Hearing health is critical to child development. Timely identification and intervention of hearing loss can impact a child’s developmental skills.. Hearing loss in children can lead to delayed speech and language skills, learning problems in school, and negative self-image. Pediatric audiologists are audiologists for kids. They are hearing and balance specialists who diagnose and treat childhood hearing loss. Pediatric audiologists are educated in pediatric hearing evaluation and pediatric hearing treatment.
What If My Child Has Hearing Loss?
Over 1,000,000 children in the US have some degree of hearing loss. Child hearing loss may be temporary due to wax impaction or ear infections, which block or limit sound from reaching the inner ear. Permanent hearing loss does not have a single cause. Common causes of permanent child hearing loss are congenital conditions or genetic mutation, craniofacial abnormalities, head trauma, medications that affect the auditory system (ototoxic), or traumatic birth experiences. In older children, noise exposure from personal listening devices (AirPods) can also contribute to permanent hearing loss.
Early treatment and intervention are essential for setting your child up to have the best outcomes possible. Without early intervention and auditory input, children may have delayed speech and language skills and have educational difficulties.
Discovering your child may have hearing loss can feel overwhelming. 90% of children born deaf or hard-of-hearing are born to hearing parents. You are not alone.
Signs of Hearing Loss in Children
Signs of hearing loss in toddlers and children can differ across ages.
- Newborns with exposure to in-utero or birth infections such as cytomegalovirus, who spent time in NICU, or are diagnosed with a syndrome associated with hearing loss.
- Infants over 6 months old who do not seek out where sound is coming from or react to loud sounds.
- Toddlers, if their babbles are not becoming simple words or do not react to their name.
- Preschoolers who have delayed speech and language, or are unable to follow simple instructions.
- School-aged children who are easily frustrated, appear distracted, or have educational delays.
Children with hearing loss may have delayed speech or language development, behavior changes, or inattentiveness. Their speech may sound unclear and be difficult to understand by those outside their immediate family. A child with hearing loss may seem unaware of their own voice, speak too loudly or softly, mumble, sound off-pitch, respond inappropriately to questions, ask for repetition, not follow directions, or appear to ignore others.
“When talking about global speech concerns from hearing loss, I tend to really talk about “unclear speech” vs specific speech sounds being missed because there is such a difference in acceptable development of speech sounds. This is a tool I refer back to quite often with families! Once we know if there is a hearing loss and configuration of the hearing loss then we go into details about how that impacts those speech sound acquisitions and auditory access.”
— Dr. Ashlee Vandiver
Newborn Hearing Screening
Newborn hearing screenings are objective screenings completed before a newborn is discharged from the hospital. The goal of the screening is to gain information about an infant’s auditory function. They are non-invasive and completed while your baby is sleeping; the nurse technician places earphones over their ears that play sounds to initiate the automatic response.
If your child fails a newborn hearing screening, it does not automatically indicate your child is deaf. However, it is very important to have a second hearing screening as soon as possible and no later than one month old.
If your infant fails the second screening, you should schedule a diagnostic assessment with a pediatric audiologist by 3 months old. If your child is diagnosed with hearing loss, they should be fit with amplification by 6 months old.
What Does a Pediatric Audiologist Do?
Pediatric audiologists complete advanced training working with pediatric patients. These professionals are educated on child development and techniques to complete testing on children.
Administering age-appropriate tests requires an extensive understanding of child development and is a critical part of pediatric testing. Pediatric audiologists also counsel and connect families with other professionals, such as ENT or speech-language pathology, and, if identified, give recommendations and provide care for hearing aids or cochlear implants. A pediatric audiologist is also an integral part of the education team for children with hearing loss.
Evaluation and Treatment Options
There are multiple hearing tests for children that evaluate each part of the ear.
- Tympanometry uses pressure changes in the ear canal to give us information about the middle ear and tympanic membrane (eardrum).
- OAE (otoacoustic emissions) measures how well the sensory outer hair cells in the cochlea respond to noise.
- ABR (auditory brainstem response) measures the response of the auditory nerve and brainstem to sound. Sticker electrodes are placed by the ears and on the forehead, and earphones are used to play sounds.
- Behavioral Observation Audiometry (BOA) and Visual Reinforcement Audiometry (VRA) are used for infants and toddlers to observe their responses to sounds presented to each ear or through speakers.
- Conditioned Play Audiometry (CPA) is when a patient is taught to play a game, such as stacking a block, after hearing a sound or “beep”.
If hearing loss is identified, communication and treatment options will be discussed. Hearing aids, cochlear or bone-anchored implants, early intervention services, at-home listening activities, and referral to an ear, nose, and throat doctor or speech pathologist may be recommended. Treatment options are not one size fits all. Together with your audiologist, you will create a plan that is unique to your child.
When To See a Pediatric Audiologist?
Schedule an appointment after a failed screening or doctor referral, if you have concerns about speech/language delay, frequent ear infections, behaviors mentioned above, or parental intuition. If you feel something is “off” or has changed regarding your child’s behavior, request a referral to a pediatric audiologist.
Hearing Loss in Children: Early Diagnosis Matters
Early diagnosis and treatment are key. Pediatric audiologists are essential partners in children’s hearing care, development, and education. If you have any concerns about your child’s hearing, seek out a professional opinion from a pediatric audiologist.