Hearing Loss in Children

Did you know that about 1-2 in every 1000 US children, suffer from the moderate to bilateral hearing loss? In fact, hearing loss is one of the most common congenital deformities present in newborns. It is particularly problematic in children with undetected and untreated hearing loss. Most of the time, these children may not be able to develop normal speech and language or acquire the cognitive abilities of knowing, thinking, and judging that is needed for learning. In situations where the hearing loss is not identified until 2 or 3 years of age, a child may suffer from permanent impairment of speech, language and learning.

Hearing loss in children can range from a mild impairment to a profound hearing loss. The most common myth among people is that hearing is either normal or you are totally deaf. If a child is responding to sounds, it is not an indication that the hearing is normal. In fact, there are many subtle gradations between normal hearing and deafness. So, a child's hearing loss may not be apparent. This might result in even a child suffering from moderate hearing problem, becoming educationally handicapped. This unmamanged hearing loss results in the impairment of speech and language development, academic capabilities and educational development, and self-image and social, emotional development.

Causes of Hearing Loss in Children

There are basically two different types of hearing loss in children. These hearing losses may be either sensorineural or conductive. Sometimes, a person may be affected by a combination of both these hearing losses, which is referred to as mixed hearing loss.

Causes of Sensorineural Hearing Loss: A permanent loss of hearing, sensorineural hearing loss in children is the result of something affecting the inner ear or the auditory nerve. Congenital factors such as toxoplasmosis, rubella, CMV, herpes, or syphilis, genetic factors or syndromes, low birth weight, noise, oxotoxic medications and genetics are some of the common causes of sensorineural hearing. However, it should be noted that in 50 percent of the congenital hearing loss cases, the cause cannot be discerned.

Causes of Conductive Hearing Loss: Conductive hearing loss is the result of a physical abnormality, affecting the outer or middle ear or a fluid infection in the middle ear space. The possible causes of conductive hearing loss include both congenital and acquired factors. The congenital causes of conductive hearing loss are abnormalities in the formation of the outer ear, eardrum, the inner ear canal or the tiny bones that deliver sound waves to the inner ear. On the other hand, the most common acquired hearing loss are caused by factors such as excessive earwax, foreign bodies in the ear like beads, tumors, problems with the Eustachian tube, acute or chronic ear infections and perforation of the eardrum.

Signs of Hearing Loss in Children

Partial deafness is easier to spot in children with the help of these signs. Here is a checklist of developmental guidelines that can help diagnose hearing loss in children, based on their age. If your child is not reaching these milestones, then it would be best to consult an audiologist.

Birth to four months
Most babies are startled by sudden loud sounds especially when sleeping in a quiet room, the baby moves or wakes up at the sound of voices or noises.
They seem to calm down when they are crying on hearing the mother's voice which they now recognize better than other voices.
They turn their head toward a sound at the age of 3 to 4 months.

4 to 8 months
Babies turn their heads and eyes towards a sound when the sound is coming from outside the child's peripheral vision.
Babies begin to enjoy the sound of musical toys like rattles and bells.
When they are approximately six months of age, babies begin responding to someone talking to them with their incoherent blabber.

8 to 12 months
The voices of the babies go up and down in intonation when vocalizing.
They turn directly toward a soft noisemaker, or to the calling of their name.
Babies seem to enjoy music and respond by listening and even "singing" along.

12 to 16 months
Children understand words and speak about 25 single words

18-24 months
Children undergo a "name explosion" when they begin to understand that everything has a word that goes with it. This leads them to speak two word sentences with their vocabulary extending to about 100-200 words.

24-36 months
Children begin speaking fully in sentences and usually know about 200-400 words.

For older children, there are other significant signs of hearing loss.

• Tilting head when trying to listen
• Trouble holding head steady
• Slow to stand and sit
• Difficulty hearing some sounds but not others
• Not startled by sudden, loud noises
• Not responding when called
• Presence of others not acknowledged until within sight range
• Delayed, garbled speech
• Speech limited to vibrating noises rather than single word/syllable sounds
• Asks for instructions to be repeated
• Withdrawn behavior
• Looking at lips when listening to others

If you suspect hearing loss in your children based on these signs, then it is best to consult an audiologist as soon as possible, to get the ear problems checked. Sometimes your audiologist may prescribe hearing aids to be worn. It should be noted that a child of any age can be tested for hearing loss and based on the child's age in years and the developmental level, the tests can be modified to suit them.