Hearing Loss
Hearing loss has been called an
"invisible" disability.
Why?
- You can't tell someone is deaf
just by looking at him.
- Hearing loss often doesn't
cause physical pain.
But hearing loss can greatly affect your child's life.
Here are some facts on hearing loss:
- About 1 out of 1,000 baby born
is born with a hearing loss.
- You can start having hearing
loss any time during your life.
- In this country, about 10 million children younger than 18 have a permanent hearing loss.
- Many more people develop
hearing loss later in life.
Signs of Hearing Loss
As a parent, you'll probably be the first to notice if something's wrong.
Check to see if your baby might have a problem.
As a parent, you'll probably be the first to notice if something's wrong.
Check to see if your baby might have a problem.
Types of Hearing Loss
Sensorineural hearing loss? Progressive hearing loss? What do all these words mean? In this section we explain the different kinds of hearing loss.
Causes of Hearing Loss
Learn what the common causes of deafness are.
Learn what the common causes of deafness are.
Genetics of Hearing Loss
Like blue eyes and freckles, deafness can be passed down through the family. Read this section to find out how genetics may affect your children's hearing.
Like blue eyes and freckles, deafness can be passed down through the family. Read this section to find out how genetics may affect your children's hearing.
Can My Child Hear?
From newborn hearing screening to OAEs, we tell you about the different ways to test hearing.
From newborn hearing screening to OAEs, we tell you about the different ways to test hearing.
Signs
of Hearing Loss
As your child grows, does something seem wrong with his/her hearing?
- Sleep soundly even when you
talk loudly near her?
- Not babble anymore (after 9
months)?
Signs of normal hearing
If you think your child has a hearing loss, talk to your doctor. Also, read this timeline of normal things most hearing babies do.
Just remember, all children are different. They may not do all of these things on time:
If you think your child has a hearing loss, talk to your doctor. Also, read this timeline of normal things most hearing babies do.
Just remember, all children are different. They may not do all of these things on time:
From birth to 3 months:
- React to loud noises
- Wake up at loud sounds
- Be soothed by the sound of your
voice
- Start making sounds in the back
of her throat, like going "goo"
From 3 to 6 months:
- React to the sound of your
voice
- Start turning he/her head or eyes
towards sounds
- Like playing with toys that
make noise
- Stop to listen to voices
- Smile when someone talks to him/her
- Cry in different ways when she
needs different things - such as if he/she's hungry, or needs to be changed.
From 6 to 12 months:
- Answer to his/her name
- Make many different baby talk sounds
- Start to understand simple
words, like "mama," "dada," and "wave
bye-bye"
- Turn his/her head to familiar
sounds, like a telephone ringing
- React to changes in your tone
of voice
By 12 months:
- Copy sounds that he/she hears
- Answer simple questions like,
"Where's the ball?"
- Recognize his/her name
- Understand what "no"
means
From 12 to 18 months:
- Give you a toy when you ask him/her
- Point to parts of the body when
you ask him/her
- Put sounds together
- Use a few simple words, like
"mama," "more," and "no."
- Follow simple directions that
you tell him/her
By 18 months:
- Understand about 50 words
By 2 years:
- Understand yes and no questions
- Use words that you often use at
home or school
- Make simple sentences
- Follow simple orders without
being shown what to do
By 2 ½ years:
- Use about 270 words
- Say or sing short rhymes and
songs
- Check out interesting sounds,
or tell others about them
By 3 years:
- Make simple sentences of 3 to 4
words
- Use about 1,000 words
- Be able to tell a story
- Know his/her name and the names of
people in her family
- Sing songs
Types
of Hearing Loss
There are different kinds of hearing loss.
- Conductive hearing loss is when sound can't reach your
inner ears.
- Sensorineural hearing loss is when the cochlea or the auditory nerve isn't working.
- Mixed hearing loss is when
there is both conductive and sensorineural hearing loss.
Another way of talking about different types of hearing loss is by
how a person hears.
- Unilateral hearing loss is when hearing loss is only in one ear.
- Progressive hearing loss is when the hearing loss gets
worse over time.
- Fluctuating hearing loss is when the hearing loss changes.
