Hearing Loss in Children

Hearing ability is of utmost importance for the development of speech and language skills in a child. In the earlier times it was very difficult to detect hearing loss in children. However, with advanced medical science and technology hearing loss in children can be detected at an early stage. If you feel that your child may have a hearing problem, you should get immediate medical help to avoid any complications. Here is all that you need to know about hearing loss in children and how you can effectively manage this medical condition!

How Common is Hearing Loss in Kids?

Hearing loss in children can occur due to various reasons but 60 percent of it is because of preventable causes. As per the recent study conducted by WHO on deafness and hearing loss, around 360 million people across the world have hearing problems and out of this population 32 million are children. These figures state that over 5 percent of the entire world population suffer from hearing disabilities.

Are Hearing Loss and Deafness Same?

Hearing loss or deafness is when a person is not able to hear sounds partially or completely. Hearing loss is when the child is not able to hear sounds below a certain decibel (25 decibels or more). The child may have mild, moderate or profound hearing loss. If a child is unable to comprehend or listen to normal conversations then it may be a case of mild or profound hearing loss. Sometimes the milder cases of hearing loss may become profound hearing loss. A child with a profound hearing loss is not able to hear from both the ears and use sign language for communication. However, deafness can be classified into three categories:

1. Pre-Lingual Deafness

Loss of hearing ability before the child could speak or understand words

2. Post-Lingual Deafness

Loss of hearing ability after the child could speak and understand words.

3. Unilateral or Bilateral Deafness

If hearing impairment is in one ear it is called unilateral deafness and when it is both ears, it is called bilateral deafness.

Types of Child Hearing Loss

Hearing loss can be broadly classified into following categories:

1. Auditory Processing Disorder

Auditory processing disorder is a condition where the brain is unable to process or convert the speech or words into meaningful messages. The person with this disorder may find it difficult to comprehend the source of the sound.

2. Conductive Hearing Loss

Conductive hearing loss is a condition where the body’s ability to conduct sound waves is hampered. This disruption results when passage of the sound waves is affected in the ear canal. In children otitis media, which is the inflammation of the middle ear, is the most common type of conductive hearing loss. This type of hearing disability in children affects the hearing quality, which means your child may find it difficult to hear few sounds frequencies.

3. Sensorineural Hearing Loss

This type of hearing loss results from the problem in the inner ear. Sensorineural hearing loss is when the inner ear or the inner ear nerves are damaged and the child may find it difficult to hear dim sounds. This is a kind of permanent hearing loss that may result from head injury, serious illness, genetic factors or ill-effects of medicines.

4. Mixed Hearing Loss

In case where conductive hearing loss and sensorineural hearing loss occur at the same time, it is called mixed hearing loss. This may happen when the middle as well as the inner ear of the child gets damaged resulting in hearing disability. This condition may result from a chronic ear infection that may infect the middle and the inner ear.

Apart from the above mentioned categories, hearing loss can also be categorized into high frequency hearing loss and low frequency hearing loss.

5. High Frequency Hearing Loss

This type of hearing loss occurs when the child has difficulty in hearing sounds within 2000 to 8000 hertz. This type of hearing loss may result from genetic factors, exposure to loud sounds, certain illnesses, side effects of medicines etc.

6. Low Frequency Hearing Loss

When there is a problem in hearing sounds below 2000 hertz or below than that, it is called low frequency hearing loss. Sensorineural hearing loss may hamper the child to hear low frequency sounds.

Causes of Childhood Hearing Loss

There can be many causes of childhood hearing loss; some of the causes are as follows:

1. Causes of Congenital Hearing Loss

Congenital hearing loss is a hearing loss that is present at the birth. This loss can be because of genetic or non-genetic reasons. Some of the non-genetic causes can be:

• Alcohol or smoking in pregnancy
• Diabetes in pregnancy
• Infection in pregnancy (German measles, Herpes simplex, toxoplasmosis etc.)
• Brain or nervous disorder in the baby
• Premature birth
• Low birth weight
• Birth traumas or injuries

The possibility of non-genetic factors causing hearing loss in babies in only 25 percent, however the possibility of babies born with hearing disability at birth due to genetic factors is up to 50 percent. Some of the genetic causes can be following:

• Autosomal recessive hearing loss may occur when the child gets the recessive or abnormal gene from the parents. Autosomal recessive hearing loss constitutes 70 percent of all genetic hearing loss cases.
• Autosomal dominant hearing loss may occur when the defective or abnormal gene from one of the parents with hearing disability may gets passed on to the child. This kind of hearing loss occurs in 15 percent of the genetic hearing loss cases.

Though the above mentioned genetic and non-genetic causes may result in congenital hearing loss but the cause of some of the cases of hearing loss at birth may be difficult to establish.

2. Causes of Transient Hearing Loss

Transient hearing loss may be caused due to infection in the middle ear or otitis media. Otitis media is a very common type of infection in young children due to the positioning of Eustachian tube, at this stage. This tube is smaller and horizontal during the developmental stage thus may cause blockages and infections. This type of hearing loss is temporary and heals on its own but if the reoccurring infection goes untreated, it may damage the eardrum, bones, and auditory nerves.

