What is hearing loss?
When a child has trouble with hearing it is called a hearing
loss. There are many types and degrees of hearing loss.
Types of hearing loss are classified by where in the ear the
problem occurs.
Types of hearing loss include:
- Conductive hearing loss: This type of hearing loss
occurs when something interferes with sound waves
traveling through the outer and middle parts of the ear.
Possible causes include:
- complete blockage in the outer ear by wax
- ear infection or a collection of fluid in the middle
ear
- damage to the tiny bones in the middle ear.
Conductive hearing losses may or may not be permanent depending on the cause.
- Sensorineural hearing loss:
This type of hearing loss is
caused by a problem in the innermost part of the ear or
in the auditory nerve (the term auditory refers to
hearing). Possible causes include:
- abnormal development of the inner part of the ear
- injury to the ear from diseases, such as meningitis
and rubella
- tumors
- a physical injury to the inner ear.
Sensorineural hearing losses are permanent. Sometimes
the problem with the inner ear also causes problems with
balance. Children with both hearing and balance problems
may have mild delays in the development of their motor
skills.
A child may have both a sensorineural hearing loss and a
conductive hearing loss. This type of hearing loss is
called a mixed loss.
What are the levels of severity?
Hearing losses are also classified by their severity: mild,
moderate, severe, and profound. The level of severity is
determined by the loudness of sound that a child can hear.
The loudness of sound is measured in decibels (dB).
Mild:
Children with mild hearing losses can hear sounds of
30 to 40 dB or louder. They may have trouble hearing faint
or distant speech. The most common cause of a mild hearing
loss is fluid collection in the middle ear.
Moderate:
Children who have moderate losses of hearing can
hear sounds louder than 45 to 60 dB. They need speech to be
loud. It is hard for these children to understand speech in
group situations.
Severe:
Children with severe losses can hear sounds of 65
to 85 dB or louder. They can hear only loud voices one foot
or less away or loud sounds in the environment.
Profound:
Children with profound hearing losses may hear
loud sounds of 90 dB or more, but they may be more aware of
vibrations than sound. The term deaf usually applies to
children with profound hearing losses or to children with no
hearing at all.
What are the symptoms?
Your child may have a hearing problem if:
- Loud noises do not startle your child by 3 or 4 months of
age or if your child does not turn towards the source of
a sound.
- Your child notices you only when he or she sees you.
- Your child does not experiment with sounds other than
gargles and other vibrating noises that he or she can
feel.
- By 15 months of age, speech is delayed or hard to
understand. Single words such as "dada" or "mama" are not
spoken.
- Your child does not always respond when called.
- Your child hears some sounds but not others.
- Your child hears poorly and has trouble holding his head
steady. Your child is slow to develop unsupported sitting
or walking.
- Your child has a cleft lip or palate, kidney disease,
short stature, or other birth defects.
How is it diagnosed?
A child is never too young to have a hearing test. Early
testing is important. Every child who may have a hearing
loss needs thorough testing of his hearing and middle ear
function. An audiologist performs hearing tests. He or she
is specially trained to recognize and evaluate hearing.
After a hearing loss is diagnosed, your health care provider
will try to find out the cause of the hearing loss.
Additional tests may include blood tests, an EKG, and a CAT
scan (a special x-ray) of the middle and inner ear. It is
important to try to find out if the cause, especially if it
is a genetic cause. Then you will know if your next child
has a chance of having the same problem.
Results from these tests help determine the best treatment
and educational strategy for your child.
What is the treatment?
A child's early years are very important for learning and
the development of language. Treating hearing impairment
early makes a big difference in how well a child functions
later in life. The audiologist tries to provide the best
use of a child's remaining hearing. She or he designs a
treatment plan for your child. This plan consists not only
of making sound louder with hearing aids, but also hearing
and language training, and parent support and training.
- Hearing aids
Hearing aids do not restore hearing. They are
loudspeakers that help get the best sound possible to
your child's ear. The aid makes sounds louder, not
clearer. It may distort some sounds. Children of all
ages can use hearing aids. The aids even help young
infants.
Make sure that you talk to the ear doctor about what
sounds your child can hear with and without a hearing
aid, the effects of noise on your child's hearing, and
how to keep the hearing aids in the best working order.