It may sometimes be worse and sometimes better.
Some other types of hearing loss don't fit any of these groups.
- Auditory neuropathy is when the cochlea works but
there is something wrong with the auditory nerve. This hearing loss can be
very confusing.
- Central Auditory Processing Disorder (CAPD) is when there's something wrong
with how your child's brain interprets the signals it gets from the ear.
Conductive
Hearing Loss
Conductive (kun-DUK-tiv) hearing loss is when sound can't reach your inner ear.
What causes conductive hearing loss?
- Ear infections
- Ear infections can make fluid
build up in the middle ear.
- Something growing inside the
ear canal.
- Earwax pressing on the eardrum.
How it affects your child's hearing
- This may make sounds seem
quieter.
- Your child might not be able to
hear quiet sounds.
Can it be fixed?
Yes. This kind of hearing loss can usually be fixed with:
Yes. This kind of hearing loss can usually be fixed with:
- Medicine to treat ear
infections
- An operation
Sensorineural
Hearing Loss
Sensorineural (sen-sor-ee-NEW-ral) hearing loss is when the cochlea or the auditory nerve isn't working.
What causes
sensorineural hearing loss?
- Side effects of medicine
- Infections
- High fevers
- Genetics (passed through the
family)
How it affects your child's hearing
- The hearing loss is permanent
- The hearing loss might get
worse
- Your child may not be able to
hear quiet sounds.
- Your child may not be able to
tell the difference between sounds.
- This would make it hard for
your child to understand what people say.
Can it be fixed?
Probably not. Sensorineural hearing loss is usually permanent.
The cochlea or auditory nerve could be damaged.
Or they may never have grown right in the first place.
Probably not. Sensorineural hearing loss is usually permanent.
The cochlea or auditory nerve could be damaged.
Or they may never have grown right in the first place.
Unilateral
Hearing Loss
If you think your child is having trouble hearing, take him
to an audiologist to get his hearing tested. It may be a unilateral hearing
loss. Then get help early. With early help, your child will succeed.
Unilateral (yoo-nih-LAT-er-al) hearing loss affects only 1 ear. People with unilateral hearing loss can hear normally in 1 ear, but have trouble hearing out of the other ear. The amount of hearing loss is different for different people. It can be mild, moderate, severe, or profound.
What causes unilateral hearing loss
There is more than one possible cause?
There is more than one possible cause?
Some children are born with a unilateral hearing loss. For them,
the hearing loss is passed down in the family, or genetic. Or it might
be because of problems with the pregnancy or when the child was born.
Some people get a unilateral hearing loss later on in life. The
cause is usually an illness (like meningitis or mumps) or a bad ear infection. It
could also be caused by loud noise, like loud music or jackhammers.
Signs of unilateral hearing loss
People with unilateral hearing loss can hear well in most situations. This is because 1 ear is normal. But sometimes there are problems. If your child has unilateral hearing loss, he might have trouble:
People with unilateral hearing loss can hear well in most situations. This is because 1 ear is normal. But sometimes there are problems. If your child has unilateral hearing loss, he might have trouble:
- Figuring out where sounds are
coming from. This is called localization.
- Understanding what people say
when there is other noise at the same time. Like other people talking,
buzzing from lights, or TV or music.
- This is worse when the
"good ear" is close to the other noise
- Paying attention in class
- Following directions in class
- Learning new things
If your child has trouble with some of these things, he might have
a unilateral hearing loss. Take him to an audiologist as soon as possible for a hearing
test. Also, take him to an otolaryngologist.
How to help your child
If your child has unilateral hearing loss, the good news is that there are simple things you can do to help him.
If your child has unilateral hearing loss, the good news is that there are simple things you can do to help him.
Hearing aids
Sometimes a hearing aid worn on the ear with hearing loss can help. It depends on the amount and kind of hearing loss. Ask your child's audiologist about a hearing aid. The audiologist will figure out if it would help your child.
Sometimes a hearing aid worn on the ear with hearing loss can help. It depends on the amount and kind of hearing loss. Ask your child's audiologist about a hearing aid. The audiologist will figure out if it would help your child.
