Hearing Loss in Children - Diagnosis

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What are the causes, risk factors, and signs of hearing loss in children?

There are a number of risk factors for hearing loss in children, so there are 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 Alport 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, and
  • 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 associated with subsequent 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 pounds) 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 sign 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, all states in the U.S. have instituted a universal hearing screen so that all babies have their hearing screened before they go home from the newborn nursery.

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