Hearing loss in children

About one in 1,000 children in Germany is born with a severe hearing loss; others are moderately or slightly hard of hearing. One possible consequence is that these children only learn to speak to a limited extent or not at all, which affects their overall development. Therefore, a hearing impairment must be recognized as early as possible. Read how to recognize and treat hearing loss (hyperacusis) in children.

Consequences of hearing loss in children

Good hearing is necessary for the optimal development of children: Only through good hearing do children learn to speak and understand, communicate, correctly perceive nuances and intonations in conversation and find their way in life.

Poor hearing is often associated with a loss of orientation, for example, in traffic, learning problems, and later career choices, which are also restricted. Therefore, hearing disorders must be detected as early as possible.

 

Forms and causes of hearing loss

Depending on which area of ​​the ear is affected, a distinction is made between conductive and sensorineural hearing loss:

• Conductive hearing loss: In this case, the sound only reaches the inner ear to a limited extent because the transmission in the auditory canal or middle ear is impaired. A conductive hearing loss is usually only temporary, for example, in the case of a wax plug, an otitis media or a tympanic effusion. However, hearing may remain permanently impaired due to recurring infections since calcium can build up on the auditory ossicles, and they can no longer transmit sound.
• Sensorineural hearing loss: Here, the sound absorption and processing in the inner ear is reduced – primarily due to damaged sensory hairs. Sensorineural hearing loss in young children is usually congenital and bilateral; premature babies are particularly affected. In older children, for example, medication, infectious diseases such as mumps and measles or meningitis lead to primarily irreparable damage to the inner ear.

Hearing loss in infants can be caused by triggers before, during or after birth. Triggering factors before birth include alcohol consumption by the mother or illnesses in the mother, such as severe viral infections, metabolic diseases or syphilis. Problems during childbirth, such as lack of oxygen or premature birth, can also cause hearing impairment. After birth, the leading causes of hearing problems in infants are inflammation or infectious diseases.

In addition, the growing noise pollution in everyday life leads to hearing problems in children and young people. Whether it’s music boxes for the little ones, battery-powered fire engines and toy pistols for the older children, constant sprinklers from “buttons” in their ears, or loud noise in clubs and concerts for young people, some teenagers today already hear worse than their grandparents.

Another classification is according to congenital and acquired as well as temporary and permanent disorders. Depending on the extent of the hearing loss, one speaks of low, medium and high degrees of hearing loss and deafness (hearing loss). One-third of children’s permanent hearing impairments are genetic, one-third are acquired, and the other third are unexplained.

Early detection of hearing loss in children

With painless, objective hearing test methods such as the OAE test (OAE = otoacoustic emissions), more than 95 per cent of congenital hearing disorders can be recorded in the first few days of life. Since the beginning of 2009, such a hearing test for babies in the first three months of life has been part of the health insurance benefits. The child’s hearing is rechecked in the later pediatric examinations (especially U3, U4, U5).

With this screening, it is usually possible to discover existing hearing disorders so early that, with the appropriate therapy, a speech and developmental delay does not occur in the first place.

 

Criteria for healthy hearing in childhood

Nevertheless, as a parent, you should closely monitor your child in everyday life. If they meet the following points, they are probably going through normal hearing and language development, and you don’t have to worry about their hearing:

• In the 4th to 6th week of life, it is normal for babies to be startled by sudden loud noises. With good encouragement from the parents, they should calm down again.
• Babies laugh out loud in the 3rd to 4th month of life and babble. They should also move their eyes in the direction of the sound source.
• Babies in the 6th to 7th month of life can usually say their first two-syllable “words” and listen to music.
• At 10 to 12 months, infants will respond to soft touches from about a meter away. They should also understand prohibitions.
• Around their second birthday, toddlers should be able to follow instructions whispered in their ears.

Tips for simple “hearing tests”: The noises and tones should be made so that the child cannot see or feel the source and only reacts to what he hears and not to other stimuli. The noises should vary in loudness, lightness and dullness, as sometimes only certain pitches are not adequately perceived.

Signs of hearing problems in children

If one or more of the following applies to your child, you should speak to your paediatrician. While every child develops at their own pace, it’s better to be safe than sorry at the slightest sign. For example, a hearing test can only determine a minor hearing loss; the precise observation of the child’s behaviour alone is insufficient.

These signs indicate hearing loss in children:

• The child needs to progress in language development; He finds it difficult to speak even short sentences.
• If addressed, it only answers with a delay or not at all.
• The child is not startled by loud noises (e.g. slamming doors) or does not wake up.
• It cannot imitate sounds or animal sounds.
• It has trouble locating sounds and is unresponsive to sounds and speech outside of its field of vision.
• It cannot denote everyday objects such as clothing or body parts.
• The child has few social contacts and is a loner.
• Ear infections are increasing in children.

Treating hearing loss in children

If the suspicion of hearing impairment is confirmed, there is no time to lose: even in children who have outgrown infancy, a hearing loss that has not been treated for a long time impedes development. If possible, therapy for congenital hearing disorders should begin within the first six months of life: the child’s auditory pathways need acoustic stimuli in the first few years of life to mature correctly.

 

Therapy options: Hearing aids for children

Most children’s hearing can be improved with hearing aids. These should be fitted professionally by a specially qualified hearing care professional, the pediatric audiologist.

In addition to hearing aids that amplify the sound, some children also have a cochlear implant that processes the sound waves. Depending on how old your child is and how hearing and speaking are impaired, further measures accompany the therapy:

• speech therapy
• auditory training
• Learning to read lips and sign language
• Assistance in coping with everyday life (for child and parents)

Parents to support treatment.

It is essential that you, as a parent, stand by your child’s hearing problem and support it. It would help if you didn’t make your child feel like they have a flaw – this can lead to a lack of self-confidence, a loss of open-mindedness and a reduced zest for life. A child will only learn to manage their hearing impairment and accept a hearing aid if their parents do the same.

Hearing aids must be worn regularly. In addition, it makes sense to inform the people with whom the child deals with the hearing impairment. Otherwise, communication problems with all the social consequences, such as difficulties at school and loneliness, are inevitable.