Your child will also need to learn how to hear better;
for example, by ignoring noises in the environment and
paying attention to voices.
- Cochlear implants
The cochlea is the part of the ear that turns the
vibrations we call sound into electrical signals. The
brain then interprets the signals into meaningful sounds
such as speech. Some children with hearing loss may
benefit from an electronic device called a cochlear
implant (CI).
A CI has of three parts: a microphone, a microcomputer,
and a cochlear electrode. The microphone, worn behind
the ear, sends the sound to a microcomputer. The
microcomputer is connected to the microphone by a wire
and is worn in a pouch attached to the belt. It turns
the sound into an electrical code which is sent by radio
wave to the cochlear electrode. The wire electrode is
surgically implanted through the skull behind the ear
into the cochlea. The cochlear implant does not give the
child normal hearing. However, the child may be able to
interpret the signals produced by the implant after he or
she gets used to the signals and what they mean.
Your team of doctors and hearing specialists will help
you decide if an implant is right for your child. The
results of an implant may vary from child to child. Most
all children who get an implant have improved hearing and
oral language abilities. Therapy given after surgery may
also play an important role in how well your child's
hearing improves.
Ear tubes
A buildup of fluid in the middle ear could worsen your
child's hearing loss. Your child may need to have
ventilating tubes (ear tubes) to help drain fluid in the
middle ear. Any additional hearing loss may make a big
difference in what a child can hear. A child with ear
tubes can continue to use hearing aids.
- Therapies
Language training programs for hearing-impaired children
are offered as early as infancy. Parent-infant programs
help parents provide an environment rich in language for
their child.
Hearing-impaired children use a variety of ways to
communicate. You and your health care provider will need
to decide which way works best with your child. If your
child has some hearing left, it may be best to train your
child to make the most of his or her speech and hearing
abilities. For a more severe hearing loss, a child may
need to be trained to use speech, hearing, vision,
speech-reading, finger spelling, reading, writing, or
signing (American Sign Language) to communicate.
Think about and discuss the following questions to help
determine the best method of communication for your
child:
- How much hearing does your child have left?
- How does your family communicate with your child?
- Are you willing to attend sign language classes?
- What resources are available to you and your child?
- Education
Contact your local school district before your child
starts school. Children with hearing loss usually
require some special classroom changes. A team of
professionals will help evaluate your child and put
together an Individual Education Plan (IEP). Parents
have a right to help put together this plan. You may
also ask your health care provider to review the plan.
In some schools there are programs available for children
with hearing loss. Ask and find out all the services
that may be available for your child.
- Follow-up
Hearing-impaired children need regular hearing, ear, and
eye exams. Younger children need to be tested more
frequently than older children because their ear canals
are growing and changing shape. Because your child's
primary way of learning and communicating is through
sight, regular eye exams are important to make sure there
are no problems.
How can I help my child learn to communicate?
- Talk directly to your child. Always face your child and
bend down to his or her level before you begin to speak.
Use short, simple phrases and sentences. Don't use baby
talk. Speak clearly and not too fast.
- Use many facial and body expressions.
- Talk about things that are important to your child.
Provide materials, toys, and games that are interesting
to your child to stimulate conversation.
- Repeat words and phrases often. As part of your child's
daily routines--for example, getting dressed--emphasize
words like shirt, socks, and shoes. Add words to your
child's one- and two-word phrases. For example, when
your child says "blue train," say back to the child, "The
blue train is going fast."
- Encourage your child to join in your conversation.
Praise your child's efforts at making sounds. Respond to
the meaning your child is trying to communicate.
Encourage taking turns in conversation.
- Avoid having conversations in places where there is a lot
of noise, including sound from television, radio,
electrical appliances, and competing conversations.
When should I call my child's health care provider?
Call during office hours if:
- there is any sudden change in your child's response to
sound, especially from a cold
- you are concerned about your child's hearing.
Disclaimer: This content is reviewed periodically and is subject to
change as new health information becomes available. The
information provided is intended to be informative and educational and is not a
replacement for professional medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
HIA File CHL3727F.HTM Release 9.0/2006. Copyright © 2006 McKesson Corporation and/or one of its subdiaries. All Rights Reserved.
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