Detecting Hearing Loss in Children

Childhood Skin Problems Slideshow

Audiology Author: Jillyen E. Kibby, MA, CCC-A
Medical Editors: James K. Bredenkamp, MD (ENT) & Frederick Hecht, MD (Peds)

Table of Contents

• Why test a child's hearing?
• What are the risk factors for hearing loss in children?
• Who tests hearing in children?
• Can very young children have their hearing tested?
• How is hearing tested in an older infant or young child who cannot follow specific instructions?
• How can hearing be assessed in a child who is unable to cooperate?
• Are any additional tests done during a pediatric hearing evaluation?
• What happens when hearing loss is detected?
• What does the future hold for diagnostic hearing testing in children?
• Determining Hearing Loss in Children At A Glance

Myth

Accurate hearing testing cannot be done until a child reaches the age of 5 or 6.

Fact

Current technology now permits the accurate assessment of hearing in children starting within a few hours of birth.

Why test a child's hearing?

A child with undetected hearing loss may not be able to develop normal speech and language or acquire the cognitive abilities (knowing, thinking, and judging) needed for learning. Children whose hearing loss is not identified until, say, two or three may suffer from permanent impairment of speech, language, and learning.

The early identification of hearing loss permits the initiation of treatment and rehabilitation of hearing impaired children to begin at a very young age. The child can learn more normal speech skills when hearing loss is identified early and receives intervention.

Hearing loss can range from a mild impairment to profound loss. Many people think that hearing is graded as normal or deaf. They may also think that the child is hearing normally if he or she is responding to sounds and voices. There are many subtle gradations, however, between normal hearing and deafness and a child's hearing loss may not be evident.

For example, it is common for a child with moderate hearing loss to develop speech and language and yet miss over half of what is being said. A child in this situation will have a distinct disadvantage in development and learning and will often reach a point where advancement stops until the hearing loss is detected and treatment begins.

The stress on this child (and the family) can be enormous, because the child does not understand why there is constant struggle to learn seemingly simple material (and the family is baffled as to why their bright child is not doing well).

The degree of hearing loss often determines what impact the it will have on the child throughout life. However, the impact of hearing loss, irrespective of degree, can be lessened by early identification and treatment.

What are the risk factors for hearing loss in children?

There are a number of risk factors for hearing loss in children so there are a a number of special reasons why a child's hearing may need to be screened or tested. Common indications for a hearing evaluation include:

• Speech delay

• Frequent or recurrent ear infections

• A family history of hearing loss (hearing loss can be inherited)

• Syndromes known to be associated with hearing loss (for example, Down syndrome, the CHARGE syndrome, and Crouzon syndrome)

• Infectious diseases that cause hearing loss (for example, meningitis, measles and cytomegalovirus (CMV) infection)

• Medical treatments that may have hearing loss as a side effect, including some antibiotics and some chemotherapy agents.

• Poor school performance

• Diagnosis of a learning disability or other disorder, such as autism or pervasive developmental disorder (PDD)

In addition, the circumstances surrounding the pregnancy and birth may be relevant to hearing loss. If there is a history that includes any of the following, a child should have a hearing assessment.

• Low birth weight (less than 2 lbs) and/or prematurity

• Assisted ventilation (to help with breathing for more than 10 days after birth)

• Low Apgar scores (numbers assigned at birth that reflect the newborn's health status)

• Severe jaundice after birth

• Maternal illness during pregnancy (for example, German measles (rubella))

• Hydrocephalus

Some parents start to suspect that their child cannot hear normally because the child does not respond to his or her name consistently or asks for words, phrases or sentences to be repeated. Another clue can be that the child does not seem to be paying attention to sounds or to what is being said.

On the average, only half of all children diagnosed with a hearing loss actually have a known risk factor for hearing loss. This means that the cause is never known in about half of children with hearing loss. For this reason, many states in the US have instituted a universal hearing screen so that all babies have their hearing screened before they go home from the newborn nursery.

From the Doctors at MedicineNet.com

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