Why do children have hearing loss?
Hearing loss is a common condition in children and is present in one out of every one thousand births. Because of this deafness is known as the most common disability diagnosed at birth. As some types of hearing loss progress over time, by the time a child is a five years of age or reaches school age, the incidence rate of hearing loss increases to approximately three out of every one thousand births. There are many different causes and types of hearing loss that may affect a child’s learning and development in different ways and to varying degrees.
In Australia, the Statewide Infant Screening Program or (SWISH) ensures that all newborns receive a hearing screening during their first few days of life. Early detection can help to improve speech, language and listening outcomes, so the screening program helps families identify a potential hearing loss early and refer parents/carers to further clinical professionals if required. The screening is non-invasive and is usually conducted on babies while they are sleeping.
What is hearing loss?
Hearing loss in children and adults is a condition of the auditory pathway that can occur anywhere from the outer part of the ear that we can see, all the way up to the brain where messages from the ear are interpreted as meaningful sound. Hearing loss may affect hearing sensitivity (the ability to hear sounds at the same volume as others) or clarity (the ability to distinguish different sounds from each other). For many children, hearing loss may affect both sensitivity and clarity. When you consider how much children use listening to learn how to communicate, socialise, read and spell this has the potential to impact on many areas of their development.
When hearing loss affects one ear, we call this unilateral hearing loss, when it affects both ears, it is called bilateral hearing loss. In both instances, it is recommended to seek professional help as early as possible, speaking to your GP is the best first step.
What causes hearing loss in children?
There are many reasons for hearing loss in a child, for some children, hearing loss may be present at birth (congenital) others may occur after a child is born (acquired). There are different types of hearing loss that a child may have, more information can be found here.
Causes of hearing loss present at birth
Genetic hearing loss: this is where changes in the genes responsible for forming parts of the auditory pathway are inherited from a child’s parents which in turn causes hearing loss. Most parents will not have hearing loss themselves despite carrying the genes for hearing loss. Sometimes genetic hearing loss can be part of a syndrome such as Downs Syndrome, CHARGE syndrome and Pendred Syndrome.
Differences in anatomy: this is often a random malformation that occurs when a baby is forming in the uterus. This can include the incomplete formation of parts of the auditory pathway such as the outer ear (microtia) or the inner ear (Mondini dysplasia, cochlear nerve hypoplasia)
Congenital viral infection: This is when a virus is passed on to a baby through the blood of the placenta during pregnancy after its mother has been infected. Viruses which may cause hearing loss include Measles and cytomegalovirus (CMV).
Causes of hearing loss after birth
Progressive hearing loss: Some types of hearing loss can get worse over time. Sometimes children will develop hearing loss after they are born.
Viruses and infections: Some viruses and bacterial infections can cause hearing loss such as bacterial meningitis, measles, meningococcal meningitis and some untreated ear infections.
Side effects from medications: Hearing loss can be caused by some lifesaving medications such as chemotherapy drugs and antibiotics such as Gentamycin.
Injury: Hearing loss can sometimes be the result of an injury to the head or ear. This can sometimes occur after falls or vehicle accidents where fractures to the skull occur.
Glue Ear/ middle ear infections
Glue ear is the common name given to an accumulation of fluid in the middle part of the ear. This is very common particularly in children under the age of seven. Sometimes this fluid can become infected and turn into a middle ear infection. Whilst there is an accumulation of fluid in a child’s ears, their hearing can be temporarily affected. It can make sounds softer and more muffled for children. For a number of children, this fluid can stay for more than 3 months, this is what we would call chronic glue ear.
This has the potential to impact a child’s speech, language and communication development if they are not hearing well for long periods. For most children, we expect their hearing to improve once the fluid clears. Often glue ear can be managed medically, if this is an issue for a child, it is recommended that their GP be consulted for further advice. Some children also benefit from seeing an Ear Nose and Throat (ENT) specialist for further treatment.
What are the signs of hearing loss in children?
Some symptoms of hearing loss in children can be subtle and can be caused by other developmental and health conditions. These can also vary depending in the cause of the hearing loss and the severity, for example, milder hearing losses may be more difficult to pick up with less obvious symptoms. If your child does any of the following, it may suggest that it is worth investigating their hearing and ear health by talking to their GP or paediatrician.
- A child may not turn to nearby or distant sounds, others may not turn in the correct direction
- The child may not startle to loud sounds
- Younger children may be late in reaching speech and language milestones such as babbling, making different sounds and developing their first words. Others may not reach these milestones at all
- Older children’s speech may not be clear and unfamiliar people may have difficulties understanding what they are saying
- A child might only respond to louder sounds and speech, they may also ask for things to be repeated
- They may also frequently ask for the radio or television to be turned up louder
- Children with hearing loss may have more difficulty hearing in background noise such as at the shops, noisy play centres or at family gatherings
What should I do if I think my child has a hearing loss?
If you are concerned about your child’s hearing, it is important to investigate it as soon as possible. The sooner a hearing loss can be picked up, the earlier your child can receive help with developing their communication skills.
Speak to your GP, paediatrician or early childhood nurse about your concerns. They are able to do a basic check of your child’s ear health and may refer your child for a hearing test with an audiologist. Hearing tests vary with the age of the child, but they are painless, non-invasive and generally aim to make testing fun for children.
Where you access hearing testing will depend on your child’s age and your location. Hearing tests for children may be conducted at children’s or public hospital clinics, local area health services, through private audiology clinics or through Hearing Australia. Your GP or paediatrician will be best placed to advise you on your local audiology services.
Written by Brooke Rose, Audiologist at The Shepherd Centre.
- National Acoustic Laboratories (NAL) LOCHI Key findings: https://www.outcomes.nal.gov.au/key-findings
- Hearing Australia Hearing loss demographics for children 2019: https://www.hearing.com.au/HearingAustralia/media/assets/Documents/Aided-Child-demographics-2019-Hearing-Australia.pdf
- Centre for disease control and prevention: https://www.cdc.gov/ncbddd/hearingloss/data.html