FM system
An FM system can help your child hear well in noisy places, like the classroom or a restaurant. A child might wear a hearing aid and use an FM system, too.
An FM system can help your child hear well in noisy places, like the classroom or a restaurant. A child might wear a hearing aid and use an FM system, too.
In the classroom
Most children with unilateral hearing loss do very well in school.
But they might need extra help. Get your child the help he needs as soon as
possible. That way, he will not fall behind in school. Children with unilateral
hearing loss that do not get help sometimes fall behind or even fail a grade.
But children that do get help can succeed in school as much as hearing
children. Here are some simple things you can do to help your child do well in
school:
- Make sure his teachers know
about the hearing loss.
- Your child's teachers should
let him sit wherever he can hear the best.
- Have your child sit no more
than 5 or 6 feet away.
- Ask the teacher to make sure
your child's "good ear" is close to the teacher. This will help
him hear the lessons and directions.
- Have your child sit as far as
possible from noisy places.
-
Like the hall, the playground and the street.
- Have your child sit away from
things like air conditioners, pencil sharpeners, and heaters.
-
Quiet noises might bother your child, even if they wouldn't bother someone
with normal hearing. This could make it harder for your child to learn.
- Ask the school to get rid of things that stop sound from traveling well in the classroom.
- Like tennis balls under desks, or carpeting on the floor.
- Ask the teachers to teach your
child with things he can see.
Your child may learn better that way. - Teachers can write key
vocabulary words on the blackboard.
- Teachers can also use things
like overhead projectors and videos to help your child learn better.
- Ask the teachers to make sure
that your child understands the lessons and directions before moving on to
something else.
- Ask the teacher for lessons
before class.
Sometimes your child can read ahead in the lesson book. That way, he will understand more when the teacher talks about the lesson in class.
Outside the classroom
- Teach your child to be
extra-careful in dangerous situations.
He might have trouble figuring out where sounds are coming from. - Teach him to look carefully
both ways before crossing the street.
- Put rear-view mirrors on his
bike. Teach him to look out for cars driving behind him.
- Protect your child's "good
ear."
- Use earplugs to protect your
child's hearing from very loud noises (like lawnmowers, power tools, and
loud music).
- Take your child to the doctor
to have his hearing tested often. The doctor will tell you how often to
do this.
- Ear infections can hurt your
child's hearing. If your child gets an ear infection, take him to the
doctor right away. The doctor can give your child medicine to treat the
ear infection before it hurts his hearing.
Progressive
Hearing Loss
What is progressive hearing loss?
A progressive hearing loss (pro-GRE-siv) is a hearing loss that gets worse over time. The change in hearing can happen over a few weeks, months, or even years. It can start as a mild loss and later become a moderate or severe hearing loss.
A progressive hearing loss (pro-GRE-siv) is a hearing loss that gets worse over time. The change in hearing can happen over a few weeks, months, or even years. It can start as a mild loss and later become a moderate or severe hearing loss.
Or a child can have
normal hearing as an infant and begin lose her hearing when she is 2 or 3 years
old. This is called delayed
onset hearing loss. Delayed onset hearing loss can happen when a child
is born with a virus that no one finds out about until later. Other problems at
birth can also caused a delayed onset hearing loss.
Everyone was so upset
when they found out
Relatives and teachers were also noticeably alarmed or overly concerned. That's when I realized, 'Uh-oh, something's wrong with me. The way people are reacting to it, it must be really bad.' I was ashamed of what was happening to me.
Relatives and teachers were also noticeably alarmed or overly concerned. That's when I realized, 'Uh-oh, something's wrong with me. The way people are reacting to it, it must be really bad.' I was ashamed of what was happening to me.
Causes of progressive hearing loss
There is more than one cause. But you may not know what it is.
There is more than one cause. But you may not know what it is.
- Genetic
-
Most progressive hearing losses are inherited. This means it was passed
down through the family Doctors know about some genes that might cause progressive
hearing loss. But they are still looking for other genes.
- Illness
-
Hearing losses that happen because of diseases like meningitis are more likely to get worse over
time.
- Hearing loss from medicine
-
Some medicines used when a child is very sick can cause a hearing loss. Or
they can cause a child with hearing loss to lose more hearing. The hearing
loss can keep getting worse even after the child stops taking the
medicine.
