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How can I tell whether my child has good hearing?
The only way to tell for sure is to have her hearing tested. When your child was born, she probably had a newborn hearing screening before leaving the hospital. Since then, her doctor should have checked her hearing at well-child checkups.
Some preschools provide hearing and vision screenings for the children attending their facilities. And most states require that public schools provide routine hearing and vision screenings for their students. Check with your child's preschool or school to see if and when these are offered.
Parents and caregivers are often the first to notice when something is wrong with a child's hearing, though – so between screenings you'll want to be aware of possible warning signs of a hearing problem, such as your child not answering simple questions correctly or not following directions.
See all the signs of a hearing problem in a child. If you notice any of these signs, or have a sense that something is amiss, talk with your child's doctor.
What may seem like a hearing problem may have other causes – a toddler who hasn't begun talking yet may just be a little behind the average and soon to catch up. And a child who doesn't respond when you talk to her may simply be preoccupied or tired.
But if your child does have a hearing problem, the sooner she's diagnosed and gets individualized language training or a hearing aid, the more likely she'll be to meet developmental speech and language milestones, says David H. Darrow, professor of otolaryngology and pediatrics at Eastern Virginia Medical School in Norfolk.
What will the doctor do?
Your child's doctor may administer a hearing test and then refer you to an audiologist (hearing expert) if your child doesn't do well on the test. He may also refer you to an audiologist or another specialist – such as an ear, nose, and throat doctor – if your child speaks at a below-average level, if she's not meeting normal developmental milestones, or if she has persistent fluid behind the eardrum.
The audiologist will tailor another hearing test – using subjective and objective methods – to your child's age and developmental level.
What causes hearing problems?
There are two types of hearing loss – congenital (meaning the child was born with it) and acquired (meaning hearing was lost sometime after birth). About 2 to 3 in every 1,000 healthy babies in the United States are born with significant hearing impairment. (Those who need to be admitted to the neonatal intensive care unit are more likely to have hearing problems.)
Sometimes hearing impairment is inherited – even if both parents have normal hearing. Other times a baby's hearing is damaged because her mother had a viral infection during pregnancy, such as German measles (rubella), toxoplasmosis, or herpes. Some children are born with impaired hearing because of low birth weight or premature birth, or abnormal inner ear development. In some cases, there's no explanation.
After birth, a child may suffer hearing loss when the nerves in the inner ear are damaged by an injury, a tumor, or an infection, such as chicken pox, the flu, meningitis, or mononucleosis. Medications such as chemotherapy agents, salicylates, loop diuretics, and certain intravenous antibiotics may also cause hearing loss.
Hearing loss can also be caused by fluid retained in the middle ear – after infection or because of poor ventilation of the ear. This fluid can remain in the ear for weeks, even after an infection is gone. The fluid can impair hearing until it clears or is surgically removed. (It's hard to hear through an ear filled with fluid.)
Permanent hearing loss from fluid is rare, but it can occur in children whose fluid remains untreated, resulting in structural changes in the eardrum or hearing bones.
If your child has recurrent ear infections or middle ear fluid, her doctor may recommend a hearing test. He may also recommend inserting tubes into her eardrums so that any fluid that accumulates behind them will be able to drain out and the ear remains ventilated.
Earwax and foreign objects in the ear can also cause temporary hearing loss.
How are hearing problems treated?
If your child was born with hearing loss or developed the problem due to an illness, it may not be reversible, but there are many options for helping her hear as much as possible. Talk to an audiologist about the possibilities for your child, such as a hearing aid (a small electronic device, worn inside or behind the ear, that amplifies sound), an FM trainer (to selectively amplify an individual voice – a teacher's, for example), or a cochlear implant.
A cochlear implant consists of electrodes that are inserted into the inner ear (cochlea) and an external device that picks up and processes sound. The implant functions as a replacement for the inner ear by carrying the auditory signal to the brain. If your child's hearing impairment is classified as severe or profound, she may be a candidate for a cochlear implant.
Implants help many children with severe hearing loss who are unable to benefit from hearing aids. But even with a hearing aid or implant, most children will need speech therapy for several years in order to speak understandably.
For some deaf children, speaking and listening are not possible. In these cases, it's important for the child to start learning sign language as soon as she can. Some families choose a combined approach that allows the child to function as well as possible in both the deaf and hearing communities.
Your child's doctor can refer you to an audiologist, or you can search for one at the American Academy of Audiology's website.
What can I do to prevent hearing loss in my child?
While some causes of hearing loss are not preventable, there are some things you can do to minimize the risk from other factors:
- Never insert anything into your child's ear canal, and teach her never to put anything in her ears. Even cotton-tipped swabs can cause damage.
- Immunize your child against childhood diseases, because some of these – like mumps – can cause hearing loss.
- Monitor your child's colds and ear infections. If she shows signs of hearing or speech impairment after having an ear infection, talk with her doctor about testing her hearing.
- Don't expose your child to noise that's too loud, especially ongoing noise. Loud music or television (especially from ear buds or headphones), appliances, or toys can damage your child's hearing over time. If you have to raise your voice to be heard over a noise, then it's too loud.