Hearing Loss in Children
Hearing loss doesn’t have to be an obstacle for your child.
Today’s loud world has made hearing loss an epidemic, particularly among young people. Recent estimates suggest that 15 percent of children aged 6 to 19 experience hearing loss, and that it affects 1.3 million under the age of three. These alarming statistics reflect the fact that today’s world is more connected to audio than ever before, whether it be for leisure, work, or general communication. As the use of earbuds remain popular, the need for awareness regarding hearing loss has never been greater.
However, not all hearing loss is caused by noise exposure. In young children, frequent viral infections or congenital deficiencies can lead to hearing complications.
No matter what the cause, hearing loss in children can be debilitating if not identified and treated early. Although adults who lose their hearing fear being unable to communicate like they used to, children born with compromised hearing are at risk of never learning how to express themselves verbally.
While hearing loss is comparatively uncommon in infants and small children, it is never too soon to educate yourself on hearing safety and treatment options so you know what to do if your child ever displays signs of hearing loss.
Fearing the diagnosis
For a parent, discovering that a child has hearing loss can be devastating. Countless questions begin racing through your head about their future education, social life, and happiness. The cost of treatment and accommodations may be daunting, or perhaps you feel guilty for not having noticed the warning signs earlier.
Many parents’ anxieties stem from assumptions about hearing care that are simply no longer true. In the past, hearing restoration used to be a costly process that provided mediocre results due to insufficient technology. Today, the field of audiology is wider and more effective than ever, with options like cochlear implants or hearing aids available to treat most forms of pediatric hearing loss.
Despite these recent advancements, early intervention is still the most effective way to protect your child’s health. A 2012 study found that a hearing loss diagnosis before 6 months of age can significantly boost a child’s communication skills with proper treatment. With the help of speech and language therapists, and the compatibility features of a modern hearing aid, your child can expect to receive the same educational and social advantages as their peers by spending more time in a standardized classroom.
Understanding the world of hearing loss and audiology is the first step toward making the right decisions for your child’s hearing health. Since children—and their ears—develop much more rapidly than adults, you will likely need to make regular appointments with a hearing care professional to have your child’s hearing tested as they mature, and get their hearing aids readjusted or replaced to accommodate their developing ears and listening needs.
Breaking down the jargon
You and your doctor don’t always speak the same language. In fact, a significant amount of medical advice is not followed properly (or at all) simply because it is difficult to understand. Jargon, particularly in the field of audiology, can create a barrier between the hearing aid professional and the patient that makes healthcare frustrating. The pages on this website are intended as resources for parents to learn more about hearing loss and hearing aids at their own pace so they can get the most out of their child’s hearing care experience.
When diagnosed in the first few years of life, hearing loss is estimated to cost society $1 million per child over the course of a lifetime. While healthcare coverage can help cover most of these costs, the best way to save money and prevent additional complications is by following the advice of your doctor. This includes providing the proper accommodations for your child at home, seeking special education services offered by the school district, and participating in intensive activities that promote speech and language development.
If all this sounds overwhelming, that’s okay! Being a parent presents one of the greatest life challenges even for children without special needs. It’s only natural to sometimes feel overwhelmed when it comes to treating a disability. Thankfully, government regulations and a heightened awareness of the importance of hearing has made the world far safer and more accessible for those with hearing loss in comparison to the past. With the vast amount of resources available to help your child succeed, it’s likely that they won’t even view their hearing loss as a disability.
Screening your newborn's hearing
Infants can have their hearing tested almost immediately after birth. These specialized tests are intended to diagnose any hearing problems as early as possible to prevent them from worsening. This process is painless for your child and should not last more than 30 minutes.
Two types of tests are available to measure your child’s hearing. They are:
- Otoacoustic Emissions (OAE): A small instrument is inserted into the newborn’s ear canal. The echo response of programmed sounds is measured to determine how sound waves move through the inner ear.
- Automated Auditory Brainstem Response (AABR): The newborn is presented with clicks or tones using soft headphones. The response of their hearing nerve is recorded using three electrodes placed on the baby’s head.
It is important to note that children who turn their head or otherwise respond to sound in their environment still may not have normal hearing. While a response to everyday speech or noise indicates that some hearing is present, they may still have complications like high-frequency hearing loss. Parents are encouraged to test their newborn’s hearing even if the infant appears to be aware of their acoustic surroundings.
Multiple tests may be required if hearing loss is suspected, as failing a newborn screening does not guarantee that the condition is present or permanent. If it is indicated by a screening, parents will likely be referred to an ophthalmologist to determine if it could be related to vision problems. Because more than 50 percent of hearing loss cases in children are hereditary, a genetic workup may also be recommended. Often, temporary cases of hearing loss can be alleviated with medical treatment (such as antibiotics to fight ear infections) or minor surgery. More persistent cases will likely require a hearing aid and communication therapy.
