Hearing Loss in Children

Causes:

There are many causes of hearing loss in children. They may be hereditary or non-hereditary. Approximately 50% of hearing loss in childhood is caused by a genetic reason. This can be present at birth, or may onset later throughout childhood or even later in life. Viral infections, problems at birth, prematurity, meningitis and ear infections are a few of the non-genetic causes of hearing loss in children.

Diagnosis:

Hearing is now screened at birth in almost all American hospitals. Many babies are being diagnosed very early in life, however, some babies with hearing loss are missed by the screen, or not further evaluated in follow-up after being detected to have a hearing loss. Some babies may be born with normal or fairly normal hearing and then lose it quickly. No baby is too young to be tested for hearing loss. Auditory Brainstem Response testing, Auditory Steady State Response Testing and Otoacoustic Immissions testing are the modalities by which babies are evaluated for hearing loss. These tests can be performed in our office under mild sedation within the first year of life. Babies older than 1 year generally need to be tested under deeper sedation in the operating room. Behavioral testing can begin around 1 year of age, or when a baby has developed good head control. Hearing testing in the sound booth is adapted to the age and development of the child. Babies and children of all ages need to be evaluated by an experienced ear physician trained in the diagnosis and management of pediatric hearing loss. The physical examination of child is extremely important in the diagnosis.

Symptoms of Hearing Loss in Children

There may be no obvious signs of hearing loss early on in a child’s life. Some families note failure to blink or startle at loud noises, failure to turn the head toward familiar sounds, greater responsiveness to loud noises than to voices, a failure to babble, coo, or squeal, the consistent ability to sleep through loud noises, and monotonal babbling. In the toddler years, speech delay is the most common symptom of hearing loss. Lack of interest in music, word games, loud voice use, shrieking, behavior problems and temper tantrums may also occur. Older children can often begin to complain and report their hearing loss, but others are unable to and their hearing loss can manifest by poor school work, inattention and inappropriate responses to questions. A change in personality is sometimes noted by a parent or teacher.

Severity and Treatment of Hearing Loss

Children with mild hearing loss usually have normal speech, and their diagnosis is often delayed. They have problems hearing well in the background noise at daycare and school. A child with a mild loss in both ears will likely need some amplification to hear well in group settings and at school. Children with moderate hearing loss need hearing aids to acquire clear speech, but this is usually easily attained with proper amplification and speech therapy/auditory verbal therapy. They usually succeed in regular schools with some academic help or other educational services. Children with severe hearing loss do not hear speech at normal or loud conversational levels and will not learn to talk without hearing aids and special education for the deaf. The prognosis is variable and depends on the age of diagnosis and treatment and the cause of the hearing loss. The earlier the child is diagnosed and aided with hearing aids, the faster acquired and better their speech will be. Children fit with hearing aids before 6 months can often go to normal schools in early grade school. Children fit with hearing aids after 6 years of age may never develop normal speech and language. Children with severe hearing loss require speech and auditory verbal therapy to learn to speak and some require cochlear implantation. The prognosis for children with profound hearing loss again depends on the age of diagnosis and treatment. Speech, auditory verbal therapy and other services are required. Many of these children with achieve their highest speech potential with cochlear implantation.

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Single Sided Deafness in Children

Children with complete hearing loss in one ear and normal hearing in the other ear still have great difficulty hearing in background noise and many therefore have difficulty in a noisy classroom environment. Up to one third may have academic difficulties and fail a grade. An FM unit, Bone Anchored Hearing Aid soft band device or implant may be considered.

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