- Introduction To Hearing Loss
- Types Of Hearing Loss
- Causes Of Hearing Loss
- Signs Of Hearing Loss
- Hearing Loss Screening
- Treatment For Hearing Loss
- Prevent Hearing Loss
- For Parents Of A Child With Hearing Loss
A 2012 study by the World Health Organization (WHO) revealed that 32 million children in the world suffer from disabling hearing loss (1).
That is right. It’s millions!
The WHO also states that 60% of childhood hearing disability or loss is due to preventable causes (2). A small, careless incident or accident can push your child into a world of silence. It’s a jittery thought, isn’t it?
Hearing Loss And Deafness – Are They Same?
Hearing impairment, hearing loss, or deafness refer to a person’s inability to hear sounds partially or completely. Hearing impairment or loss usually means that the child has trouble hearing as well as an average child can. They are unable to hear sounds below the standard frequency, which is around 25 decibels or more in both ears (3).
Hearing disability can be mild, moderate, or severe (profound) and can affect both or one ear. The severity of the child’s hearing impairment depends on how loud someone or something has to be, to be heard by the child.
A child is considered hard of hearing if the impairment is between mild and moderate and the kid may have difficulty hearing normal conversations. When the child is diagnosed with mild hearing loss, and it worsens into profound hearing loss, it is referred to as progressive hearing loss.
A person with profound hearing loss has no hearing at all in both the ears. They cannot hear sounds at any frequency and use sign language to communicate. Deafness can be classified into three categories, based on when the child develops the disability.
- Pre-lingual deafness is when the child has lost the ability to hear any sounds at all before he or she has learned to speak words or understand them. The only way these kids can acquire or learn to speak is through sign language.
- Post-lingual deafness is when the child has acquired deafness after he or she has learned how to speak and understand words. The level of difficulty of hearing can depend on when the child has lost the ability to hear and how much language he or she has learned.
- Unilateral deafness is when the child has a hearing impairment in only one ear, and bilateral deafness is when the impairment is in both the ears.
Types Of Hearing Loss
Hearing loss can be of three types, based on what is causing the impairment (4).
1. Conductive hearing loss
When the body has a problem conducting sound waves efficiently, from the outer ear canal to the eardrum and the ossicles (tiny bones) of the middle ear, it is known as conductive hearing loss. It is usually caused when something affects the passage of sound waves in the ear canal. Otitis media is one of the most common forms of conductive hearing loss in children. Also known as ‘glue ear’, otitis media is the inflammation of the middle ear. Conductive hearing loss usually affects the quality of hearing. Children with conductive hearing loss will have difficulty hearing a few sound frequencies.
2. Sensorineural hearing loss
Sensorineural hearing loss occurs when the child’s inner ear or the nerves from the inner ear to the brain are damaged. This is the most common type of permanent hearing loss and makes it difficult to hear faint sounds. Even if the speech is loud, people may just hear muffled, unclear sounds.
This hearing impairment in children can be caused due to illnesses, trauma to head, exposure to loud noise, side-effects of drugs, or genetics.
3. Mixed hearing loss
Sometimes, conductive hearing loss and sensorineural hearing loss may occur together. This means the inner, as well as the middle ear of the child, could be damaged, thus affecting the hearing ability.
4. Auditory processing disorders
Auditory processing disorders are when the brain has difficulty processing or converting sounds into meaningful messages, such as words or speech. The person may also have difficulty understanding where the sounds are coming from.
Hearing loss can also be categorized into high and low-frequency hearing loss. When an individual has difficulty hearing sounds within the 2000 – 8000 hertz hearing range, it is referred to as high-frequency hearing loss. This type of hearing loss can be caused due to aging, exposure to loud noise, genetics, use of certain toxic medicines, and diseases affecting the inner ear.
Low-frequency hearing loss can be a result of sensorineural hearing loss, making it difficult to hear sounds at a frequency of 2000 hertz or below. Another type of hearing loss, although uncommon, is fluctuating hearing loss in children. It affects kids with normal hearing as well as those with hearing problems.
Causes Of Hearing Loss In Children
Hearing loss can be congenital (from birth) or acquired due to the damage of the eardrum caused because of infection, inflammation, or any other medical condition (5).
Congenital hearing loss
As mentioned, congenital hearing loss is from birth and could be due to genetic or non-genetic factors. Around 75% of congenital hearing loss cases are genetic or hereditary, while the rest are non-genetic (6). In fact, more than 50% of all hearing loss problems are known to occur due to genetic factors.
Genetic hearing loss can be further categorized into:
- Autosomal recessive hearing loss, where the child gets two abnormal or recessive genes, one each from both the parents; 70% of genetic hearing loss cases are due to this.
- Autosomal dominant hearing loss, where the child gets the abnormal gene from one parent, who may also have hearing loss; 15% cases of genetic hearing disability are due to this.
Congenital hearing loss can also occur due to non-genetic factors like:
- Low birth weight
- Maternal diabetes
- Maternal infections caused due to viruses such as herpes simplex virus, rubella virus (German measles), or cytomegalovirus
- Toxins in the body, for example, alcohol consumed by the mother during pregnancy
- Birth injuries
- Toxemia during pregnancy
Acquired hearing loss
Acquired hearing loss is when the child, who had normal hearing abilities at birth and after, develops hearing disability due to one or more of these reasons:
- Ear infections, which are common among children
- Chicken pox
- Head trauma or injury
- Medications that become toxic for the ear
- Exposure to loud noise, at a very young age (in theaters, parties, or other events)
This type of hearing loss can occur at any age.
