Hearing Loss In Children: Types, Causes, Signs & Treatment

Hearing loss in children can affect communications skills and academic performance. Approximately 1.9% of children have hearing problems, and one in every 1000 children is diagnosed with permanent hearing loss. Around 32 million children live with hearing loss worldwide. According to the World Health Organization (WHO), 60% of childhood hearing loss is preventable with early detection and treatment (1) (2).

Read on to learn about the types, statistics, causes, signs, prevention, and management of hearing loss in children.

Signs Of Hearing Loss In Children

Contact your pediatrician if you notice these signs in your child (2)(3)(4):

• At one month of age, they are not startled by loud noises.
• At three to four months of age, they do not turn to the source of a sound.
• They do not acknowledge your presence until they can see you in view.
• They gargle or make vibrating noises instead of trying consonant or vowel sounds during infancy.
• At 12 to 15 months, they do not utter words such as “mama” or “dada.”
• At 18 months, they cannot say five to ten words.
• At two years, they cannot combine two or three words into a sentence.
• By two and half years of age, their speech is delayed or hard to understand half of the time.
• They can hear only some sounds.
• They may talk well at home but have trouble listening in a noisy classroom, indicating partial hearing
• Older children often say, “huh?” and cannot understand what others are saying to them.

Types Of Hearing Loss In Children

The following are the types of hearing loss in children (3):

Conductive hearing loss: Sound does not pass through the outer and middle ear in conductive hearing loss. Soft sounds may be difficult to hear, while louder sounds may be dull (5).

Sensorineural hearing loss: Happens due to damage to the inner ear or the nerves between the brain and the inner ear (6). It can be congenital (present at birth) or genetically acquired even without a family history of deafness, as the parents could carry a hearing-loss gene without knowing it.

Causes And Risk Factors Of Hearing Loss In Children

Whether congenital or acquired, hearing loss in children could occur due to one or more of the following causes. However, it may not be possible to determine its exact cause.

The following are the causes and risk factors of hearing loss in children (1)(3)(4).

1. Genetic factors

• They contribute to around 40% of all childhood hearing loss
• One in three children with genetic hearing loss may also have other syndromes, such as Down syndrome or Usher syndrome.
• Common in children born to genetically related parents
• Congenital malformations of the ear and auditory nerve may be a result of environmental or genetic factors.

2. Birth conditions

• Premature birth
• Low birth weight
• Oxygen insufficiency at the time of birth (birth asphyxia)
• Neonatal jaundice
• Underwent blood transfusion for jaundice
• Maternal diabetes
• Outer, middle, or inner ear malformation

3. Infections

• Intrauterine infections such as rubella, herpes simplex virus, toxoplasmosis, or cytomegalovirus
• Meningitis (bacterial or viral)
• Measles
• Mumps
• Encephalitis
• Chickenpox
• Influenza
• Head injury
• Temporary mild hearing loss due to fluid build-up in the middle ear from colds, congestion, and other ear infections

4. Ear diseases

• Excessive ear wax (impacted cerumen)
• Non-suppurative otitis media (glue ear)
• Problems with the eustachian tube.
• Swimmer’s ear

5. Noise

• Prolonged exposure to loud music from electronic devices
• High-intensity sounds from fireworks
• Noisy machines in neonatal intensive care units

6. Medicines

• Ototoxic medications are sometimes used to treat neonatal infections, malaria, drug-resistant tuberculosis, and cancers

Tips For Parents Of Children With Hearing Loss

A diagnosis of hearing loss in children can be overwhelming for parents. However, the following tips can help you and your child come to terms with the situation (7).

• Accept your child as they are.
• Your acceptance will help develop their self-confidence
• Teach your child a fun and informative answer for their friends’ questions on hearing loss and assistive devices.
• Inform the child’s siblings about their hearing loss in a straightforward manner, answering their questions simply and truthfully.
• Enroll in sign language classes as a family, and include the child in all of the family’s conversations. Without a common mode of communication, they may feel lost.
• Meet the child’s teachers often to identify gaps and ensure they develop appropriately for their age, both socially and academically.
• Through your child’s audiologist, connect with a speech pathologist and education consultant for the necessary educational material to help your child succeed.
• Check with your child if they are experiencing any bullying at school, and address any concerns with the school authorities.

Treatment For Hearing Loss In Children

The treatment for hearing loss is based on the underlying cause. Following treatment options are provided for children with hearing loss (3).

• Ventilating tubes: Antihistamines, decongestants, and antibiotics are ineffective for mild conductive hearing problems due to middle ear fluid accumulation. Hence, the doctor may check if the fluid has cleared by itself after three months. Doctors may recommend fluid drainage through ventilating tubes, which are surgically inserted into the eardrums. It is a minor procedure that takes around 15 minutes and is done under general anesthesia.

• Hearing aids: For hearing loss due to outer or middle ear abnormalities, hearing aids could be used. However, since these are wearable devices, parents should pay attention that they are functioning well and worn properly, especially for younger children.

• Cochlear implants: If the child is unable to hear using hearing aids, they may need cochlear implants. Cochlear implants could give the best results when introduced early in life (ideally before one year) as it helps develop speech and hearing.

In addition to using hearing aids and implants, learning sign language is recommended. Sign language can help you teach, comfort, communicate, laugh, and develop a bond with your children. Families and immediate family members of children learning sign language should also learn it.

Prevention Of Hearing Loss In Children

Follow these tips to prevent hearing loss in children (4):

• Follow your doctor’s advice for a healthy pregnancy and get all the recommended prenatal care.
• Ensure timely childhood vaccinations.
• Keep your child away from loud toys or other sources of loud noises.
• Set your TV or video games on low volume.
• Shut the doors and windows of your house if you live in a noisy location.
• Encourage the child to use earmuffs or earplugs when exposed to potentially harmful sounds.

Hearing loss can be temporary or permanent. However, most children with hearing loss do well in life and are on par with their peers. Discuss your concerns with your doctor and follow the management guidelines. You can also connect with local or online support groups to get in touch with families who have experienced this situation.

References

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