- Hearing loss from loud noises
-
In adults, loud noises can cause progressive hearing loss. This kind of
hearing loss is usually very slow. Loud noise does not usually cause
progressive hearing loss in children.
- Middle Ear Problems
-
If there is a middle ear infection, the hearing loss may get
worse for a short time, but then get better (see fluctuating hearing
loss). A leak of fluid from the inner ear to the middle ear can also cause
progressive hearing loss. But this is rare.
How can I tell if my child has a progressive hearing loss?
1) Try to find out the cause of your child's
hearing loss.
This helps because some kinds of hearing loss are more likely to
get worse. Children who have unilateral hearing loss may be more likely to have progressive
hearing loss. Some genetic problems cause progressive hearing loss.
2) Watch your child.
Once you know how much your child hears, you may be able to tell
if she isn't hearing as well. Here are some signs that her hearing is changing:
- She seems to be saying
"what?" a lot more.
- She doesn't seem to hear the
dog barking anymore.
- She turns up the volume of the
television.
- She suddenly doesn't want to
wear her hearing aids. But before, she didn't seem to mind.
- She seems dizzy or has trouble
keeping her balance. Sometimes children who are losing their hearing get
dizzy.
- She may start to have problems
in school because she isn't hearing as well as she was.
3) Take your child to an audiologist for a hearing test if you think there may be a change in hearing.
4) Call your doctor if there is a sudden change in hearing.
Some problems must be treated right away. Sometimes a doctor will
ask you to go to the emergency room if he or she can't see you in the office
right away. Losing your hearing suddenly is called sudden
hearing loss.
Get help if your child has a progressive hearing loss
A progressive hearing loss can be confusing and scary. If your child's hearing loss is changing slowly, she may not even notice but may start to have more problems in school or with friends.- Talk to your child about her
fears. She may not want to accept that she is losing her hearing. Older
children and teens can get depressed when they learn they are losing their
hearing. A therapist may help your child talk about how she feels.
- Make sure her hearing aids are
strong enough. You may have to get new hearing aids as her hearing loss
changes.
- Keep track of how things are
going in school. She may need new help at school.
- Some children lose so much of
their hearing that they become candidates. Talk to your audiologist about
it.
- If your child has a progressive
hearing loss, it can be hard on the rest of the family too. You may feel
just as scared and confused as your child. Talking to other parents may
help. Or you may want to talk to a therapist about how you feel.
Progressive
Hearing Loss FAQ
Q. How can I find out about progressive hearing loss if it
is hard to give my child a hearing test?
A. This is a very important question. Very young children or
children with learning almost
always have audiograms that
change over time because it is hard to get a good test result. Ask the
audiologist or doctor to go over all the hearing tests to see what your child's
best hearing is.
Even if your child doesn't do well in the test room, an audiologist
will usually try a behavioral
hearing test if you
are worried about a change in hearing. And there are other tests that don't
require your child's cooperation that may help in finding a real change in
hearing. These are otoacoustic
emissions testing,tympanometry and acoustic
reflex threshold measurement. Another hearing test used is the Auditory
Brainstem Response (ABR). The doctor might have to give your child
medicine to make her sleepy before the ABR.
Q. My child passed the infant hearing screening at the
hospital when she was born, but she is not talking yet. Sometimes I worry about
her hearing. Could she have hearing loss?
A. Yes. Occasionally a hearing screening test at the hospital may
be wrong, and a hearing loss can be missed. But sometimes a child can pass a
screening, and get a hearing loss later. This is delayed onset hearing loss, a
type of progressive hearing loss. This might be caused by having CMV when the child is born.
Q. How often should my child have her hearing tested?
A. After you know about the hearing loss, take her to get a
hearing test at least every 6 months. The doctors and audiologists want to see
whether her hearing is staying the same or changing, especially in the
beginning.
Q. Can a progressive hearing loss be prevented?
A. It depends on the
cause. Medical causes, like middle ear problems, can sometimes be treated. But
sometimes treatment doesn't help, and the hearing gets worse anyway.
Q. How can I help my child when I am afraid of finding out
there is a progressive hearing loss?
