Pediatric hearing loss represents a problem that can lead to a long-term impact on a child’s development. It is estimated that between 2-6 babies have hearing loss for every 1000 babies born.
There are many causes of hearing loss. While some are congenital (present at birth), others are hereditary (genetic), acquired (develop after birth) or a combination of these. This blog introduces parents to the types of pediatric hearing loss, describes the different severity levels and highlights the importance of correcting hearing loss as soon as possible.
3 Types of Pediatric Hearing Loss
1. Conductive Hearing Loss
Conductive hearing loss is a physical problem with that blocks the conduction of sound waves from the environment to the inner ear.
A conductive problem may happen because of the following reasons:
- Outer ear problems (infection, tumor, injury, congenital malformation)
- Ear canal problems (wax, foreign body, infection, tumor, injury, congenital narrow ear canal)
- Eardrum problems ( a hole, scar tissue, swelling, infection)
- Middle ear space problems (middle ear infection or fluid, skin collection called cholesteatoma, tumor, a congenital problem, injury or disease of any of the three hearing bones)
This type of hearing loss may be present at birth, develop as a result of an ear injury or as a complication of chronic ear infections. Many types conductive hearing loss are treated with medications. If medications do not fix the problem, children may be referred to an Ear Nose and Throat (ENT) surgeon. Hey, that’s me!
When medications are not effective, some children benefit from the placement of ear tubes which drains trapped middle ear fluid.
There are a variety of surgical procedures to correct conductive hearing loss. If medications nor surgery are not effective at correcting the hearing loss, hearing aids are then used.
2. Sensorineural Hearing Loss
Sensorineural (Sense-SUR-ree-NUR-al) hearing loss occurs when the body has trouble with generating and/or transmitting of nerve impulses from the inner ear to the brain. Sound reaches the nerves in the inner ear but then has trouble reaching the brain.
A hearing nerve problem may happen because of the following reasons:
- Cochlea (Hearing organ) problems: (infection, injury, tumor, congenital)
- Hearing nerve problems: (Infection, injury, tumor, congenital)
- Hearing centers of the brain problems: (infection, injury, tumor, congenital)
This kind of pediatric hearing loss cannot be medically “cured” at this time. However, children with sensorineural hearing loss can benefit from hearing aids, FM systems, cochlear implants, and other communication therapies.
3. Mixed Hearing Loss
Although there are two main types of pediatric hearing loss, this third category is important to mention. A child with both hearing loss types is considered to have a mixed hearing loss. Children with mixed hearing loss often required treatment for each type separately to obtain maximum benefit.
What Are The Of Different Levels Pediatric Hearing loss?
Parents often believe “hearing loss” means that their child is deaf. Unfortunately, many people use the word “deaf” to mean anyone with hearing trouble. However, deaf should be reserved for children with very little or no functional hearing. Deaf people must use hearing devices or sign language to communicate.
Basically, pediatric hearing loss is diagnosed when a hearing test is performed and shows that a child is not responding to sounds in a normal range. That’s it. It does not tell you the severity, and there are wide ranges. Just as fever could mean a temperature of 101 degrees, it could also mean 104 degrees.
Mild Hearing Loss:
Children with mild hearing loss usually have normal speech but may have trouble in school. Trouble occurs because it is hard to hear teachers talking from more than 12 feet away.
These kids also have difficulty hearing when there is too much background noise.
Every hearing loss type can cause this level of hearing loss.
Some children with mild hearing loss are not diagnosed until first grade. They may be evaluated for learning problems because they cannot understand when the teacher speaks from a distance; consequently, they do not consistently respond.
Moderate Hearing Loss:
Children with moderate hearing loss show classic signs of hearing loss. They hear speech only when standing close to the speaker – less than two feet away. Parents often report that their kids seem to read lips.
In my office, I notice kids children staring at my mouth then swivel their heads to look at parents. Many people assume this constant head turning is a sign of being very attentive.
Every hearing loss type causes this level of hearing loss.
Moderate hearing loss children have delayed speech with poor articulation. These children need treatment with surgery or hearing aids as soon as possible.
If hearing is corrected early, kids often rapidly improve with speech development. They can go to regular schools but may need special help with speech.
Severe Hearing Loss:
Children with a severe hearing loss do not understand speech, no matter how close they stand to the speaker. Speech problems are immediately seen in these patients.
Conductive hearing loss alone cannot cause this level of hearing loss. All children with severe hearing loss have some degree of sensorineural hearing loss.
Severely hearing impaired children must be fitted with hearing aids very early in order to develop useful speech. Children fitted with hearing aids after age three are less likely to have clearly understandable speech. Many kids who do not get hearing aids until after first grade never develop clear speech or the ability to easily understand the speech of others.
Every child with severe hearing loss requires special help. With hearing aids, they can learn vowel sounds, pitch, and some consonants. With lip-reading, they can learn to detect about 25 percent of the consonant sounds. These children benefit from long-term services to develop and understand speech and language.
Profound Hearing Loss:
Children with a profound hearing loss can hear minimal sounds; consequently, they heavily depend on their vision to understand speech. These children are often fitted with hearing aids within a few months of life and frequently undergo surgery to place a cochlear implant. Profoundly hearing impaired children benefit from aggressive speech and communication services.
How Does Hearing Loss Affect Kids?
Young kids show significant harm to the social development. Hearing impaired kids have delayed speech development; consequently, they have trouble communicating with others. Behavior problems and extreme frustration result for a large number of children.
Speech development depends on both the severity and type of hearing loss. However, speech is also influenced by the age of diagnosis, the speed of treatment, the success of treatment, and help provided by parents and teachers.
Researchers proved that babies who had hearing loss diagnosed and treated before six months of age develop speech better than babies treated later. A universal hearing screen states that newborns must have a hearing screening test before leaving the hospital.
Babies clearly develop speech more slowly when they have hearing loss, but they are also at risk of developing learning problems. Newborn brains build nerve pathways that are needed to understand sounds. If these pathways do not form correctly, children may hear normally later in life but have a hard time understanding what they hear.
Many parents are concerned that common ear infections lead to these types of ear infections. Although ear infection complications may lead to long-term hearing loss, typical childhood ear infections do not. Parents should take all precautions to reduce ear infections to avoid any additional risk.
When children with hearing loss are identified at an early age, fit with hearing aids that they use consistently, and are trained to use their remaining hearing for understanding speech, they can acquire age-appropriate speech and language skills which allow them to function well in the hearing world.
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Disappointed that this focuses on speech rather than language. Language is the biggie, not speech per se. If kids are behind in language development by age 5 they will probably always be Persistent Language Delayed (PLD).
Thank you for taking the time to read my post. I agree that all medical topics have many areas that they can focus on. My intent with this post was to introduce the concept of different types of hearing loss and some of the immediate things that result. Your point is well taken and other posts address this complication.