Hearing Loss Detection in Children

The way humans assess and interpret the world is negotiated through sensory experiences. A hearing is one of the senses which facilitates communication allowing people to build relationships, participate in daily activities, and experience different life events.

A hearing is a key to performing academically, learning spoken language, and interacting with others. Hearing loss is a hearing disability that acts as a barrier in the path of education and social integration. Children with hearing loss can benefit to the great extent if they are identified early in life and treated with appropriate interventions.

What was happening in the past? Actually, in the past, the deaf children couldn’t be detected until they were around two years old or started talking yet. Research says that if detection and intervention for hearing loss are done prior to six months of age then it may result in positive outcomes.

As a result of research, hearing screening for a newborn has become universal in hospitals across the US as well as many developing countries like India. These children(deaf) are being diagnosed and treated at much younger ages. Early detection of hearing loss along with appropriate early interventions is analytical to speech and language development.

hearing detection in child

Estimation of the hearing loss in children

As per the data analysis after proper study, there are around 1.4 babies among every 1,000 newborns have a hearing loss. Research from the National Health Survey,2005 as conducted by the Centers for Disease Control and Prevention (CDC) found that 5 per 1,000 children are influenced by hearing loss. And most of the cases were being diagnosed among the children between ages 3 and 17.

As a result of this, hearing loss is making youth as it’s victims due to the noisy environment. In 2013, the CDC made an estimation that at least 12.5 percent of children as well as the adolescents of age group 6-19 have suffered permanent hearing damage due to excessive noise exposure. Below is the figure showing the estimates of causes of preventable hearing loss.

estimates of childhood hearing loss that is preventable

Why is early detection of childhood hearing loss important?

Children with deafness often need special attention. ENT specialists treat birth defects of the ear, nose, and throat. They diagnose and treat developmental delays, ear infection, asthma and allergy, airway problems, and so on.

An early identification helps such children to receive proper treatment during the first two years of life. This is because of the reason that is a critical period for developing speech and language skills. More sooner a child’s hearing loss is detected, the quicker the family can make the best decision for their child’s communication approach. There are many services used to support deaf children. Here are a stats in the figure depicting why is early detection of childhood hearing loss important. It helps in hearing loss education also.

stats for early detection of childhood deafness

Remember that hearing loss can occur at any time of life. Even if your loved one does not have a hearing loss today then too regular checkups and yearly hearing tests must be performed by audiologists or other health providers. This is because that they can monitor potential changes in hearing. They can timely suggest the excellent resources and intervention services overcome barriers to communication.

Causes of childhood hearing loss

Several possible causes of hearing loss have been traced in children for both congenital or acquired. It can also be conductive, sensorineural or mixed. There is a need for parents, caretakers, teachers, and others to know the symptoms of hearing the loss in children. The reason is the undiagnosed hearing problem can lead to the significant development of emotional problems among children causing long-lasting effects.

Risk Factors

First of all, remove this misconception from your mind that hearing loss can only happen at a particular age. No, it can happen any time during whole life. Hearing loss is actually a spectrum with minor hearing problems at one end and complete deafness at the other. Have a look at the image that explains Hearing Loss as a Spectrum among children.

Hearing Loss Spectrum

Following are the factors that can enhance the probability of a child to have hearing loss issue:

Genetic causes: There are around 1 out of 2 cases of the hearing loss in babies affected due to genetic causes. There may be some chances that they might be affected due to the family genetic problem for hearing. It is found that there are around 1 out of 3 babies who suffer from genetic hearing loss and thus have a “syndrome” too. This implies that they have other conditions along with the hearing loss known as Down syndrome.

1 out of 4 cases of the hearing loss in babies: It occurs mostly due to maternal infections during pregnancy. It can also occur due to some complications after birth, and head trauma. Let’s discuss with the help of an example.
Suppose, the child was exposed to infection before birth. After spending 5 days or more in a hospital, he had complications while in the NICU. Thus he needed a special procedure like a blood transfusion for treatment. There were certain side-effects like head, face or ears abnormally shaped than usual. He was diagnosed with a neurological disorder that may be associated with hearing loss. He had an infection around the brain and spinal cord called meningitis responsible for hearing loss.

For about 1 out of 4 babies: For this case, the cause is still unknown.

Hearing Loss Screening in children

Hearing screening is performed routinely by hospitals on infants in the initial 24-48 hours after the child takes birth. Now, what If an infant fails the initial screening? In such case, he or she is scheduled for a second screening but only after a few weeks.

