Golisano Children's Hospital at Strong -- Pediatric Audiology

Patient and Family Services

Pediatric Audiology

Stop, Look, and Listen for Signs of Hearing Loss

It’s crucial to detect signs of hearing loss in infants and toddlers as early as possible so that they don’t miss the most critical stage of speech and language development: from birth to 4 years old.

As you observe your child's development from infancy on, look for age-appropriate behaviors like the ones listed below. If you suspect a problem, talk with your pediatrician without delay.

From birth to 4 months, does your baby:
-Stir or respond to loud sounds?
-Startle at loud noises?
-Calm at the sound of a familiar voice?
-Respond to your calming voice?

From 4 to 9 months, does your child:

-Turn eyes toward the source of familiar sounds?
-Smile when spoken to?
-Notice rattles and other sound-making toys?
-Cry differently for different needs?
-Make babbling sounds?
-Seem to understand simple word/hand motions such as "bye-bye" with a wave?

From 9 to 15 months, does your baby:
-Babble a lot of different sounds?
-Respond to his or her name?
-Respond to changes in your tone of voice?
-Say "ma-ma" or "da-da" or other elementary words?
-Understand simple requests?
-Repeat some sounds you make?
-Use his or her voice to get your attention?

From 15 to 24 months, does your child:
-Recognize and point to familiar objects when they are named?
-Listen to stories, songs and rhymes?
-Follow simple commands?
-Use several different words?
-Point to body parts when asked?
-Name common objects?
-Put two or more words together?
-Enjoy the time you and your child spend together.

Hearing Loss in Children

For a child, the ability to hear is the foundation for speaking, learning, playing, and social skills. When something is wrong with hearing, fast response on your part can make all the difference for improving your child’s prospects for successful treatment.

What is Hearing Loss in Children?

Children learn to communicate by imitating the sounds they hear. Young children with hearing loss that goes undetected and untreated can miss much of the speech and language that’s going on around them. It can delay their speech, language, and social development. And put them at higher risk for learning problems.

It’s estimated that two in every 100 children under 18 have some amount of hearing loss. With early diagnosis and treatment, most children can be helped. Early fitting of hearing aids and an early start with therapy can pave the way for successful development of speech and language.

Symptoms of Hearing Loss in Children

Even minor hearing difficulties can become big trouble if they’re not caught and treated early on. Keep your own ears and eyes open for signs of a possible problem. These include:

Using excessively high volumes with TV or radio

Responding inappropriately to questions

Failing to respond when called

Watching others to imitate what they are doing

Experiencing speech problems or delayed speech and language

Having difficulty in school

Speaking differently than children of the same age

Types of Hearing Loss in Children

There are two primary categories of hearing loss in children: congenital, which is present at birth, and acquired, which occurs after birth. These hearing losses may be sensorineural, conductive, or mixed.

Causes of Hearing Loss in Children

Possible causes of congenital hearing loss include:

Infections during pregnancy (German measles, toxoplasmosis and cytomegolavirus)
Ototoxic medication used during pregnancy
Birth complications:
- Serious infection present at birth (e.g. toxoplasmosis, herpes)
- Rubella or cytomegolavirus
- Baby required neonatal intensive care
- Birth weight under 3 lbs.
- Abnormalities of baby's head, face or ears
- Baby required blood transfusion
- Premature infant treated with drugs for respiratory life-sustaining measures
Disorders of the brain or nervous system
Genetic syndromes, such as Ushers, Down's and Waardenburg's syndromes
Family history of hearing loss

Possible causes of acquired hearing loss include:

Untreated middle-ear infections

Infections, such as meningitis, mumps, measles, or whooping cough

Perforation of the eardrum

Excessive noise from sources such as toys, fireworks, or loud music

Diseases such as otosclerosis or Ménière's disease

Full medical history and possibly lab tests

A complete physical exam

Detailed questions about the hearing problem to help isolate possible causes

Lab tests and imaging studies

Referral to an otolaryngologist (ear, nose, and throat specialist), who will do an in-depth, hearing-specific examination. Diagnostic imaging studies may also be used.

Referral to an audiologist for a full hearing evaluation

Hearing Evaluations for Infants

Most hospitals routinely screen babies for hearing problems shortly after delivery. This enables medical professionals to take action early on if there’s a problem.

Pediatric tests determine whether sound is being conducted efficiently or if there’s any damage to a child’s inner ear or nerve pathways. Other tests determine if the baby’s brain is processing what’s being heard.

If your infant hasn’t been tested yet, talk with your pediatrician. In many communities, hearing screenings are offered at no or low cost through HMOs, clinics, and other health care organizations.

Treating Hearing Loss in Children

Hearing loss in young children often turns out to be a temporary condition. Many types of hearing problems can be resolved completely with early detection and prompt medical attention. Even children with permanent sensorineural hearing loss can get a new lease on hearing with some help from doctors and audiologists. With the latest advances in hearing aids (12-week old babies wear them now), Cochlear implants, and assistive listening devices, medical professionals have more ways than ever to help hearing-impaired children get more out of life.