Some children may also develop sudden hearing loss, although it is rare. This kind of hearing loss is usually sensorineural and indicates a problem with the inner ear, the outer ear, or the entire organ (7).
Signs Of Hearing Loss In Children
When your child does not answer your call, you might just think that he or she is ignoring you. This is especially when you have a preteen or teenager. You may not really suspect any wrong with their hearing abilities.
Inability to hear partially or completely is a sign of hearing loss. But how would you know unless the child tells you about it?
You should look out for these common signs of hearing problems in children.
If your child has hearing loss, he or she may:
- Have poor speech abilities, limited vocabulary, and speaking
- Be able to hear very well at times, but other times he or she just won’t respond
- Seem inattentive more often
- Turn the volume on the TV unusually high
- Have difficulty learning; often fails to respond in class
- Keep asking “what” or “pardon” often, making you repeat something multiple times
- Tend to move forward towards the person speaking; could also turn one ear towards you to hear better
- Respond with irrelevant or inappropriate answers when asked a question
- Look at you intensely or with concentration as if they are trying to read your lips
- Start speaking loudly
- Complain of ear pain or of hearing noises that others cannot hear
- Try to copy or imitate others by looking at them, especially in a classroom when the teacher is giving the instructions out loud
Hearing Loss Screening For Kids
Doctors use a broad range of evaluation and testing methods to determine whether a child has a hearing disability and how severe it is. All newborns should get a hearing evaluation done. Also, the American Academy of Pediatrics recommends that children should get an auditory screening test done (8):
- When they start school
- At ages six, eight, and ten
- Once during middle school
- Once during high school
The screening tests vary for babies and children.
- The auditory brainstem response (ABR) is one of the most common tests done to check hearing abilities in newborns. However, these screening tests may not be able to detect mild or moderate hearing disabilities in infants.
- Another common test is the otoacoustic emissions, which can be done on a sleeping infant or children who are old enough to sit still and quiet. In this, a small probe connected to a computer is placed in the ear canal to check for echo response.
- Central auditory evoked potential or CAEP test, wherein the audiologist uses earphone and miniscule electrodes to check if the auditory pathway to the brainstem isto functioning properly. This can be done for children of all ages, and does not require the child’s participation.
- Tympanometry is a diagnostic procedure that allows the doctors to see how the eardrum moves when a sound moves through the ear canal. This is usually accompanied with a visual ear examination to check the organ’s health.
- Middle ear muscle reflex (MEMR), which is also known as an acoustic reflex test, checks how well the ear responds to loud sounds by evoking a reflex. A soft rubber tip is placed in the ear canal to test the reflexes of the ear by exposing it to sounds at different decibels.
Treatment For Hearing Loss In Children
The treatment for hearing loss or impairment depends on how severe the impairment is when the child lost the ability to hear.
- Medications such as antibiotics may be given by the pediatrician if an ear infection is causing hearing difficulties.
- In case of otitis media, doctors would recommend you to wait and watch as the condition goes away after some time.
- Surgeries can help treat certain types of minor hearing impairments caused due to wax or other objects blocking the ear canal.
- Hearing aids are used to assist kids with sensorineural hearing loss, as it cannot be cured through medications or surgery. A hearing aid is an external device that is attached to the ear and is ideal for mild to moderate hearing loss.
- Cochlear implants are ideal for profound hearing loss or deafness. A cochlear implant is a surgically implanted device that helps in converting sounds into electronic impulses, which are then transferred through the inner ear.
Prevent Hearing Loss In Children
Acquired hearing loss can be avoided when you take a few precautions to minimize the risks.
- Avoid exposing the child to loud noises or music early in life to prevent damage to the eardrum. Don’t allow children to use headphones or earphones until they are at least six to seven years old.
- Do not let the child play with tiny toys or things that can be put inside the ear. Foreign objects inside the ear canal can damage it.
- When traveling to places with loud music, such as a concert, sporting events, or watching fireworks, use ear protectors or plugs to reduce the level of noise.
Here is a simple rule to know if the sound is loud enough to be dangerous for the child. If you have to speak loudly or use your loudest voice to talk over the noise and communicate with a person at arm’s length, the noise could put your hearing ability at risk. Here’s what you can do:
- Turn down the volume
- Take the child out of that place or situation
- Use earplugs or protectors to minimize the impact of that sound
For Parents Of A Child With Hearing Loss
Living with a child with impaired hearing is not easy.. Here are a few tips that can help you and your child handle hearing loss.
1. Early intervention and treatment
One of the first things to do is to take your child to a specialist immediately. Proper diagnosis is important to come up with the right course of treatment, as no one treatment or intervention method works for all.
2. Learning sign language
When the child suffers total hearing loss or deafness, sign language is the only mode of communication. Seek the help of a professional to help your child and you learn the language quickly.
3. Special education
There are several special schools and institutions for children with hearing loss. Talk to your sign language instructor or find a local community that can help you learn about these schools, the education that they provide, and how these schools can help your child.
4. Social and emotional support
In case of pre-lingual deafness, the child does not have a chance to learn a spoken language. In post-lingual deafness, he has difficulty communicating in spite of knowing how to speak. This can impact the child emotionally and socially.
Even mild or moderate hearing loss can affect a child’s school and social life. A study has found that kids with hearing loss tend to perform poorly when compared to kids with normal hearing (9). It is at such times that the child can use all the support he or she can get from you.
Dealing with deafness is challenging as you do not know how to communicate with the child. Your child will miss a group conversation or might have problems in socializing. But remember that there is help at hand. You can approach a support group through the pediatrician, audiologist, or your sign language school. But know that you don’t have to deal with it by yourself.
How can we make life easier for kids with hearing loss? Share your suggestions here.