But sometimes infants who pass the hearing screening the first time after their birth may exhibit signs of hearing loss as they grow. Don’t be late to visit your pediatrician if you observe that your child is having difficulty hearing you. One way to detect whether your child’s hearing is getting abnormal is by monitoring important speech and hearing milestones.

From birth to four months, your infant should:

  • scare at loud sounds
  • wake up at loud noises
  • respond to your voice by smiling or murmuring
  • cool down listening to a familiar voice

From four months to nine months, your infant should:

  • notice toys making sounds
  • turning or twisting head towards familiar sounds
  • make babbling noises
  • understand hand motions

From nine to 15 months, your infant should:

  • repeat some basic sounds
  • understand simple requests
  • use its voice to seek your attention
  • react to name

From 15 to 24 months, your infant should:

  • using simple words
  • pointing body parts on interrogation
  • try to name common objects
  • listen to songs, rhymes, and stories with full of interests

When should the hearing be evaluated?

Most children are born with a hearing loss as identified by newborn hearing screening. But there may be some cases where it is caused by infections, trauma, and disturbing noise levels. According to the researchers, there is the number of deaf people whose hearing disability level gets double between birth and the teen years. So it’s important to have regular hearing checkups for the kids.

A newborn baby must have a proper hearing screening before getting discharged from the hospital. Now an Early Hearing Detection and Intervention (EHDI) program has been established in every state and territory in the United States. The program detects every child with a permanent hearing loss just before 3 months of age. And after that, it provides intervention services before 6 months of age.

It’s important to have a hearing screening of baby within the first 3 weeks of life. It doesn’t always mean there’s a hearing loss if your baby does not pass the hearing screening. But if your newborn doesn’t pass the initial screening test he or she must get a retest within 3 months. This can help to begin the treatment right away.
Hearing tests are usually done at ages 4-10 and in case of a concern too. But don’t be late to go to ENT specialists if your child seems to have trouble hearing.

Tests to Evaluate Hearing

What if your child is too young to have all the behavioral hearing testing or another medical test? It’s okay! Doctors can check for hearing problems by looking at how well your child’s ear, nerves, and brain are working. There are certain tests to evaluate hearing.

Auditory brainstem response (ABR) test: In this test, the doctor put the tiny earphones in the ear canals. Now small electrodes are placed behind the ears and on the forehead. Normally, hissing sounds are sent through the earphones. These electrodes measure how the hearing nerve responds to the clicking sound.

When test results are measured on a chart, normal hearing has a certain appearance. Due to this, a normal ABR suggests that the inner ear and lower part of the auditory system of your baby are working quite well for typical speech. Hearing loss is indicated and depicted by an abnormal ABR.

Auditory steady-state response (ASSR) test: This test is same as the ABR. The difference is that an infant usually needs either sleep or sedation for the ASSR test.

What happens here? Actually, a clicking sound passes into the ear canals. The computer picks up the brain’s response to the sound and hence automatically decides the level of hearing loss whether mild, moderate or severe.

Central auditory evoked potential (CAEP) test: This test is also same as ABR. It employs the use of the same tiny earphones and small electrodes. This test allows the audiologist to analyze the working pathways from the brainstem to the auditory cortex. Doctors advise having CAEP test for particular types of hearing loss. It is possible to have this test at any age.

Otoacoustic emissions (OAE) test: A sleeping infant or an older child can undergo this test if they may sit quietly to have this test. Here, a doctor places a tiny probe in the ear canal. Then many pulsing sounds are sent through it. The probe records an “echo” response from the outer hair cells in the inner ear as recorded by the computer.

Treatments for childhood hearing loss

There are many recommended forms of treatment for childhood hearing loss. If you notice that your infant or child is showing any above-mentioned symptoms, consult your family doctor. Your pediatric audiologist will perform some hearing tests on your child.

There are several objective tests that infants can undergo as well. These tests are even painless. After examination, the audiologist will talk to you about your child’s hearing ability. Then he will recommend an appropriate medical intervention.

Treatment of hearing loss at childhood using different methods:

Preventions

There are some tips for parents to follow as it can help in preventing hearing loss in their children:

  • Have a healthy and safe pregnancy
  • Learn how to work during pregnancy
  • Make sure regular childhood vaccines are provided timely to your child
  • Try to keep your child away from the high noisy environment
  • Learn more about how to prevent noise-induced hearing loss

Outcome

Hearing loss affects a child that he faces trouble developing speech, language, and social skills. Sooner the children with hearing loss get hearing services, the more quickly they can reach their full potential. So, if you are a parent suspecting your child with hearing loss, trust your instincts and consult your doctor. This can help in hearing loss detection in children to get better treatment to heal faster.

Hearing Loss Detection in Children
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