3. Causes of Acquired Hearing Loss

This type of hearing loss is not present from the birth rather it is acquired after the birth. Following are some of the causes that may result in acquired hearing loss in infants:

• Diseases such as whooping-cough, mumps, measles and meningitis.
• Perforated ear drum
• Injury or trauma on the head
• Ill-effects of certain medicines
• Ear infections
• Exposure to loud noises

Hearing loss in children may occur in any age. Some children may also experience sudden hearing loss, though this is not very common but it may result from the damage to the inner ear, outer part of the ear or the entire ear.

Symptoms of Hearing Loss in a Child

1. General Signs

• If your child appears to be inattentive
• If your child has speech or speaking disability
• If your child has difficulty in learning (not been able to listen in the class)
• If your child gives weird or irrelevant answers
• If your child has a habit of bending towards the person who is talking, to be able to listen carefully
• If your child speaks loudly
• If your child tries to read your lips while having a conversation with you
• If your child experiences ear pain or hears unusual noises

2. Signs of Hearing Loss in Babies

• If your baby does not feel startled at loud noises
• If your baby does not respond to the source of sound (after 6 months of age)
• If your baby respond to some sounds but not all sounds
• If your baby reacts after seeing you but not to your voice
• If your baby is unable to babble single syllables (by 1 year of age)

3. Signs of Hearing Loss in Children

• If your child’s speech is not clear
• If your child’s speech is delayed
• If your child is unable to follow instructions
• If your child turns up the TV’s volume too high
• If your child often requests you to repeat what you said

Though every baby or child is different, however, they are expected to reach a certain benchmark at a certain age. If you find that your child is missing that, you need to get in touch with your doctor as it may be a sign of hearing disability.

Diagnosis of Childhood Hearing Loss

Following measures may be adopted to diagnose hearing loss in babies and young children:

1. Birth to Four Months

• Your baby should respond to loud noises
• Your baby should respond or react to your voice (by smiling or cooing)
• You baby should wake up or startle at high pitched noises

2. Four to Nine Months

• Your baby should smile or react when spoken to
• Your baby should turn head at various sounds
• Your baby should turn head to the toys that make sound
• Your baby should reciprocate or understand hand movements (like bye or hi)

3. Nine to Fifteen Months

• Your baby should respond to the name
• Your baby should repeat common words
• Your baby should make babbling sounds
• Your baby should understand common words
• Your baby should use voice to get parent’s attention

4. Fifteen to Twenty Four Months

• You baby should be able to follow simple instruction
• Your baby should be able to say simple words
• Your baby should name common objects
• Your baby should be able to point to various body parts when asked to do so
• Your baby may point to familiar objects when you ask
• Your baby may listen to songs and rhymes

However, the auditory screening test can be done once:

• When the child stats going to school
• When the child is 6, 8 or 10 years old
• When the child in middle school
• When the child is in high school

Following are some of the test that may be recommended for the babies and children to diagnose hearing loss:

• Auditory brainstem response
• Central auditory evoked potential
• Otoacoustic emissions
• Middle ear muscle reflex
• Tympanometry

Treatment for Children with Hearing Loss

The treatment for hearing loss in children varies according to the severity and symptoms. Based on this, your doctor may advise following treatment option:

1. Medicines

If the hearing loss is due to the infection in the ear, the doctor may prescribe antibiotics to cure the infection that may be the cause of hearing problem in the child.

2. Hearing Aids

If the child is suffering from sensorineural hearing loss, then your doctor may recommend hearing aids for the child, as medicines or surgery will not able to cure this kind of hearing loss.

3. Surgery

If the child is experiencing hearing loss due to blockage or wax in the ear, surgery may be prescribed to cure this kind of temporary hearing loss.

4. Cochlear Implants

If the child is facing deafness or profound hearing loss, the doctor may recommend these implants. These are surgically implanted to convert the sounds into the electronic impulses which then get transferred through the inner ear.

5. Speech Therapy

If the hearing loss has affected the speech or speaking skills of the child, the doctor may advise for speech therapy after the child gets the cochlear implants or hearing aids.

If the child is suffering from otitis media, the doctor may advise you to wait because this condition usually gets better on its own after a certain time.

Prevention

Hearing loss (acquired hearing loss) can be prevented. Here’s how you can effectively prevent hearing loss in children:

• Do not expose your child to loud noises or sounds at an early stage. This may damage the child’s eardrums.
• Refrain your child from using headphones or earphones (till 6 to 7 years of age)
• Make use of earplugs or ear protectors whenever exposing your child to loud noises or sounds (music concerts, live matches or other such events)
• Do not let your child play with very small toys that your child may accidentally put into the ear.
• Refrain from watching TV or listening to music at high volume

Tips for Parents

Here are some tips for parents of a child with hearing disability or loss:

• If any symptoms or signs of hearing loss in a child are established, it is suggested to seek immediate medical help to avoid any further complications and get timely medical treatment.
• If the child is facing deafness or total hearing loss, it will be a good idea to make the child learn sign language.
• You may enrol the child in special educational institutes or school that specializes in imparted education to children with hearing disabilities.
• It is very important to lend emotional and social support to the child to deal with hearing loss.

Timely medical intervention may prove to be extremely beneficial in case of a child as well as paediatric hearing loss.

Hearing loss can affect your child in more than one ways; therefore it is of utmost importance that you get medical help as soon as you register any signs of hearing loss in your child. Proper medical guidance and support will help you deal with this problem effectively.