June 5, 2019

Is my child's hearing OK?

Most of us don't have to think twice about our hearing, but what about the possibility that our kids might be experiencing some hearing loss?

Fortunately, nearly every baby born in a hospital in the United States is screened for proper hearing. In Wisconsin, 99 percent of babies are screened, according to the Wisconsin Sound Beginnings program. So thankfully, most parents know if their newborn requires further hearing testing and possible treatment.

Some infants, however, might not show signs of hearing loss until they get a little older — even if they pass their newborn screening at birth. 

"The ability to hear well is essential for proper childhood development," said UW Health clinical audiologist Jennifer Ploch. "Untreated hearing loss may lead to delays in language development and social skills. Children with hearing loss may also experience challenges or difficulties learning at school. That is why we are very proactive with families when it comes to seeking treatment for their baby."

Early intervention guideline

The American Academy of Pediatrics' Early Hearing Detection and Intervention Goal uses a "1-3-6" guideline to assess hearing in newborns.

All babies should have their hearing screened by 1 month of age, hearing loss diagnosed by 3 months and early intervention (including the use of hearing devices) by 6 months. The sooner these measures take place, the better.   

If your baby is not engaging normally — turning his or her head toward familiar sounds, listening and reacting to familiar songs or rhymes, or babbling — Ploch said it might be worth making a checklist to bring to your pediatrician's or family practitioner's attention.

In general, there are four categories of signs to watch:

  • Speech and language development

  • Difficulty hearing with background noise

    • Do you notice a big change in your child's ability to hear if there is a television, dishwasher or car radio on in the background? Does your child struggle more at a restaurant or social gathering, when many people are talking?

    • Does your child turn the TV volume up very high or sit very close to the TV?

  • Difficulty hearing from a distance

    • Does your child's hearing seem to be notably worse if she or he is in the next room?

    • Do you often hear your older child say "what?" or "huh?" several times a day?

  • Struggles in school

    • Do you notice changes in your child's ability to keep up in school? Children who can't hear as well are less likely to pay attention in class, which can lead to inattentive or disruptive behavior.

    • Is your child having more trouble socially? Are friends or classmates turning away because your child is not hearing the conversation?

How hearing loss is treated

Children with a diagnosed hearing loss don't have to suffer needlessly. Sometimes hearing loss can be temporary, especially for children who have repeated ear infections.

For kids with a permanent hearing loss, however, treatment can run the gamut from speech and language therapy to wearing a hearing aid or receiving a cochlear implant.

"If a child has a permanent hearing loss significant enough to affect their speech and language development, we often recommend use of a hearing aid," Ploch said.

Younger kids often don't mind wearing a hearing aid, especially if they get to choose one in their favorite color.

By middle school, children typically want their hearing aid as small and inconspicuous as possible. "We understand that many middle- and high-school kids don't want to feel or look different, so we work with them to make the experience as easy as possible," Ploch said.

What's more obvious - your hearing aid or your hearing loss?

Sometimes, a child will simply refuse to wear their hearing aid because they don't want it to be visible. In these cases, "I often ask the child, 'What do you think is more obvious — your hearing aid or your hearing loss?' " Ploch said.

Thinking about it in these terms sometimes helps middle schoolers or older teens appreciate the social costs of not wearing their hearing aid.

"If you are missing out on the conversation or withdrawing from interaction because you can't hear well, your friends may feel ignored, which can lead to more peer stress," Ploch said.

Cochlear implants

In those cases when hearing aids still do not provide enough improvement, cochlear implants are considered.

"Unlike a hearing aid, which makes sounds louder, a cochlear implant is a surgically implanted device that sends impulses past the damaged portion of the inner ear directly to the auditory nerve, carrying sound signals to the brain," Ploch said. "Patients wearing implants do not quite hear normally, but with time and practice, these individuals often make considerable gains in understanding speech."

When in doubt, check it out

Parents who might be questioning their child's ability to hear normally are advised above all to do one thing: Have it checked out.

"Nobody knows your child as well as you do," Ploch said. "If your gut is saying that your infant, toddler or school-age child might be suffering from a hearing loss, talk with your pediatrician or family physician about it. The earlier hearing loss is addressed, the better your child's quality of life will be."