Hearing Loss in Children
For a child, hearing and speech are essential tools of learning, playing and developing social skills.
Children learn to communicate by imitating the sounds they hear. If they have a hearing loss that is undetected and untreated, they can miss much of the speech and language around them. This results in delayed speech/language development, social problems and academic difficulties.
Hearing loss, in varying degrees, affects two in every 100 children under the age of 18. Fortunately, there are very few hearing losses that cannot be helped with modern technology. The most effective treatment is achieved through early intervention. Early diagnosis, early fitting of hearing aids, and an early start on special education programs can help maximize a child's hearing. This will give your child the best chances for successful speech and language development.
Types of Pediatric Hearing Loss
There are two primary categories of hearing loss in children, congenital (present at birth) and acquired (occurring after birth). These hearing losses may be sensorineural, conductive or mixed.
Possible causes of congenital hearing loss:
- Infections during pregnancy (German measles, toxoplasmosis and cytomegolavirus)
- Ototoxic medication used during pregnancy
- Birth complications (serious infection present at birth, such as toxoplasmosis, herpes, rubella or cytomegolavirus; baby required neonatal intensive care; birth weight less than 3 lbs.; unusual appearance of baby's head, face or ears; baby required blood transfusion; or drugs used for respiratory life-sustaining measures on premature infant)
- Disorder of the brain or nervous system
- Genetic syndromes, such as Ushers, Down's and Waardenburg's syndromes
- Family history of hearing loss
- Untreated middle-ear infections
- Other infections, such as meningitis, mumps, measles or whooping cough
- Perforation of the eardrum
- Excessive noise, such as fireworks or loud music
- Disease, such as otosclerosis or Ménière's disease
- Serious injury to the head
- Ototoxic medication
Some children have sensorineural hearing loss (also called nerve deafness), which is permanent. Most of these children have some usable hearing, and children as young as three months of age can be fitted with hearing aids.
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It is routine practice in most hospitals to perform hearing tests for babies shortly after delivery. This assures early intervention in the event that the newborn exhibits any signs of hearing loss. If your infant was not tested at birth, it is recommended that you contact the PAMF Center for Hearing Health to schedule a thorough hearing evaluation for your baby.
Infant/Toddler Hearing Checklist
Parents are often the first people to sense that their child has a hearing problem. It is important to recognize the signs of hearing loss in infants and toddlers as early as possible. The most critical period for speech and language development is from birth to four years of age.
All infants and toddlers can be given a thorough hearing evaluation. Observe your child's development from infancy on. The following are age appropriate behaviors for infants and toddlers. If you suspect a problem, do not delay in getting your child's hearing tested. It's never too early to ask.
Does your baby:
Birth to 4 months:
- Awaken or stir at loud sounds?
- Startle at loud noises?
- Calm at the sound of a familiar voice?
- Respond to your voice (smiles or coos)?
- Turn eyes toward source of familiar sounds?
- Smile when spoken to?
- Notice rattles and other sound-making toys?
- Cry differently for different needs?
- Make babbling sounds?
- Seem to understand simple word/hand motions such as "bye-bye" with a wave?
- Babble a lot of different sounds?
- Respond to his/her name?
- Respond to changes in your tone of voice?
- Say "ma-ma" or "da-da"?
- Understand simple requests?
- Repeat some sounds you make?
- Use his/her voice to attract attention?
- Point to familiar objects when they are named?
- Listen to stories, songs and rhymes?
- Follow simple commands?
- Use several different words?
- Point to body parts when asked?
- Name common objects?
- Put two or more words together?
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Preschool & Older Hearing Checklist
It is important to observe your child for any signs of potential hearing loss.
Does your child:
- Turn up the volume of the TV excessively high?
- Respond inappropriately to questions?
- Not reply when you call him/her?
- Watch others to imitate what they are doing?
- Have articulation problems or speech/language delays?
- Have problems academically?
- Complain of earaches, ear pain or head noises?
- Have difficulty understanding what people are saying?
- Seem to speak differently from other children his or her age?
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The PAMF Center for Hearing Health offers a broad range of testing and evaluation services for infants, children and adolescents. These tests can assess whether sound is being conducted efficiently, or if there is damage to the inner ear or nerve pathways. We can also perform tests to determine if the brain is processing what your child is hearing.
We offer age-appropriate tests for infants and children. For infants, we use special physiologic testing that does not require a behavioral response from them. From about 6 months of age and older, behavioral testing can be conducted. The testing process is safe, painless and fast -- usually less than 30 minutes.
Diagnosis and Treatment
After your child is tested, the audiologist will discuss your child's diagnosis with you, along with recommendations for appropriate treatment:
- If your child has a hearing loss, we will refer you to a physician in the PAMF Department of Ear, Nose & Throat.
- Depending on the nature of the disorder, a hearing aid or other amplification device may be necessary. The audiologist will guide you and your child through every step of the selection, fitting, use and care of these devices.
- For a child diagnosed with severe hearing loss, we provide case management and referrals to appropriate resources including the PAMF Department of Ear, Nose & Throat, regional centers of education and speech pathology, and habilitation/rehabilitation.
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