Hearing Loss in Children

Request an Appointment

As the parent of a child with newly diagnosed hearing loss, you will have many questions and concerns regarding the nature of this problem, its effects on your child’s future, treatment options, and resources. This brief guide will give you the necessary initial information and provide guidance about the availability of resources and the respective roles of different care providers.

It is always difficult for parents to receive bad news about any aspect of their child’s health. Reacting with anger, grief, and even guilt is not unusual when finding out that your child is hearing-impaired. These feelings are best managed by discussing them with a family member, close friend, clergy, or mental health professional. At times, the feeling may also result in a degree of denial. Feel free to seek a second opinion, but it is unadvisable to delay further recommended diagnostic evaluations for your child. The best treatment for hearing loss of any degree is an appropriate early intervention. Significant delays may result in irreversible harm to your child’s hearing, speech, language, and eventual educational development.

You will come into contact with many healthcare and rehabilitation specialists during the long-term management of your child’s hearing loss. Some of them will be involved early in the journey and again at intervals. Others may step in later on. The following are professionals you will encounter and the role each of them will play in managing your child’s hearing loss.

The Audiologist

The audiologist is likely to be the first professional you encounter and possibly the one who gives you the initial news regarding your child’s hearing loss. The audiologist will carry out behavioral or objective testing (such as auditory brainstem responses) or a combination of these approaches to determine the degree and type of hearing loss.

Following a medical consultation, the audiologist will recommend appropriate amplification, providing your child with hearing aids and well-fitting ear molds, as he or she grows. The audiologist may also be the professional who provides you with information and referral to an early intervention program. Over time, the audiologist will provide periodic follow-ups to chart your child’s progress and to monitor his or her hearing loss.

Otologist, Otolaryngologist, or Pediatric ENT

Upon diagnosis of hearing loss, your child will be referred to an ear, nose, and throat specialist (otolaryngologist) or one who specializes in childhood ear and hearing problems. This physician’s initial role is to determine the specific nature of the underlying problem that may be at least partially causing the hearing loss. Additionally, the physician will also determine if the problem is medically or surgically treatable and, if so, provide the necessary medical or surgical treatment. Such treatments could include something relatively simple, like the placement of eardrum ventilation tubes or more complex surgical procedures. The ENT specialist may also refer your child for additional diagnostic procedures, such as imaging studies (X-rays, CT-scans, MRI scans), to define the type and source of hearing loss further. The doctor also provides clearance for hearing aid fitting, after determining that no other intervention is indicated. If it is determined that your child needs a cochlear implant, the otolaryngologist, along with the audiologist, will carry out further tests and examinations and will perform the implant surgery.

Pediatrician or Family Practitioner

Your child’s primary care physician may be either a pediatrician or a family practice doctor. If your child is not diagnosed with a hearing loss in the newborn period but develops hearing loss later in life, it is the responsibility of this doctor to make appropriate referrals to an ear, nose and throat specialist and an audiologist to rule out or diagnose hearing loss. Your child’s primary care doctor may also participate in the treatment of ear infections or refer them to an otolaryngologist for treatment. The primary care physician or the otolaryngologist may also provide a referral to a doctor who specializes in medical genetics to find out if your child’s hearing loss may be hereditary. That may help you determine if a similar hearing loss could occur in your other children.

Early Intervention Specialist

This professional is typically someone with an educational background. He or she can help you find resources in your community; define family members’ roles in early intervention and management of the hearing loss; and can help you with questions regarding future educational placement. This specialist will also help you with your observations and concerns about your child and give you information and support regarding your child’s educational needs in the future.

Speech/ Language Pathologist (SLP)

This professional will evaluate the impact of your child’s hearing loss on speech/language development, and monitor his/her progress, noting if progress with that speech/language is falling behind. If this happens, the SLP may refer back to the audiologist or otolaryngologist to determine if any changes have occurred in your child’s hearing. The SLP will also help your child to learn proper speech production, including correct articulation of speech sounds. If you choose oral communication for your child, in addition to the speech-language pathologist, your child may also be treated by an auditory-verbal therapist, who can help your child acquire the full range of speech sounds and guide the family to additional medical or audiological treatments. The auditory-verbal therapist will also help the child’s family become familiar with appropriate speech/language, auditory, and cognitive developmental milestones you may expect for a child with hearing loss.

Finally, many other people can provide additional assistance for your hard-of-hearing child. Parents of older hard-of-hearing children, and hard-of-hearing adults, can share their experiences with you and may have suggestions for educational and recreational resources in the community.

Hearing Screening for Children

Approximately two to four of every 1,000 children in the United States are born deaf or hard-of-hearing, making hearing loss the most common birth disorder. Many studies have shown that early diagnosis of hearing loss is crucial to the development of speech, language, cognitive, and psychosocial abilities. Treatment is most successful if hearing loss is identified early, preferably within the first few months of life. Still, one in every four children born with serious hearing loss does not receive a diagnosis until 14 months old.