While more than 90 percent of deaf children are born to hearing parents, hearing loss in a child could mean that the parent is at risk of developing—or already has—hearing loss. Even if you don’t believe you have hearing loss, every family member should make an appointment for a hearing test.
Recognizing the signs after infancy
In cases where these tests are not performed or hearing loss develops after infancy, behavior and communication issues are often the first sign of a hearing loss. This may be especially noticeable if you have an older child who does not have hearing loss, as certain developmental stages will seem delayed or might be skipped over entirely.
Here are some of the most common behavioral signs that could indicate your child had hearing loss. Consult a hearing care professional immediately if your child:
- Seems to have trouble paying attention or following instructions.
- Shows signs of social isolation or introversion. While not necessarily an indication of hearing loss, this could be a clue that your child perceives something about themselves as different from their peers.
- Stares at you deeply when you speak to them, as though scrutinizing your face for visual cues that will help them understand.
- Asks for the TV or other audio sources to be turned up louder than should be necessary.
- Struggles to keep up with schoolwork. Speak with your child’s teacher about their listening skills if you notice a decline in grades.
- Always turns one ear toward the direction of speech, as though it is functioning better than the other.
Knowing the ages that most newborns and children develop communication skills will also allow you to track your child’s progress. By the time they reach these age ranges, your child should be able to do the following:
- Birth to 4 months:
- Respond to your voice, especially coos and other gentle sounds
- Relax in the presence of a familiar voice
- Exhibit a startled or fearful reaction to loud sounds
- Wake up or otherwise respond to high volumes while sleeping
- 4 to 9 months:
- Look at familiar sounds by turning their head
- Smile or laugh when addressed
- Cry for help
- Recognize the sounds of toys and rattles
- Recognize basic word and gesture combinations such as “hello” with a wave
- 9 to 15 months:
- Say “mama” or “dada”
- Mimic your sounds
- Call out to others with more complex babbles
- Recognize their name when spoken
- Recognize tonal changes in your voice
- 15 to 24 months:
- Identify certain objects verbally or by pointing
- Follow basic instructions
- Identify parts of the body
- Combine two or more words with a limited vocabulary
- Enjoy listening to music and stories
Comorbidities of hearing loss in children
The most common disorders associated with early hearing loss fall under three categories—visual impairment, neurodevelopmental disorders, and speech and language disorders.
In terms of vision, hard of hearing children are more likely to experience significant eye problems. This can be especially dangerous because those who can’t hear as well often rely on visual cues to understand what’s being said to them. Vision problems are more likely to arise if bilateral hearing loss is present, and certain genetic conditions like Usher’s syndrome have been known to cause both hearing and vision loss. For this reason, many children will be referred to an ophthalmologist after receiving a hearing loss diagnosis.
Neurodevelopmental disorders delay a child’s ability to learn fine motor skills and can affect their personal and social life, as well as their academic performance. These disorders, which include intellectual disabilities and attention-deficit/hyperactivity disorder (ADHD), affect only two to 14 percent of those diagnosed with early hearing loss. Children who are born with congenital hearing loss will likely need significant neurodevelopmental therapy, as the auditory system of their brain is delayed by an average of 20 weeks compared to a newborn with normal hearing. Without regular auditory stimulation and training, the parts of the brain responsible for hearing could remain undeveloped.
Speech and language complications usually arise due to a lack of meaningful interactions with sound. While most children learn to speak passively by observing their environment, a child with hearing loss may have to strain to hear and understand what is spoken. Over time, this will discourage them from participating in communicative activities, slowing their skills development at an age when language acquisition usually occurs rapidly.
Hearing loss and autism
One of the biggest worries parents express is that their child’s hearing loss could be linked to autism or another developmental disorder. The current comorbidity rate of autism spectrum disorder (ASD) and hearing loss is higher than ever. One to six percent of children with hearing loss are also diagnosed with an ASD, compared to roughly one in 68 cases (roughly 1.5 percent) in children with normal hearing.
The symptoms of autism in young children are often similar to the symptoms of hearing loss. Even if you don’t suspect that your child has an ASD, you should have a talk with a developmental pediatrician or psychologist to determine if their symptoms are hearing related or if they could be signs of a separate disorder. Ideally, treatment should begin as soon as the first symptom is detected, as the time spent waiting for an official diagnosis could lead to further developmental delays.
My child isn't listening or communicating well. Now what?
