Could Your Child Have Hearing Loss? And if So, Now What?

As parents and caregivers, we sometimes joke about “selective hearing” in our kids. But what do you do if you suspect they really might not be hearing you?

“If left untreated, hearing loss can seriously impact their speech, language development, education and overall cognitive skills,” says pediatric otolaryngologist Samantha Anne, MD, “so, it’s important to let your doctor know if you suspect any difficulty with your child’s hearing.”

Dr. Anne offers insight into what might cause your child’s hearing loss and options for treatment.

What causes hearing loss in children?

As with any health issue, there’s a lot of nuance around hearing loss, which means a lot of possibilities when it comes to types, causes and treatments. Everyone is different … and everyone’s ears, are too!

Issues of hearing loss in kids can be:

• Temporary or permanent
• In one ear (unilateral) or both ears (bilateral)
• Present at birth (congenital) or acquired in childhood

Let’s take a look at some of the most common causes.

Causes of temporary hearing loss

Temporary hearing loss typically resolves within a few months. Possible causes include:

• Earwax blockage. Sometimes, the culprit of your child’s hearing issue is a buildup of earwax. About 10% of children deal with impacted earwax, which is typically easy to treat — though, you should never try to remove your child’s earwax on your own.
• Ear infection. A cold or virus can cause an ear infection or an accumulation of fluid in the middle ear. This can temporarily muffle your child’s hearing. “Congestion and fluid in the ear from the infection limits movement of the eardrum,” Dr. Anne explains, “but when the infection and the fluid clear, the hearing returns.” Middle ear infections are the second most common childhood illness.
• Trauma. If your child hits their head, blood can flow into the middle ear and cause temporary hearing loss.
• Noise exposure. Noises louder than 85 decibels (most portable music players reach higher than 100 decibels) can damage the tiny hair cells in the ear. Short-term exposure causes temporary hearing loss (for example, on the day after a concert).

Causes of permanent hearing loss

Several issues can cause permanent hearing loss:

• Genetic conditions. Certain syndromes and inherited gene disorders, including osteogenesis imperfecta and trisomy 13, cause hearing loss in children.
• Premature birth. Babies who are born early and spend time in the neonatal intensive care unit (NICU) may have risk factors for hearing loss, including low birth weight and treatment with antibiotics and a ventilator.
• Ear malformations. Babies can be born with ear deformities or narrow or obstructed ear canals that can affect their hearing.
• Noise exposure. We already discussed how short-term noise exposure can cause temporary hearing loss, but long-term exposure can permanently damage the hair cells in the ear.
• Trauma. If an injury causes nerve damage or fractures the temporal bone where the inner ear sits, this can cause hearing loss. Doctors can’t always repair hearing loss caused by trauma.
• Illnesses. Encephalitis (inflammation of the brain) and meningitis can cause lasting hearing loss in children.

Signs of hearing loss in kids

Does any of this sound familiar? Your child:

• Doesn’t realize you’re in the room until they see you
• Seems like they’re ignoring you when you speak to them
• Has limited speech skills or often mispronounces words
• Has trouble understanding or following instructions
• Constantly asks you to repeat things (or says, “What?” or “Huh?” a lot)
• Has been moved to the front of the class for “not paying attention”
• Watches TV or listens to music at very loud volumes
• Becomes frustrated in situations with a lot of background noise

These signs could all point to the same issue — hearing loss. And while you might think your child is too young to be treated for hearing loss. But when it comes to hearing, there’s no such thing as “too young.”

About 1 to 2 in 1,000 babies are born with some type of hearing loss. But studies have found that when kids are diagnosed with hearing loss at birth and begin receiving intervention and support as early as 3 to 6 months old, they often develop language skills that are equal to those of their hearing peers.

How hearing loss is diagnosed in kids

In the U.S., newborn babies are given a hearing screening right after birth to confirm they can hear. Your child will also likely have hearing screenings done at preschool and/or elementary school and during well-checks with their pediatrician.

But if you suspect your child has hearing problems, you can ask their pediatrician for a hearing screening at any time. In fact, Dr. Anne says that it’s important to investigate as soon as you start to have concerns.

“The earlier we can improve a child’s hearing, the better they do and the faster they catch up to their peers, in terms of speech and language development,” she points out. “Finding out about hearing loss early and understanding what might be causing it can help us give you a better idea of what to expect and how to best provide support to your family.”

Your child’s pediatrician can refer you to specialists to start the evaluation process and have them tested to figure out the cause of their hearing issues. This will likely include an audiologist, a healthcare provider who specializes in diagnosing and treating hearing disorders, and an otolaryngologist (ENT), who specializes in conditions that affect the head and neck.

Types of hearing tests

Hearing tests for kids may include:

• Pure-tone testing to find the quietest volume they can hear at each pitch
• Bone conduction testing to show whether there are issues with the tiny hair cells in their cochlea — the small, snail-shaped organ in their inner ear
• Speech testing to figure out how they understand speech
• Auditory brainstem response (ABR), a test that checks the connections between your child’s inner ear and their brain
• Otoacoustic emissions (OAE), which checks on inner ear function
• Tympanometry, a test that checks how well the eardrum moves

“If you’re concerned about hearing loss in your child, have them evaluated ASAP,” Dr. Anne reiterates. “There should be no reason that hearing should be the cause of a child not reaching their potential.”

Hearing loss treatment for kids

If your child is diagnosed with hearing loss, what comes next? “Knowing about the different treatment options can help us choose the best approach to manage your care and get the best possible results,” Dr. Anne says.

Here are a few options for treating hearing loss in kids:

• Hearing aids. These small, wearable devices make sounds louder. “Hearing aids have consistently been shown to help children with hearing loss in terms of speech and language outcomes,” Dr. Anne confirms. “Educational performance and behavioral issues have been shown to improve in kids who use hearing aids.”
• Cochlear implants. This electronic device is placed under your child’s skin through surgery. They’ll then wear a processor over their ear, which directs sound signals to the implant. “It has an electrode that stimulates the hearing nerve directly,” Dr. Anne explains.
• Bone-anchored hearing aid (BAHA). These surgically implanted devices use vibrations through the bones in your child’s skull to send sounds to their inner ear. They may partially restore hearing for people with certain types of hearing loss.
• Frequency modulation (FM) systems. These devices can help kids with hearing loss better navigate the world around them. The person who’s speaking to your child (like a parent or teacher) wears a small microphone, while your child wears a receiver. The FM uses radio waves to pipe speech from the microphone directly to the receiver.
• Hearing habilitation. This therapy helps your child adjust to hearing loss and learn to use visual cues and read lips, which can make it easier for them to communicate.

Bottom line? If you think your child may have a hearing problem, make an appointment with your pediatrician. Again, it’s always better to find out sooner rather than later.

“Hearing loss is something we can easily address to improve your child’s quality of life and help them meet their developmental milestones,” Dr. Anne reassures. “We’ll do everything we can to get your child where they need to be and not let hearing loss hold them back.”