Our world is full of sounds—traffic noise, music, conversations—but many children don’t hear them as clearly as they might. We asked Melissa Wilson, audiologist and co-founder of Sound Speech and Hearing Clinic in San Francisco, how to recognize and treat any hearing problems your child might have.
When we talk about “hearing loss,” we don’t just mean complete deafness. There’s a huge range, from mild to profound (or total) hearing loss. In addition, a person’s right ear may hear differently from his left ear, and each instance of hearing loss may be intermittent or constant, correctable or permanent. Diagnosing the correct degree and type of hearing loss as soon as possible gives your child the best outcome.
Most parents who are worried about their child’s hearing will ask their pediatrician. That’s a fine first step—some pediatricians can do basic hearing screenings or tests right in the office. If not, they should be able to refer you to a pediatric audiologist for further testing.
Audiologists can dig much deeper. For example, it’s pretty hard to put headphones on a rowdy 2-year-old and ask her to raise her hand when she hears a sound. Instead, we can use a sound booth—a fully controlled acoustic environment—and play sounds through the wall speakers. We have games to play, and we’re able to condition very young children to react and respond to a variety of sounds. Audiologists can also objectively measure the movement of the middle ear (i.e., the ear drum) and the response of the inner ear (the cochlea) to assess different parts of the child’s auditory system.
The two main questions parents ask me if their infant is diagnosed with hearing loss are, “Will she be able to talk?” and “Will he be able to go to college?” Speech and language outcomes are going to depend on the degree and type of hearing loss, the intervention chosen, and the goals of the family. For example, in cases of severe or profound hearing loss in both ears, technology and training can certainly lead to the child learning to talk, but other children may do better with signed language systems, or a combination of both spoken and signed communication (what we refer to as different modalities). Regardless of the modality for speech and language, rest assured that hearing loss has nothing to do with intellectual ability. If your child has hearing loss, most big cities or regions, like the Bay Area, have great resources, including lots of programs available regardless of income.
A good thing for homebirth parents to keep in mind: Babies born in hospitals get mandatory hearing screenings, but babies born at home don’t necessarily get them. One to three of every 1,000 babies are born with a permanent hearing loss, and half of those children have no risk factors or family history of hearing loss. The most important thing new parents can do for their child’s hearing is to complete a newborn hearing screening, if she didn’t get one already.
Audiologists follow a rule called 1-3-6. It calls for screening by 1 month of age, more comprehensive testing by 3 months, and having an intervention plan in place by 6 months. That’s because those first few months are crucial for speech and language development. The earlier you catch any problems and intervene, the better the developmental outcomes.
For parents of toddlers: You’re the ultimate hearing test because you know your child. If you notice any change in how your child is responding to sounds—not dancing when you put on music, not running in from a different room when his favorite show comes on TV, not listening to you in the same way—bring him in to an audiologist for more thorough testing. Two other signs to watch for in young children are your child seeming to lapse in speech abilities (maybe he’s not getting the auditory stimulation he needs to properly produce speech sounds) or tugging at his ears frequently (it can be a sign of middle ear fluid).
Mild hearing loss sometimes goes undiagnosed until kids start school. Hearing and understanding in a noisy classroom is much, much more difficult for these children, and their academic progression slows. That’s why hearing screenings are important in this population.
Not all hearing problems are hearing loss: If your child has trouble listening and understanding in the classroom, it’s possible he has a Central Auditory Processing Disorder (CAPD). With this, the ears hear sounds just fine, but the brain doesn’t process them correctly. It’s not ADD, but the two disorders can co-exist. Your child might show problems with reading, spelling, language, difficulty interpreting vocal tones like sarcasm, or an inability to fill in the blanks when dealing with difficult hearing situations, like in a lot of noise or understanding someone with a thick accent. Just as with hearing loss, there are interventions that can be put in place to treat CAPD.
I see a lot of teens who have the ears of a 40-year-old. We all start to lose hearing sensitivity in the higher pitches as we age, but more and more adolescents—the CDC reported in 2010 that as many as 16 percent of teens!—are presenting with high frequency, noise-induced hearing loss. We’re all inculcated from a young age to wear sunglasses to protect our eyes, but we don’t think much about protecting our ears. Even constant urban noise can damage hearing over time.
Two easy ways to protect your child’s hearing: One is free—if you can convince them to turn down the music on their music players! The NIH has a wonderful site called “It’s a Noisy Planet,” which gives great tips on knowing how loud is too loud, how to talk to your child about damaging noise levels, and what type of headphones or ear buds are best. The other solution is custom protective ear plugs with special filters so you can still have conversations and enjoy music, but the steady, damaging noise is filtered out. Great for both teens and parents!
As an audiologist, I help improve communication. My favorite part of my job is getting to know families and their unique needs, and then working with the other committed professionals in this field—other audiologists, speech language therapists, teachers, medical doctors, psychologists—to develop a plan that will meet the overall communication needs of the child and the family. (A close second is when children choose to customize their hearing protection or hearing aid ear pieces with crazy colors and glitter!)
Photo: Bridget Coila/Flickr