Hearing Loss in Children:

Hearing is critical in the first few years of life for social emotional and cognitive development. An untreated hearing loss can cause permanent language delays and learning disabilities. Even a mild or partial hearing loss can affect a child's ability to speak and understand language. The good news is, hearing problems can be treated if they're caught early — ideally by the time a baby is 3 months old. So it's important to get your child's hearing screened early and evaluated regularly.

The audiology staff at Metro Hearing and Balance has been specially trained to diagnose and treat hearing loss in any age child. Dr. Traci Woods and Sally Teodoro MCD CCC-A have a combined experience of over thirty years working with pediatric hearing loss. A variety of tests are used to assess hearing in children.

RISK FACTORS:

Hearing loss is a common birth defect, affecting about 1 to 3 out of every 1,000 babies. A number of factors can lead to hearing loss, and about half the time, no cause is found.

Some of the main factors are:

• Premature birth
• A stay in the neonatal intensive care unit
• high bilirubin requiring a transfusion
• certain medications that can lead to hearing loss
• a family history of childhood hearing loss
• complications at birth
• frequent ear infections; had infections such as meningitis or cytomegalovirus
• exposure to very loud sounds or noises even of brief duration

WHEN TO HAVE YOUR CHILD’S HEARING TESTED:

Most children who are born with a hearing loss are diagnosed through a newborn hearing screening. But in some cases, the hearing loss is caused by things like infections, trauma, and damaging noise levels, and the problem doesn't emerge until later in childhood. So it's important to have kids' hearing evaluated regularly as they grow.

Your newborn will likely have a hearing screening before being discharged from the hospital (most states require this). If your baby doesn't have this screening, or was born at home or a birthing center, it's important to have a hearing screening within the first 3 weeks of life.

If your baby does not pass the hearing screening, it doesn't necessarily mean there's a hearing loss. Because debris or fluid in the ear can interfere with the test, it's often redone to confirm a diagnosis. If your newborn doesn't pass the initial hearing screening, it's important to get a retest within 3 months in order to start treatment right away. Treatment for hearing loss can be the most effective if it's started by the time a child is 6 months old.

Kids who seem to have normal hearing should continue to have their hearing evaluated at regular doctors' appointments. Hearing tests are usually done at ages 4, 5, 6, 8, 10, 12, 15, and 18, and any other time if there's a concern.

But if your child seems to have trouble hearing, if speech development seems abnormal, or if your child's speech is difficult to understand, schedule a hearing evaluation.

SYMPTOMS OF A HEARING LOSS:

Even if your newborn passes the hearing screening, continue to watch for signs that hearing is normal.

Some hearing milestones your child should reach in the first year of life:

• Most newborn infants startle or "jump" to sudden loud noises.
• By 3 months, a baby usually recognizes a parent's voice.
• By 6 months, an infant can usually turn his or her eyes or head toward a sound
• By 12 months, a child can usually imitate some sounds and produce a few words, such as "Mama" or "bye-bye."

As your baby grows into a toddler, signs of a hearing loss may include:

• limited, poor, or no speech
• frequently inattentive
• difficulty learning
• often increases the volume on the TV
• fails to respond to conversation-level speech or answers inappropriately to speech

DIAGNOSING A HEARING LOSS:

Several methods can be used to test a child's hearing, depending on the child's age, development, or health status.

Behavioral Testing

This involves careful observation of a child's behavioral response to sounds like speech and pure tones. Pure tones are the distinct pitches (frequencies) of sounds. A child is usually seated with a parent in a sound treated room and tested using two audiologists.

The behavioral response might be an infant's eye movements, a head-turn by a toddler, placement of a game piece by a preschooler, or a hand-raise by a gradeschooler. Speech responses may involve picture identification of a word or repeating words at soft or comfortable levels. Even very young children are capable of a number of behavioral tests.

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Otoacoustic emissions (OAE) test

This brief test is performed with a sleeping infant or an older child who may be able to sit quietly. A tiny probe is placed in the ear canal, then many pulse-type sounds are introduced and an "echo" response from the outer hair cells in the inner ear is recorded. These recordings are averaged by a computer. A normal recording is associated with healthy outer hair cell function and reflects normal hearing, although in some cases the hearing loss may be due to problems in other parts of the hearing pathway.

ABR or OAE tests are used at hospitals to screen newborns. If a baby fails a screening, the test is usually repeated. If the screening is failed again, the baby is referred for full hearing evaluation.

Tympanometry

Tympanometry is not a hearing test but a procedure that can show how well the eardrum moves when a soft sound and air pressure are introduced in the ear canal. It's helpful in identifying middle ear problems, such as fluid collecting behind the eardrum.

If your child has failed a newborn screening or a school screening or if you suspect your child may be having difficulty hearing, schedule a hearing evaluation as soon as possible.