A. When you help your child to hear her best, you are helping her!
If she does have a progressive loss, you can make sure her hearing aids
continue to help her as much as possible. You can also tell her family, friends
and teachers what to do to help her understand better. It is not easy to look
out for something that might get worse. But you need to look out to help your
child do the best she can do!
Fluctuating
Hearing Loss
If you think your child's hearing is changing, get his
hearing tested. Then get help early.
Fluctuating hearing loss can be confusing to parents. It can
happen to children with normal hearing, and to children with hearing loss.
What is fluctuating hearing loss?
A fluctuating hearing loss (FLUK-chew-ate-ing) changes over time. It can get worse and better. It's different from progressive, where the hearing loss gets worse suddenly, or over time.
Fluctuating hearing loss can cause conductive, sensorineural or
mixed hearing loss. Sometimes fluctuating loss can become a permanent hearing
loss that gets worse over time. Take your child to an audiologist and a doctor
to see if you can do something about the fluctuating hearing loss.
Causes of fluctuating hearing loss
If you think your child has a fluctuating hearing loss, get him tested to find out what's causing it. If you find out the cause, you may be able to do something about it.
Middle and Outer Ear Problems
- Infections often cause
fluctuating hearing loss. Your child's hearing can get worse during an
infection when there's liquid in the ear. But it should get better once
the ear infection clears up.
- Earwax can block your child's
ear canal. This can cause a hearing loss. Earwax can be a problem for
children who wear earmolds and hearing aids. When earwax blocks your
child's ear canal, his hearing aid may a high-pitched noise whistling
noise called feedback.
Disease
Different diseases can affect hearing in different ways:
- Meniere's Disease causes fluctuations in hearing.
But this doesn't happen a lot in children.
- Autoimmune inner ear illness
can make hearing worse. But with treatment it may get better.
- Meningitis can cause hearing loss in 1 out
of 10 children. But sometimes the hearing loss gets better after several
months.
Auditory Neuropathy
Sometimes children with auditory neuropathy have fluctuating
hearing loss. Doctors think that damaged auditory nerves cause auditory
neuropathy. But because we don't know exactly what causes auditory neuropathy,
we don't know why it causes changes in hearing.
Enlarged Vestibular Aqueduct
A vestibular aqueduct is the channel that connects a child's inner
ear to his brain. This problem means that a child's vestibular aqueduct is
bigger than it should be.
If your child has this problem, he could have a progressive or
fluctuating hearing loss. He should also be careful not to hit his head (this
could cause more damage).
Loud Noises
Loud noises can cause a small hearing loss and ringing in the ears
for several hours. Then hearing gets better. But this short-term hearing loss
can get worse over many years. This doesn't happen a lot to children, but
protect your child against loud noises anyway.
Signs of fluctuating hearing loss
It can be hard to tell if your child has fluctuating hearing loss. This is true especially if your child is very young, like a baby or toddler. But here are some signs of a fluctuating hearing loss:If a child has normal hearing
As a baby, he might:
- Not show interest in music
- Not become quiet when his
mother speaks
If your baby starts acting only a little bit differently, you
might not notice anything.
It's easier to tell if an older child with normal hearing has a
fluctuating hearing loss. He might:
- Not pay as much attention as
before
- Get distracted more easily
- Not understand directions
correctly
If a child has a hearing loss
If you already know that your child has a hearing loss, it may be
easier to tell if he starts acting differently to sounds you know he should
hear. As a baby, he might:
- Not want to wear his hearing
aid
- Act like his hearing aid
battery isn't working anymore
An older child can tell you when his hearing changes.
Auditory
Neuropathy
Auditory neuropathy (AN) (AW-dih-tor-ee new-RAH-puh-thee) is a type of hearing loss that can look very
confusing.
- Your child might seem to hear
sometimes and not hear at other times.
- She may hear when it's quiet,
but not hear when there is other noise.
- She may pass certain types of
hearing tests but fail others.
What is auditory neuropathy?
Auditory neuropathy is a type of hearing loss where the cochlea seems to work. But there is something wrong with how the auditory nerve works.
Children with A have different amounts of hearing loss.
