Hearing Loss in Children

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For years, routine hearing tests took place only when children entered school. However, hearing loss can cause serious problems much earlier. The most significant is the delayed development of language and speech.

Early intervention and detection of hearing loss is important to prevent problems with speech and language development. We offer a team approach when a child is diagnosed with hearing loss. Our ENT specialists work closely with audiologists and speech pathologists to evaluate and manage hearing, speech, language and balance problems in your child.

young girl holding hearing aid

Hearing Tests

There are many types of hearing tests that can be used to check your child’s hearing. Some of them may be used on all ages, while others are used based on your child’s age and level of understanding.

For Newborns

We recommend hearing tests before newborns leave the hospital. There are two primary types of hearing screening methods for newborns that may be used alone or together.

  • Evoked otoacoustic emissions (EOAE) is a test that uses a tiny, flexible plug that is inserted into the baby’s ear. Sounds are sent through the plug. A microphone in the plug records the otoacoustic emissions (responses) of the ear in reaction to the sounds. There are no emissions in a baby with hearing loss. This test is painless and is usually completed within a few minutes, while the baby sleeps.
  • Auditory brainstem response (ABR) is a test that uses electrodes (wires) attached with adhesive to the baby’s scalp. While the baby sleeps, clicking sounds are made through tiny earphones in the baby’s ears. The test measures the brain’s activity in response to the sounds. As in EOAE, this test is painless and takes only a few minutes.

If the screening tests identify that your child has a hearing loss, further testing is needed. It is recommended that all babies with hearing loss be identified by 3 months of age so that treatment can begin before the baby is 6 months old (an important time for speech and language development).

For Infants

Evaluation of hearing in the infant may include the use of the above mentioned EOAE and ABR tests. Also, the following may be used:

  • Behavioral audiometry is a screening test used in infants to observe their behavior in response to certain sounds. Additional testing may be necessary.

For Toddlers

Evaluation of hearing may include the above mentioned tests, along with the following:

  • Play audiometry is a test that uses an electrical machine to transmit sounds at different volumes and pitches into your child’s ears. Your child usually wears some type of earphones. This test is modified slightly in the toddler age group and made into a game. The toddler is asked to do something with a toy (i.e., touch a toy, move a toy) every time the sound is heard. This test relies on the cooperation of the child.
  • Visual reinforcement audiometry (VRA) is a test where the child is trained to look toward a sound source. When the child gives a correct response, the child is “rewarded” through a visual reinforcement such as a toy that moves or a flashing light. The test is most often used for children between 6 months to 2 years of age.

Older Children

Evaluation of hearing for the child older than 3 to 4 years may include the above mentioned tests, along with the following:

  • Pure tone audiometry is a test that uses an electrical machine that produces sounds at different volumes and pitches in your child’s ears. The child usually wears some type of earphones. In this age group, the child is simply asked to respond in some way when the tone is heard in the earphone.
  • Tympanometry (also called impedance audiometry) is a test that can be performed in most physician offices to help determine how the middle ear is functioning. It does not tell if the child is able to hear, but helps to detect any changes in pressure in the middle ear. This is a difficult test to perform in younger children because the child needs to sit very still and not be crying, talking, or moving.

Treatment Options

Technology to help hearing-impaired children is evolving rapidly. Children generally benefit from some sort of amplification, ranging from digital hearing aids to cochlear implants. Training in sign language and lip-reading may also be recommended.

 

American Health Journal: Hearing Loss in Children

In this segment of American Health Journal, Dr. Nguyen Pham, talks about hearing loss in children, which is the most common birth defect.

Frequently Asked Questions about Hearing Aids

Hearing aids can help improve hearing and speech, especially in children with sensorineural hearing loss (hearing loss in the inner ear due to damaged hair cells or a damaged hearing nerve). Sensorineural hearing loss can be caused by noise, injury, infection, certain medications, birth defects, tumors and problems with blood circulation. Hearing aids are electronic or battery-operated devices that can amplify and change sound. A microphone receives the sound and converts it into sound waves. The sound waves are then converted into electrical signals.

The type of hearing aid recommended for your child will depend on several factors, including his or her physical limitations, medical condition and personal preference. There are many different types of hearing aids on the market, with companies continuously inventing newer, improved hearing aids. However, there are four basic types of hearing aids available today. Consult your child’s doctor or audiologist for additional information on each of the following types:

In-the-ear (ITE) hearing aids: These hearing aids come in plastic cases that fit in the outer ear. Generally used for mild to severe hearing loss, ITE hearing aids can accommodate other technical hearing devices, such as the telecoil, a mechanism used to improve sound during telephone calls. However, their small size can make it difficult to make adjustments. In addition, ITE hearing aids can be damaged by ear wax and drainage.

Behind-the-ear (BTE) hearing aids: As the name implies, these are worn behind the ear. This type of hearing aid, which is in a case, connects to a plastic earmold inside the outer ear. These hearing aids are generally used for mild to severe hearing loss. However, poorly fitted BTE hearing aids can cause feedback, an annoying “whistling” sound, in the ear.

Canal aids: These aids fit directly in the ear canal and come in two styles: in-the-canal (ITC) aid and completely-in-canal (CIC) aid. Customized to fit the size and shape of the individual’s ear canal, canal aids are generally used for mild to moderate hearing loss. However, because of their small size, removal and adjustment may be more difficult. In addition, canal aids can be damaged by ear wax and drainage.

Body aids: Generally reserved for profound hearing loss, or if the other types of hearing aids will not accommodate, body aids are attached to a belt or pocket and connected to the ear with a wire.
Nearly all children who have a hearing loss that may be improved with hearing aids can benefit from these devices. The type of hearing aid recommended may depend on several factors, including, but not limited to, the following:

• The shape of the outer ear (deformed ears may not accommodate behind-the-ear hearing aids)
• Depth of depression near the ear canal (too shallow ears may not accommodate in-the-ear hearing aids)
• The type and severity of hearing loss
• The manual dexterity of the child to remove and insert hearing aids
• The amount of wax build-up in the ear (excessive amounts of wax or moisture may prevent use of in-the-ear hearing aids)
• Ears that require drainage may not be able to use certain hearing aid models
Once the hearing aids have been fitted for the ears, your child should begin to gradually wear the hearing aid. Because hearing aids do not restore normal hearing, it may take time to get used to the different sounds transmitted by the device. Follow these tips to help your child adjust to hearing aids:

• Be patient and give your child time to get used to the hearing aid and the sound it produces.
• Start in quiet surroundings and gradually build up to noisier environments.
• Experiment where and when the hearing aid works best for your child.
• Keep a record of any questions and concerns you have, and bring those to your child’s follow-up examination.
Hearing aids need to be kept dry. Methods for cleaning hearing aids vary depending on the style and shape. Other tips for taking care of hearing aids include:

• Keep the hearing aids away from heat.
• Batteries should be replaced on a regular basis.
• Avoid the use of hairspray and other hair products when the hearing aid is in place.

Long Live Childhood

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