for children who qualify
- • Supports language and communication development
School-Age Services:
- • Older kids may qualify for special education services
- • Individualized Education Programs (IEPs)
- • 504 plans for accommodations
- • Support services in school
Getting this help early is the best way to prevent delays and improve a child's development.
Frequently Asked Questions (FAQs)
Q: How do I know if my child has hearing loss?
A: Signs of hearing loss vary by age. In babies, watch for:
- • Not startling to loud sounds
- • Not turning toward sounds
- • Not responding to their name
- • Delayed speech and language development
In older children, signs include: not following directions, needing higher TV volume, unclear speech, learning problems, or difficulty understanding speech in noise. If you have concerns, talk to your pediatrician and request a hearing evaluation.
Q: My baby didn't pass the newborn hearing screening. What does this mean?
A: Not passing a hearing screening doesn't necessarily mean your baby has hearing loss. It means they need further testing. Many babies who don't pass the initial screening have normal hearing. However, it's important to have follow-up testing as soon as possible (ideally within a month) to rule out or identify hearing loss. Early identification and treatment are crucial for language development.
Q: Can hearing loss be cured?
A: It depends on the type of hearing loss:
- • Conductive hearing loss: Often can be treated medically or surgically, and hearing may be restored
- • Sensorineural hearing loss: Usually permanent, but hearing aids, cochlear implants, and therapy can help significantly
- • Mixed hearing loss: The conductive component may be treatable
- • Central hearing loss and APD: Focus on therapy and strategies to improve communication
Even if hearing loss can't be "cured," early intervention and appropriate treatment can help children develop language and communication skills successfully.
Q: At what age can a child get hearing aids?
A: Babies can be fitted with hearing aids as early as a few weeks old, and it's recommended to fit them before 6 months of age if there is permanent hearing loss. Early fitting is crucial because the first 6 months of life are critical for language development. Your audiologist will work with you to find the right hearing aids for your child's needs and ensure they're properly fitted and adjusted.
Q: What's the difference between a hearing aid and a cochlear implant?
A: Key differences:
- • Hearing aids: Amplify sounds, worn externally, non-surgical, suitable for mild to severe hearing loss
- • Cochlear implants: Bypass damaged parts of the ear, surgically implanted, stimulate the hearing nerve directly, typically for severe to profound hearing loss when hearing aids aren't sufficient
- • Both require ongoing support and therapy
- • Your audiologist and ENT doctor can help determine which is appropriate
Q: Will my child be able to learn to speak if they have hearing loss?
A: Yes, many children with hearing loss learn to speak very well, especially with early intervention and appropriate treatment. The key factors are: early identification (before 6 months), early fitting of hearing aids or cochlear implants, intensive therapy and support, family involvement, and consistent use of assistive devices. Children with hearing loss can develop excellent communication skills through speech, sign language, or a combination of methods. The earlier intervention begins, the better the outcomes.
Q: What resources are available for families of children with hearing loss?
A: There are many resources available:
- • Early intervention services (free in each state for qualifying children)
- • School-based special education services
- • Support groups for families
- • CDC: Hearing Loss in Children
- • American Speech-Language-Hearing Association (ASHA)
- • Local audiologists and ENT specialists
- • Speech-language pathologists
- • Educational specialists
Your pediatrician can help connect you with local resources and support services.
Key Takeaways
Early Detection
Newborn hearing screening and regular checkups help catch problems early
Early Intervention
Treatment before 6 months of age leads to better language development outcomes
Team Approach
A team of specialists can provide comprehensive support for your child
⚠️ Important Note
This article provides general information about hearing loss in children and is not intended to replace professional medical, audiological, or educational advice. If you have concerns about your child's hearing, always consult your pediatrician and consider an evaluation by an audiologist. Early identification and intervention can make a significant difference in your child's language development, learning, and overall success. Treatment should be tailored to your child's specific needs by qualified professionals.