Early hearing screening for children is important and should be done in the hospital shortly after birth. If your child’s hearing is not screened before leaving the hospital, it is recommended that screening be done within the first month of life. If test results indicate a possible hearing loss, get a further evaluation as soon as possible, preferably within the first 3 to 6 months of life.

In recent years, health organizations across the country, including the American Academy of Otolaryngology-Head and Neck Surgery, have worked to highlight the importance of screening all newborns for hearing loss. These efforts are working. Recently, many states have passed Early Hearing Detection and Intervention legislation. A few other states regularly screen the hearing of most newborns but have no legislation that requires screening. So, check with your local authority or hospital for screening regulations.

Infant Hearing Loss

Your newborn child may have some degree of hearing loss if he or she

  • does not startle, move, cry, or react in any way to unexpected loud noises,
  • does not awaken to loud noises,
  • does not turn his/her head in the direction of your voice,
  • does not freely imitate sound, or
  • has failed a newborn hearing screening test,

More than three million American children have a hearing loss, and an estimated 1.3 million of them are under 3 years of age. Parents and grandparents are usually the first to discover hearing loss in a baby because they spend the most time with them. If at any time you suspect your baby has a hearing loss, discuss it with your doctor. He or she may recommend evaluation by an otolaryngologist-head and neck surgeon (ear, nose and throat specialist) and additional hearing tests.

Hearing loss can be temporary, caused by ear wax, middle ear fluid, or infections. Many children with temporary hearing loss can have their hearing restored through medical treatment or minor surgery. Some children, however, have sensorineural hearing loss (sometimes called nerve deafness), which is permanent. Most of these children have some usable hearing, and children as young as 3 months old can be fitted with hearing aids.

Screening Tests for Newborns and Infants

Two tests are used to screen newborns and infants for hearing loss. They are otoacoustic emissions (OAE), and auditory brain stem response (ABR).

Otoacoustic emissions involve placing a sponge earphone in the ear canal to measure whether the ear can respond properly to sound. In normal-hearing children, a measurable “echo” should be produced when sound is emitted through the earphone. If no echo is measured, it could indicate a hearing loss.

Auditory brain stem response is a more complex test. Earphones are placed on the ears and electrodes are placed on the head and ears. Sound is emitted through the earphones while the electrodes measure how your child’s brain responds to the sound.

If either test indicates a potential hearing loss, your physician may suggest a follow-up evaluation by an otolaryngologist.

Symptoms of Hearing Loss in Young Children

Hearing loss can also occur later in childhood. In these cases, parents, grandparents, and other caregivers are often the first to notice that something may be wrong with a young child’s hearing. Even if your child’s hearing was tested as a newborn, you should continue to watch for signs of hearing loss, including:

  • Not reacting in any way to unexpected, loud noises.
  • Not being awakened by loud noises.
  • Not turning his/her head in the direction of your voice.
  • Not being able to follow or understand directions.
  • Poor language development.
  • Speaking loudly or not using age-appropriate language skills.

If your child exhibits any of these signs, report them to your doctor.

Diagnosing a Child’s Hearing Loss

Hearing loss in children can be temporary or permanent. It is important to have hearing loss evaluated by a physician who can rule out medical problems that may be causing the hearing loss, such as otitis media (ear infection), excessive earwax, congenital malformations, or a genetic hearing loss.

Treatment Options for Children with Hearing Loss

If it is determined that your child’s hearing loss is permanent, hearing aids may be recommended to amplify the sound reaching your child’s ear. In some instances, ear surgery may be able to restore or significantly improve hearing. For those with certain types of very severe hearing loss who do not benefit sufficiently from hearing aids, a cochlear implant may be considered. Unlike a hearing aid, the implant bypasses damaged parts of the auditory system and directly stimulates the hearing nerve, allowing the child to hear a louder and clearer sound.

Early Diagnosis is Crucial for Pediatric Hearing Loss

Research indicates that if a child’s hearing loss is remedied by age 6 months, it will prevent subsequent language delays. You will need to decide whether your deaf child will communicate primarily with oral speech and/or sign language, and seek early intervention to prevent language delays. Other communication strategies such as auditory verbal therapy, lip-reading, and cued speech may also be used in conjunction with a hearing aid or cochlear implant, or independently.

Early diagnosis is crucial in the management of pediatric hearing loss. When a diagnosis is delayed, there can be a significant impact on speech and language development. Early fitting of hearing or other prosthetic aids and an early start on special education programs can help maximize a child’s existing hearing. This means your child will get a head start on speech and language development.

Contact Us

If you are concerned about your child’s hearing, please contact Integrated ENT at (303) 706-1616 to schedule an appointment. You may also request an appointment online.