As you might expect, the first step is to consult a medical professional. Delays in language skills could result from an inability to hear due to ear infections, glue ear, or another audiological condition common in young children. A pediatric audiogram will provide your doctor with vital information about your child’s hearing ability and may reveal the cause of any complications.
During the first visit, you may be inundated with information. For this reason, it’s important to ask any questions you have before the appointment is over, and request any relevant documentation or brochures that could help you understand your child’s condition. If your doctor says something that confuses you, ask them to repeat it. And if your child gets hearing aids, make sure you leave knowing exactly how to properly handle and maintain their devices without doing damage to their hearing or the hearing aids’ electronics.
You can prepare yourself for a hearing care appointment by reading the information available on this website. The more you know about hearing loss and possible treatment options, the more equipped you will be when it comes time to make a decision about your child’s hearing health.
Treating hearing loss at home
Once a hearing loss has been discovered, you may be asked to perform activities at home to boost your child’s listening and language skills. This could involve using toys or playing games that involve sound or listening comprehension skills. If you need ideas, the internet is filled with activities and other resources that can foster speech and language growth at home.
There are several ways you can make your child feel more comfortable with hearing. They may need to interact with certain sounds more often than a child with normal hearing before they can recognize or respond to them, so repeating statements or instructions is recommended. Try to interact with your child as often as possible, as more intensive stimuli are needed to hold their attention. Use a clear, direct tone when speaking, and try to limit the amount of time spent in noisy environments. When your child shows listening or communication growth, be sure to praise their success so they feel encouraged to continue learning.
Treating hearing loss at school
Parents whose children have received a hearing loss diagnosis are eligible for no-cost programs to assist in their early learning and development. More information regarding your child’s right to a full education under the Individuals with Disabilities Education Act (IDEA) is available from the U.S. Department of Education website.
If your child is already in school, it is helpful to arrange regular meetings with teachers and staff to prepare any accommodations or make adjustments to their Individualized Education Program (IEP). This program outlines the special education services your child will need to receive an education that meets all the national standards for excellence. Speech and language goals for your child are set depending on their age group, with common standards available for preschool and kindergarten through fifth grade.
Plan to meet with your child’s teacher before the school year begins to discuss accommodations and goals. When discussing your child’s condition, be sure to do the following:
- Inform the teacher about the degree of your child’s hearing loss and any limitations
- If your child has unilateral (in one ear) hearing loss, ask for their seat to be placed away from noise sources close to the normal-hearing ear
- Create a schedule to communicate regarding your child’s progress
- Ask if additional counseling options are available
You may also want to watch this video on teaching hard of hearing students with your child’s teacher. Throughout the one-hour film, your child’s teacher will receive important information on how best to accommodate, address, and instruct students with hearing loss without sacrificing classroom time or quality. By watching together, you will be able to express any concerns about how best to meet your child’s needs while asking any questions you may have about the educational process.
Building a hearing loss community
Familiarizing yourself with different hearing loss support organizations and services in your community is also a great way to keep your child engaged with others. Since hearing loss is often linked to feelings of alienation, this can improve social skills and prevent your child from feeling like an outsider. Support groups often organize information sessions and invite speakers to discuss their experience with hearing loss. By making regular visits to these groups, you can build up your knowledge base of hearing-related news and topics at a rate that is comfortable for you and your child. If you cannot find a support group in your area, online support groups are available that can help children build a network within the hearing loss community and share their story, which can do wonders for their self-confidence.
Children with hearing aids don’t have to worry about missing out on their favorite sources of audio entertainment. Telecoil technology built into nearly every pair of digital hearing aids allows wearers to have all the sound they need streamed right into their devices, either with the push of a button or automatically. Most locations that transmit audio, such as movie theaters, concert halls, museums, and places of worship, now offer FM or induction loop systems that make streaming audio available to anyone with hearing aids without having to ask for a separate receiver.
With early hearing loss every day counts
Waiting to do something about your child’s hearing loss could do more harm than you realize. Protect your child from having to face undue obstacles both in and out of school by contacting a hearing care professional online and scheduling an appointment. If you suspect you might have hearing difficulties, make an appointment for yourself to test whether your ears are working their best. There’s no better time than today to take control of your and your family’s hearing health.
Explore more on treating hearing loss:
- Signs and symptoms checklist
- Identifying hearing loss in others checklist
- Economic impact of hearing loss
- Hearing loss in children
- Appointment checklist
- Dealing with resistance
- Encouraging friends and family to seek treatment
- What to expect at your first fitting
- Lifestyle inventory checklist
- 10 things to ask at your first fitting