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Understanding Hearing Loss in Children

Causes – Screenings – Signs

Causes of Hearing Loss in Children

Many things can cause hearing loss in a child. Hearing loss at birth is called congenital hearing loss. Hearing loss that happens after birth is called acquired hearing loss.

Congenital hearing loss can be caused by genetic factors, but it also can be caused by other things, like an infection during pregnancy, prematurity, injury at birth, and other health conditions.

Acquired hearing loss can result from many things, including frequent ear infections, viral and bacterial infections like meningitis or the measles, a head injury, and exposure to very loud noises.

Hearing Screening for Newborns & Children

Today, the vast majority of newborns receive a hearing screening before discharge from the hospital.

The two types of objective test technologies used to screen for hearing loss in newborns are otoacoustic emissions, and auditory brainstem response (sometimes called ABR test or BAER test).

While these screening tests can detect 80 to 90 percent of infants with moderate degrees of hearing loss and greater, it is important to understand that no screening test is perfect.

Children with mild hearing loss may pass newborn hearing screenings, and hearing screenings for newborns cannot identify children with late onset or progressive types of hearing loss.

It is especially important, therefore, that you monitor your child’s developmental milestones for hearing, language, and speech—even if your newborn passed a hearing screening test in the hospital.

If your child was born with visual, cognitive, or motor disabilities, a comprehensive audiological evaluation would be important to ensure that your child's hearing is completely normal.

If your child shows no indication of hearing loss, it is still important to see that they receive a hearing screening as they grow. According to the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP) recommends that school-aged children receive hearing screenings:

  • When they start going to school
  • At least once at ages 6, 8, and 10
  • At least once during middle school
  • At least once during high school

For children with other known health or learning needs; speech, language, or developmental delays; or a family history of early hearing loss, hearing screening might be required more often.

Watching for Signs of Hearing Loss

Although the vast majority of newborns in the United States receive a hearing screening before discharge from the hospital, hearing loss can occur at any time, and it may not be evident immediately. Severe or profound hearing loss may be obvious because the child may not respond to sound. But noticing milder forms of hearing loss—including hearing loss in only one ear—can be more difficult. That is why regular hearing evaluations as children grow and mature is so important.

Because children learn to speak by listening, children with unidentified hearing loss often have trouble learning to speak, and they experience delays in their language and speech development. For this reason, it is important to pay careful attention to causes of hearing loss in children, and how quickly and well your child is learning to speak and understand language when compared to other children of the same age. If something doesn’t seem right, ask your doctor. What causes hearing loss in children is not always immediately evident.

Signs of hearing loss to watch for in a child include:

  • Concern by a family member or teacher that a child is not quick to hear things
  • Delays in the development of a child’s ability to speak and use language as compared to others of the same age; this difference in speaking and language ability may be noticed at home, at school, or in the childcare setting
  • Difficulty with paying attention and behaving
  • Difficulty with academic performance
  • Inappropriate, delayed, or lack of response to soft and moderate-level sounds or spoken language when distractions are minimal
  • Frequent use of "what?" or "huh?"
  • Intently watching the faces of speakers
  • Difficulty understanding speech when there is background noise
  • Sitting close to the TV when the volume is loud enough for others; increasing the volume on the TV or other audio electronics to unreasonably loud levels
  • Not responding to voices over the telephone or continually switching ears when on the phone
  • Not “jumping” or becoming startled by sudden, loud noises
  • Unable to accurately figure out where a sound is coming from

For “A Guide to Your Child’s Hearing,” click here.

For additional resources, click here.

For additional information, see Hearingpedia.