Causes of Childhood Hearing Impairment

Theresa Pitt, Aud.D., M.S.H.A.A., Audiology Services in S.E. Ireland.
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Causes of Hearing Loss in Childhood

Many children will have ear infections & earaches. Up to one fifth will develop a persistent ‘Glue Ear’ (fluid behind the eardrum) at some point during childhood - most often before eight years of age - which usually affects their hearing. Sometimes this condition does not improve with medical treatment and minor surgery helps to drain the fluid and improve the hearing; this surgery usually involves inserting GROMMETS or tiny drainage tubes into the eardrum. Most grommets (yes there are several types!) are designed to ‘fall out’ themselves after 4-6 months, so parents should not be surprised if this happens. Glue Ear or ear trouble generally may run in families; it may also be connected with nasal blockage or allergic asthma.

Glue Ear is by far the commonest type of conductive hearing loss, although other structural faults in the outer or middle ear can also lead to a more 'permanent' conductive hearing loss.

Be especially vigilant for signs of hearing loss if your baby is premature or has any type of structural abnormality of the face or head, or if your toddler develops a constant habit of saying what?, or complains of buzzing in their ears or not hearing. Try to help by speaking a bit more loudly and at closer range when you can. Ensure the hearing is tested if you have any doubts, or if there is a family history of hearing problems.

As hearing loss can be both Conductive (usually temporary) and Sensori-neural (permanent) at the same time, get hearing checked after any surgery or if there are ‘risk factors’ such as family history, prematurity, or recent meningitis, measles or mumps. A severe sensori-neural hearing loss can significantly alter a child's (and of course their family's) approach to communication. Early detection is important so that appropriate means of overcoming communication difficulties can be instigated.

Attend any Developmental or Screening appointments; mild or moderate hearing loss is not always obvious to the family, but it may cause speech and language difficulty or behavioural problems if it is not recognised early. Some children may need to wear small hearing aids to help them communicate more effectively. Give hearing aids a chance to work - changes will not happen instantly and people need time to get used to managing the situation effectively.

Unilateral loss, which, in the case of sensori-neural losses, may run in families or may be caused by viral conditions such as measles or mumps, does affect children at school or in noisy situations in particular, but it will not prevent a child from learning to talk normally. It may cause concentration difficulties - perhaps more so if it develops after the age of three than if it is something the child has had from birth. So get the hearing checked if a baby has poor localisation of sounds in their environment after the age of about nine months (and this is very important if eyesight is also poor) or if an older child complains of not hearing in one ear, or if they always turn one side to you or the T.V. etc.

Some children whose ears are functioning normally and who have normal hearing may have difficulty in understanding spoken language - these symptoms relate to difficulties with the audiotory processing abilities in the brain (Central Auditory Processing Disorders or CAPDs), and may be associated with other mild learning disabilities or co-ordination difficulties. It is important to establish whether children have difficulty only in hearing, in hearing & understanding, or in understanding only, in order to offer the best therapy. These differences can be identified and assessed by a paediatric audiologist or speech and language therapist, sometimes with the help of a psychologist. General advice where CAPDs exist would be to eliminate distractions as far as possible and give information in short sentences to assist the prospects of understanding; similar advice often assists children with hearing impairment too. CAPDs can also develop in adults, especially after a stroke or other types of brain injury.

More addresses to contact about childhood hearing impairment are given on the last page of this Website.

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