Hearing ability is important for children to develop speech and language skills as they grow. In the past, hearing loss in children often went undetected until the child was around two years old, when it became obvious that he or she wasn't talking yet. However, we now know that when it comes to treating hearing loss in kids, intervention should happen as early as possible.
Research has demonstrated that treating hearing loss before a baby reaches six months of age results in significantly better outcomes than treating later. As a result, newborn hearing screening has become universal in hospitals across the United States and children with hearing loss are being identified and treated at much younger ages.
How common is hearing loss in children?
While data varies, roughly 1.7 babies per 1,000 newborns who are screened are found to have hearing loss. Among older children, about 5 out of every 1,000 children ages three to 17 have hearing loss, according to parent surveys published by the CDC.
Causes of childhood hearing loss
There are several possible causes for hearing loss in children, whether it's congenital (present at birth) or acquired (occurs after birth). Hearing losses in children may be conductive, sensorineural or mixed. It's important that parents, caretakers, physicians, teachers and others know the signs of and address hearing loss in children because untreated hearing loss can cause significant development and emotional problems for children.
Some babies are born with hearing loss, which is known as congenital hearing loss. Many different things can cause this type of hearing loss, but it's not always possible to pinpoint the precise cause. In about half of all cases of hearing loss in kids, the cause is genetic—meaning, inherited from a parent, who may or may not have hearing loss, too. The severity of the hearing loss can range from mild to profoundh.
Genetic factors that might cause congenital hearing loss include:
Non-genetic factors that might cause congenital hearing loss include:
When a child develops hearing loss later
Children can also be affected by acquired hearing loss, meaning it occurs at any point after birth. The severity of the hearing loss may range from mild, moderate to severe or profound. There are various causes of acquired hearing loss, including:
Hearing loss that comes and goes in children
Some children may experience hearing loss that comes and goes, known as transient or fluctuating hearing loss. It's also harmful to speech and language development. Transient hearing loss can be caused by otitis media, more commonly known as a middle ear infection. Twenty-five percent of kids have had one episode of otitis media by the time they are three years old. This type of infection is very common in children because of the Eustachian tube position during childhood. The Eustachian tube, which allows for air pressure equalization between the middle ear and the nasopharynx, is smaller and more horizontal during development. Thus, it is very susceptible to blockage by fluids or large adenoids (glands in the throat area).
A middle ear infection can cause transient hearing loss because excess fluids in the keep the tiny middle ear bones from working properly. Thankfully, this type of hearing loss is usually temporary and resolves itself. However, frequent, untreated middle ear infections can cause cumulative damage to the bones, eardrum or auditory nerve, creating a permanent, sensorineural hearing loss.
Hearing loss screening for children
As mentioned above, hospitals routinely perform hearing screening on infants in the first 24-48 hours after birth. If an infant fails the initial screening, he or she is usually scheduled for a second screening a few weeks later. However, sometimes infants who pass the hearing screening at birth may exhibit signs of hearing loss as they age.
One way to determine if your child’s hearing is developing appropriately is by monitoring important speech and hearing milestones, such as those listed below from ASHA.
From birth to four months, your infant should:
From four months to nine months, your infant should:
From nine to 15 months, your baby should:
From 15 to 24 months, your toddler should:
Older children sometimes develop hearing loss that wasn't present before. Here are some things to look for if you think your toddler or preschool-age child might have hearing loss:
Treatments for childhood hearing loss
Depending on the severity and cause of hearing loss in your child, hearing aids, cochlear implants and a combination of speech therapy or assistive listening devices might be recommended forms of treatment. If you notice that your infant or child shows any of the above signs, take him or her to your family doctor, who can refer you to a pediatric audiologist to have your child's hearing tested. If a child has wax buildup, an ear infection or another problem causing temporary hearing loss, the audiologist will take care of the problem or refer you to an otolaryngologist (ear, nose and throat physician) to have the temporary hearing obstruction treated.
Audiologists can perform in-depth behavioral hearing examinations for even very young children (as young as 6 months). There are several objective tests that infants, toddlers and young children can undergo as well. These tests are painless and non-invasive. After the exam, the audiologist will spend time talking with you about your child's hearing ability and recommend an appropriate treatment plan or medical intervention.
Hearing aids are just one kind of device that can help children with hearing loss hear clearly again. There are many pediatric hearing aids, including high-powered aids for children with profound hearing loss that offer high-quality hearing assistance. Many solutions for children include special coverings and other accessories to ensure that young children don't remove or misplace their hearing aids. There are several models of devices to choose from, including behind-the-ear hearing aids or those that are almost entirely in the ear canal and very discreet.
Cochlear implants are surgically implanted devices that directly stimulate the auditory nerve in the inner ear with electrical stimulation. Cochlear implants also have an external device, and many companies make kid-friendly devices that can be held on with a soft headband. Cochlear implants work for infants and children who cannot benefit from hearing aids.
Bone-anchored hearing systems
In some cases, a child may be a better candidate for a bone-anchored hearing system. People who typically get the greatest benefit from bone-anchored hearing systems include those who have severe outer or middle ear malformations, such as microtia and atresia, and those with single-sided deafness.
For children who have had hearing loss that has affected their speech, he or she might need speech-language therapy after getting hearing aids or a cochlear implant to help him or her catch up on speech delays.
Assistive listening devices
Many hearing aid manufacturing companies offer assistive listening devices such as FM systems that are discreet and work well in a classroom situation in conjunction with the child's hearing aid or cochlear implant. FM technology helps overcome the poor acoustics of classroom settings or other venues with lots of background noise. Essentially, the teacher wears or has a discreet microphone in front of him or her that transmits his or her voice directly to the child's hearing aids or cochlear implant.
Parents aren’t the only ones with a responsibility to make sure certain children with hearing loss have an equal opportunity to learn; schools have responsibilities as well. If your child is starting school, our back-to-school checklist for kids with hearing loss offers helpful advice on a smooth transition.
Finding a provider for your child
Seek help right away if you suspect your child has hearing loss. Oftentimes, your pediatrician is a good place to start. She may refer you to a pediatric audiologist or an ear, nose and throat doctor. This primer on different types of hearing specialists may come in handy as you navigate your child's journey to better hearing.