Detecting Hearing Loss in Children

  • Author:
    Jillyen E. Kibby, MA, CCC-A

    Ms. Kibby received her master's degree in Audiology with honors from California State University, Long Beach, and is currently pursuing her doctorate at the University of Florida. She completed her clinical fellowship and spent seven years at Texas Children's Hospital in Houston, where she trained for her pediatric specialty.

  • Author: David Perlstein, MD, MBA, FAAP
    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

  • Medical Editor: James K. Bredenkamp, MD, FACS
    James K. Bredenkamp, MD, FACS

    James K. Bredenkamp, MD, FACS

    Dr. Bredenkamp recieved his medical degree from the University of California, San Francisco School of Medicine. He then went on to serve a six year residency at the University of California, Los Angeles School of Medicine in the department of Surgery.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Are any additional tests done during a pediatric hearing evaluation?

A thorough diagnostic test also includes an evaluation of the middle-ear system. The middle ear is the space behind the eardrum and is a common site for ear infections in children.

A tympanogram is a measure of the compliance of the middle-ear system mobility (including the eardrum) and is an objective method for confirming abnormalities of the eardrum or middle ear space, such as

  • fluid behind the eardrum,
  • a hole or perforation of the eardrum, or
  • stiffness of eardrum or middle-ear bones (for example, otosclerosis).

The tympanogram is completed by inserting a probe in the ear and creating a vacuum-tight seal. The air pressure is changed in the ear canal from positive to negative, and the movement of the eardrum is recorded. The amount and shape of the movement can either exclude or signify different problems, as previously listed. The test is fast, objective, and is not painful (although sometimes the insertion of the probe may upset children).

When a loud sound is presented to a healthy ear, the eardrum will contract, a sort of built-in hearing protection mechanism (although it's not very effective). This contraction of the eardrum is called the acoustic reflex. The absence of this reflex can further confirm problems of the middle ear or may help to identify or confirm a hearing loss. Acoustic reflexes are typically evaluated concurrent with the tympanogram.

Many general pediatricians perform this test in their offices as a screening test and to aid in the diagnosis of ear infections or effusions (fluid in the middle ear space).

What happens when hearing loss is detected? What is the treatment for hearing loss in children?

When hearing loss is identified, a thorough search for its cause must be undertaken. In many situations, the hearing loss can be attributed to an ear infection or to fluid trapped in the middle-ear space. In this situation, the pediatrician can often prescribe antibiotics to treat the infection. If the infection is persistent, or the hearing loss is still present after treatment of the infection, then the child should be referred to a medical doctor who specializes in diseases of the ear and auditory system (an otolaryngologist or ENT). The otolaryngologist will often administer further testing, and in some situations, he or she may recommend additional therapy such as surgery (ear tubes). If the hearing loss is persistent or is related to a nerve or inner-ear problem, the otolaryngologist will often recommend an evaluation by an audiologist for hearing aids and rehabilitative therapy (which includes speech therapy and social integration of the hearing-impaired child).

Medically Reviewed by a Doctor on 9/15/2016

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