Hearing in Children

Hearing in children

Childhood deafness is a significant global issue, affecting more than 62 million children younger than 15 years old – 2/3 of whom reside in developing countries. The source of child deafness is widely under-reported and varied, but medical experts point to insufficient prenatal care, lack of immunizations, exposure to ototoxic drugs, and chronic middle ear infection as the leading causes.

The World Health Organization estimates that through immunizations, early identification and intervention programs, access to hearing aids, medical treatments, and other vehicles, over 50% of the burden of hearing loss in developing countries could be reduced or eliminated.

Unfortunately, hearing loss is becoming more commonplace in youth due to the noise in our environment. In 2013, the CDC (Center for Disease Control and Prevention) estimated at least 12.5 percent of children and adolescents ages 6 to 19 have suffered permanent damage to their hearing due to excessive noise exposure.

Causes of hearing loss in children

Temporary or permanent hearing problems in children can be caused by factors including otitis media (infection of the middle ear), exposure before birth to a disease such as rubella (German measles), genetic disorders, exposure to ototoxic drugs or loud noise, as well as certain diseases including meningitis, mumps, measles.

Ear Infections (Otitis Media)

What is an ear infection, and how common is it?
Ear infections happen when the middle ear becomes inflamed. The middle ear is the small space behind the eardrum. Ear infections are also called acute otitis media. It can occur in one or both ears.

Ear infections are among the most common childhood sicknesses and can be very painful. Many children will have at least one acute ear infection by the time they turn 1 year old. Ear infections are so common in children because the passage (Eustachian tube) between the middle ear and the back of the throat is smaller and more horizontal in children than in adults. This allows for it to be more easily blocked. Sometimes children get fluid in their middle ear but without an infection. This is called otitis media with fluid.

A small number of children will have three or more cases of otitis media with fluid by age 3. This may take a month or longer to heal. Constant ear fluid is more common in children under 2 years of age, but it can be seen in children older than 2 as well. When fluid is present in the ear for a prolonged period of time, this can pose a risk for hearing loss. Hearing loss at a young age can affect typical speech and language development.

Signs of hearing loss in children

Hearing in babies

One way to determine if your child’s hearing is developing appropriately is by monitoring important speech and hearing milestones, such as those listed below from ASHA (American Speech and Hearing Association).

From birth to four months, your infant should:

  • Startle at loud sounds
  • Wake up or stir at loud noises
  • Respond to your voice by smiling or cooing
  • Calm down at a familiar voice

From four months to nine months, your baby should:

  • Smile when spoken to
  • Notice toys that make sounds
  • Turn its head toward familiar sounds
  • Make babbling noises
  • Understand hand motions like the bye-bye wave

From nine to 15 months, your baby should:

  • Make various babbling sounds
  • Repeat some simple sounds
  • Understand basic requests
  • Use its voice to get your attention
  • Respond to name

From 15 to 24 months, your baby should:

  • Use many simple words
  • Point to body parts when you ask
  • Name common objects
  • Listen with interests to songs, rhymes and stories
  • Point to familiar objects you name
  • Follow basic commands

Older children could also acquire hearing loss that is either permanent or temporary. Here are some things to look for if you think your toddler or preschool-age child might have hearing loss:

  • Has difficulty understanding what people are saying.
  • Speaks differently than other children her or his age.
  • Doesn't reply when you call his or her name.
  • Responds inappropriately to questions (misunderstands).
  • Turns up the TV volume incredibly high or sits very close to the TV to hear.
  • Has problems academically, especially if they weren't present before.
  • Has speech or language delays or problems articulating things.
  • Watches others in order to imitate their actions, at home or in school.
  • Complains of ear pain, ear aches or noises.
  • Cannot understand over the phone or switches ears frequently while talking on the phone.
  • Says "what?" or "huh?" several times a day.
  • Watches a speaker's face very intently - many children's hearing loss escapes detection because they are very successful lip readers.


Ears are the doorway to the brain

Ears are the doorway to the brain

We tend to think that we hear with our ears and any hearing difficulties are only connected with this specific bodypart. But actually, we hear with the brain; our ears are only helping us to get sound information to the brain.
We can therefor compare ears to a doorway and a hearing loss to a “doorway problem”, because the ears are the doorway to the brain for auditory information.

The doorway can be obstructed a little or a lot (depending on the hearing loss), which means that sound information is not reaching the brain clearly.
Please watch this short video from dr Flexer - explaining what hearing loss does to a child's hearing brain.

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