Pediatric Hearing Loss

Does My Child Have a Hearing Loss?

Hearing loss is quite common in children. Seventy-five percent of children have at least one ear infection by the time they are 3 years old and fifteen percent of children between the ages of 6-19 years have a measurable hearing loss in at least one ear (NICDC, 2010; CDC, 1988-1994). Even if your child passed their newborn hearing screening, they can still have a hearing loss. Hearing loss is not always obvious, and parents are often surprised to learn that their child has a hearing loss. Because hearing loss may be related to an underlying medical condition, and because it can interfere with learning and development, it is important to diagnosis and treat it as early as possible.

Signs That Your Child May Have a Hearing Loss Include:

• Delayed or unclear speech.
• Difficulty following instructions.
• Teacher concerns about paying attention.
• Often saying, “Huh?” or “What?”
• Turning the television/radio volume up very high

Describing Hearing Loss

For an excellent overview of normal hearing, please see How We Hear by the American Speech-Language-Hearing Association. People often think of hearing as an “all or nothing” sense, but this is not the case; a hearing loss is unique to the individual child and can be described by its type, degree, and configuration.

Types of Hearing Loss

Conductive: This type of hearing loss is the most common in children. It occurs when something in the outer ear or middle ear blocks sound from reaching the inner ear. Conductive hearing losses are usually medically or surgically treatable. Causes include wax in the ear canal, malformation of the ear canal or middle ear bones, or a middle ear infection with a build-up of fluid behind the ear drum. Middle ear infections are very common in children; for detailed information, please see Ear Infections in Children by the National Institute on Deafness and Other Communication Disorders.

Sensorineural: This type of hearing loss is usually permanent, as it is caused by damage to the inner ear or auditory nerve. It is quite common for the exact cause of sensorineural hearing loss to remain undetermined. However, causes in children can include genetics, in-utero infections or viruses, oxygen deprivation at birth, disease, and exposure to very loud sounds.

Mixed: A mixed hearing loss is a combination of a conductive and sensorineural loss. For example, your child might have a known sensorineural hearing loss from birth but then has an ear infection, adding to the already present hearing loss and making it mixed.

Auditory Neuropathy/Dys-synchrony: This is a less common hearing disorder in which sound enters the outer, middle, and inner ears normally but the transmission of signals from the inner ear to the brain is disrupted. Children with auditory neuropathy may have normal hearing sensitivity, or hearing loss ranging from mild to severe. They almost always have trouble understanding speech clearly. Please see the Auditory Neuropathy Factsheet from the National Institute on Deafness and Other Communication Disorders.

Degree of Hearing Loss

Again, hearing is not an “all or nothing” sense, as a child’s hearing sensitivity can fall within a wide range. The table below shows the ranges used to classify degree of hearing loss based on severity. Decibels are the units used to measure hearing sensitivity.

Configuration of Hearing Loss

The degree of hearing loss might remain constant across pitches/frequencies, or it might change greatly. This shape or pattern is referred to as the configuration of the hearing loss. Common patterns include flat, sloping, rising, notched, and troughed. The configuration is drawn onto an audiogram, which is a graph that displays how loud (intensity in decibels) specific sounds (pitch/frequency in hertz) must be made in order for your child to just hear them. The audiogram therefore depicts the type, degree, and configuration of your child’s hearing loss. Please refer to The Audiogram by the American Speech-Language-Hearing Association for a detailed explanation.