Hearing Loss in Children

What is Hearing Loss ?

Hearing loss or impairment is the measure of decline in the ability to apprehend sounds. Hearing loss can range from partial to total, temporary to permanent, sudden to gradual and can affect one or both the ears..

How Hearing Works in adults
Fig 1: How Hearing Works

Sound waves enter the ear via the ear canal and strike the eardrum, causing it to vibrate. The vibrations from the eardrum are then amplified in the middle ear by three tiny bones. In the inner ear the vibrations are converted into electrical nerve impulses. These electrical impulses are then transmitted to the brain via chemical signals where they are interpreted as sounds.

For children, hearing, vision and speech are vital for their overall development as they are fundamental tools for playing, learning and developing social skills.

Children learn to communicate by emulating the sounds they hear. If the child suffering from hearing loss gets undetected or untreated, they cannot interpret much of the speech and language around them. This result delays in the development of speech, language and social skills. These can also sometime results in child suffer from dyslexia.

Language  and speech Development in child due to hearing delay
Fig 2: language/speech development in child

Every two out of 100 children under the age of 18 are affected by disparate degree of hearing impairments. Fortunately, with the help of latest modern technology the effects of most of the hearing loss can be ameliorated. The earlier intervention by detection is the most effective treatment. Early detection and diagnosis, with appropriate fitting of hearing aids/devices and an early start of special education programs can maximise child's hearing capabilities. This can give your child the best chances for adequate speech and language development.

Causes of Hearing Loss in Children

Hearing loss or deafness in children can be classified in two categories: congenital (present at birth) and acquired (occurring after birth).These hearing losses and further be classified into sensorineural, conductive or mixed.

Some children suffering from senorineural hearing loss (nerve deafness) have permanent impairments. Most of these children have some functional hearing which can be used to benefit from hearing aids/devices. Children as young as three months of age can be helped with hearing aids.


Parents are often the first people to sense that their child has a hearing problem. It is important to recognize the signs of hearing loss in infants and toddlers as early as possible. Initial 4 year from birth is the most critical period for the child's development of speech, language and social skills

All infants and toddlers can be given a thorough hearing evaluation. Observe your child's development from infancy on. It is important to observe your child for any signs of potential hearing loss. If you suspect a problem, do not delay in getting your child's hearing tested. It's never too early to ask.

Hearing check-list/behaviours for infants, toddlers and preschool children:

  • Birth to 3 months:
    • Reacts to loud sounds
    • Quiets to familiar voices or sounds
    • Makes cooing noises
    • Responds to speech by looking at speaker’s face
  • 3 to 6 months:
    • Turns eyes or head toward sounds
    • Starts to make speech-like sounds
    • Laughs and makes noises to indicate pleasure and displeasure
  • 6 to 9 months:
    • Babbles, ‘mama’ ‘dada’ ‘baba’
    • Shouts/vocalises to get attention
    • Will often respond to own name and ‘no’
    • Responds to singing and music
  • 9-12 months:
    • Tries imitate speech sounds of others
    • Understands simple words, eg ‘mummy’, ‘daddy’, ‘ball’, ‘dog’
    • Turns attentions to soft sounds
    • First words emerge
  • 12-18 months:

    • Appears to understand some new words each week
    • Follows simple spoken instructions, eg ‘sit down’, ‘get the ball’
    • Points to known people, body parts or toys when asked
    • Continually learns new words to say although may be un clear
  • 18-24 months:

    • Listens to simple stories or songs
    • Combines two or more words in short phrases eg ‘more food’
  • preschool & older children:
    • Turn up the volume of the TV excessively high?
    • Respond inappropriately to questions?
    • Not response when you call him/her?
    • Watch others and tries to imitate what they are doing?
    • Have problems in articulation or speech/language delays?
    • Have problems academically?
    • Complain of ear pain, earaches or head noises?
    • Struggle to understand what people are saying?
    • Imply to speak differently from other children his or her age?

While these actions doesn’t imply that your child has hearing problems, but they could be the potential indicators of one. If you have any concerns regarding the answers of any of the above questions, or if you suspect hearing difficulties in your child, contact your doctor immediately to get an appointment with an audiologist.


Doctor will examine your child and will inquire you about your child's behaviour and symptoms. Doctor may also check with you about your child's medical history. Your Doctor may perform hearing test, or may refer your child to an audiologist (hearing specialist), an otolaryngologist (specialist doctor in ear, nose and throat disorders) or an audiovestibular physician (specialist doctor in hearing, balance and communication problems).


After your child is examined and tested, the audiologist will discuss your child's diagnosis with you, along with recommendations for appropriate treatment:

  • If your child has a hearing loss, you should consult a otolaryngologist (Doctor of Ear, Nose & Throat).
  • Depending on the degree of hearing impairment and nature of the disorder, a hearing aid or other amplification device may be advised. The audiologist will counsel you and your child in throughout the procedure of selection, fitting, use and care of these devices.

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