Hearing loss in children

• Does not react to loud noises
• Does not turn to the source of a sound past 6 months of age
• Does not say simple words like “mama” or “dada” by 12 months of age
• Turns head when they see you, but does not turn head if you only call out their name
• Seems to hear some sounds but not others^{2, 3}

• Does not respond to their name when called
• Is not using two-word phrases
• Cannot follow two-step directions like “Get the toy, and put it on the chair”
• Appears inattentive in noisy environments
• Shows frustration when trying to communicate³

• Exhibits unclear speech compared to peers
• Does not say all the syllables in a word
• Lacks understanding of location words like “inside,” “on” or “under”
• Frequently says “huh?” or “what?”
• Uses increased volume on TVs or other devices³

• Has difficulty understanding what people are saying
• Speaks differently than other children their age
• Does not produce grammatically correct sentences
• Complains of earaches
• Complains of noises in their ears³

• Falls behind in school
• Struggles with speech and reading
• Speaks very loudly
• Is easily frustrated
• Experiences communication breakdowns
• Moves one ear forward when listening^{4, 5}

Conductive hearing loss is the most common type of hearing loss among infants and young children. It occurs when there is an obstruction in the outer or middle ear that stops sound waves from reaching the inner ear.^{7, 9, 10} While some children are born with this condition, it is more commonly caused by ear infections.⁷ Conductive hearing loss is typically temporary.^{7, 9, 10}

Otitis media, an inflammation of the middle ear often involving fluid buildup, is the most common cause of conductive hearing loss in children.⁹

Hearing aids are small, battery-powered devices designed to make sounds louder, assisting children with mild to moderately severe hearing loss. With the help of these devices, many children can achieve nearly normal speech clarity in quiet settings.⁷

For children with more severe hearing loss, hearing aids enable them to perceive some sounds, but they may still rely on additional tools like lip reading or sign language to fully engage in conversations.

Cochlear implants are advanced electronic devices that can help children with severe to profound hearing loss in both ears regain some ability to hear. Unlike hearing aids, which amplify sound, cochlear implants work by capturing sound with a speech processor worn behind the ear. The sound is then transmitted to an implant placed inside the inner ear, bypassing the damaged parts of the hearing system.⁷

While cochlear implants improve access to sounds, they don’t recreate normal hearing. However, with consistent auditory therapy and auditory training in children with hearing loss, children who receive these implants can often learn to understand spoken language.

For children living with hearing loss, adjustments in the classroom can make a significant difference. These may include preferential seating arrangements, assistive devices for hearing, tailored teaching methods and accommodations during tests.¹⁰

Teachers are encouraged to collaborate with audiologists, speech-language pathologists (SLPs) and the child to ensure these strategies meet the student’s needs throughout the school year.

Hearing loss can delay a child's ability to produce sounds, develop speech and communicate effectively. Addressing hearing concerns as early as possible is critical to minimizing these delays and supporting a child’s developmental progress.

The early years of life are crucial for building language skills. If hearing loss goes undetected, it can significantly disrupt a child’s ability to develop these skills and create long-term challenges in communication.

Hospitals across the U.S. conduct hearing screenings on newborns within their first month of life.⁷ This test is both quick and painless, serving as a vital early step in identifying congenital hearing loss. It is an essential safeguard, ensuring your baby’s auditory health is monitored from the start. 

However, even a successful newborn screening doesn’t eliminate the need for ongoing evaluations. Some types of hearing loss can emerge gradually or later during childhood. That’s why regular hearing assessments as your child grows are key to detecting any changes early.

• Auditory brainstem response (ABR): This painless and efficient test utilizes small adhesive electrodes placed on the baby’s scalp to measure brain activity in response to sound.¹⁴
• Evoked otoacoustic emissions (EOAE): A soft, flexible earplug is used to deliver this brief, noninvasive test, which is typically conducted while the baby sleeps.¹⁴
• Behavioral audiometry evaluation: This screening enables audiologists to observe how infants respond to specific sounds.
• Audiometry: Often used for toddlers, this technique involves transmitting sounds at varying pitches and volumes into the child’s ears using an electrical machine.
• Pure tone audiometry: This test operates similarly by delivering sounds of different pitches and volumes, so that audiologists can gauge a child’s hearing ability.14
• Tympanometry (impedance audiometry): This straightforward test is conducted and measures how your eardrum moves and if the acoustic reflex are present. This test is used to evaluate middle ear and inner ear function.

Children who do not pass an initial hearing screening should undergo a comprehensive hearing evaluation by an audiologist. This specialized professional is trained to perform detailed hearing tests to identify potential hearing loss, determine severity and classify the type. During this evaluation, the audiologist will ask about the child’s birth history, any instances of ear infections and family history of hearing issues.

There are various noninvasive procedures an audiologist can use to pinpoint the specifics of a child’s hearing loss. These evaluations are designed to be simple and painless, ensuring a stress-free process for young patients.

Certain medications, known as ototoxic drugs, can cause inner ear damage, which could lead to hearing and balance issues that can significantly affect a child's ability to learn and communicate.

Caregivers should monitor for changes in hearing, balance, concentration or signs of frustration, as these may indicate a hearing problem. If concerns arise, scheduling an appointment with a healthcare provider is recommended.

With temporary hearing loss caused by ear infections, a child should feel better within a few days of antibiotic treatment. If symptoms persist, contact a doctor as a different antibiotic may be needed. Fluid in the middle ear may remain but typically clears within three to six weeks.²¹

Using antibiotics to treat infections can lead to antibiotic resistance, making future infections harder to treat. It's best to consult a healthcare provider as treatment depends on a child’s age, symptoms and level of pain.