- It can range from mild to
profound.
- It is usually in both ears, but
the amount of hearing loss might be different in each ear. Sometimes, the
hearing loss is in just 1 ear. This is called a unilateral hearing loss.
- It can stay the same.
- It can get worse over time.
This is called progressive hearing loss.
- It can be worse some days than
others. This is called fluctuating hearing loss.
- Sometimes the hearing loss gets
better. If your child's hearing loss is going to get better, it will
usually happen before she turns 2.
Auditory neuropathy may also be called Auditory Dys-synchrony (dis-SINK-runny).
So sometimes it will be called AN/AD.
How to find out if your child has auditory neuropathy?
If your child has trouble hearing, take her to the doctor or audiologist to get her hearing tested. Try to find someone who knows about AN, and has worked with other children with it. The doctor or audiologist may need to do many tests to find out if your child has AN. This is because one test may show that your child has normal hearing. But another test may show that your child is deaf.
Two of the tests that are usually done test different parts of
your child's hearing system.
- ABR (auditory brainstem response) tests the auditory nerve. This
nerve sends sounds to the brain. If your child has AN she will probably
have a poor ABR.
- OAE (otoacoustic emissions) test whether the cochlea is
working. Children with AN usually have normal OAEs. But sometimes they
lose their OAEs over time.
Neither the ABR nor the OAE test hearing itself. They are only
looking at different parts of the hearing system to see if they are working.
It's like checking different parts of your car, but not really testing to see
if it drives!
Your audiologist may want to do other tests to find out what the
problem is. The tests will show more about where there might be a problem.
- Tympanometry tests whether the eardrum is
working.
- Middle ear muscle reflexes test
how well the sound is passing through the outer ear to the middle ear.
These are usually absent in people with AN.
- Pure tone audiometry tests how well your child
responds to different tones. This test sometimes looks normal even if your
child has AN. This is because the test is done with single tones and in a
quiet room. Children with AN can sometimes hear when it's quiet, but can't
hear when there is other noise.
- Speech audiometry tests how well your child hears
speech sounds. Children with AN usually have more trouble understanding
speech than you would expect from the other hearing tests. But since
speech audiometry is done in a quiet room, it can still look like your
child hears better than she does in a noisier place.
What causes auditory neuropathy?
Doctors do not know what causes auditory neuropathy. There is probably more than just 1 cause. Some of the things that may increase the chance of having auditory neuropathy are:- Problems at birth or premature
birth. These babies may not get enough oxygen in their brains. Or they may
have jaundice, where the baby's skin is yellow. Some doctors think these
problems may cause auditory neuropathy.
- Having a sister or brother with
auditory neuropathy. Sometimes it runs in families. So if you have one
child with auditory neuropathy, have the doctor test your other children,
too.
How
You Can Help Your Child?
Your child with auditory neuropathy may need different help from
children with other kinds of hearing loss. She may also need different kinds of
help, as she gets older. This is because her hearing loss may change.
Help your child learn language
Like all children with hearing loss, children with AN need to learn language. Children with auditory neuropathy often learn language best when they use their sight to help them. If it is important to you that your child can communicate with hearing people, you might want her to learn an English-based sign language or cued speech.Use technology to help your child communicate
Technology can also help children with Auditory Neuropathy communicate:- Hearing aids do not usually help people with
auditory neuropathy. That is because hearing aids make the sounds louder
but not clearer.
- FM and Sound Field systems help some children understand
what other people are saying.
- Cochlear implants help some children with auditory
neuropathy learn to hear and speak.
Help your child cope with AN
Auditory neuropathy can be confusing and frustrating for both you and your child. Just think how you would feel if you could hear sometimes and not hear other times. Or if people think you can hear them but you can't understand what they are saying.
Talk to your child about how she feels. Let her tell you when she
is upset. You may be able to think of things she can do that will help.
Talk to other parents of children with AN or to adults with AN. You can ask
questions and get support from other parents.
When your child has AN plus other conditions
Some children with AN have other conditions too, like cerebral palsy (CP). The same things that caused the AN, like being born too early, may have also caused other conditions. If your child has other conditions plus AN, your doctor may also send you for other medical tests.
