RUNNING HEAD: HEARING LOSS IN CHILDREN

Hearing Loss in Children

California State University Long Beach

Nicole Wager
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Hearing Loss in Children

Name of Disorder/Description:

A condition that can affect the development and growth of babies and children is hearing

loss, also referred to as a child who is hearing impaired. Congenital hearing loss is when hearing

loss is present at birth and acquired hearing loss occurs after birth (Palo Alto Medical

Foundation, 2019). Hearing loss occurs when any part of the ear, the outer, middle, or inner ear

is not working as it normally should. The Centers for Disease Control and Prevention [CDC]

(2018), provides the medical terms for the four types of hearing loss. Conductive hearing loss,

sensorineural hearing loss, mixed hearing loss which is a combination of both conductive and

sensorineural, and auditory neuropathy spectrum disorder (Center for Disease Control and

Prevention, 2018). Auditory neuropathy and sensorineural hearing loss are similar because both

types involve damage to the inner ear structures. The Palo Alto Medical Foundation [PAMF]

describes conductive hearing loss as the result from problems within the middle and outer ear,

preventing sound from reaching the inner ear. They describe sensorineural hearing loss as

occurring when there is damage to the inner ear nerves and therefore cannot transmit sound

signals to the brain. (Palo Alto Medical Foundation, 2019).

Hearing loss is not a communicable condition, but it can be caused by genetics or loud

noises which the CDC refers to as noise-induced hearing loss. While genes are reported to be

responsible for approximately 50% of the children diagnosed with hearing loss, there are other

ways it develops as well (CDC, 2018). Hearing loss can result from something blocking the

sound pathway or can occur after a child having an ear infection. Other causes of hearing loss

come from infections within the mother during pregnancy, complications during the birth, and
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children having a low birth weight (CDC, 2019). Some of the common terms used to describe a

child’s degree of hearing loss are mild, moderate, severe, and profound, with mild being minimal

and profound being unable to hear any speech at all. Hearing loss is a complicated condition for

those who are not affected by it because there is not one specific source it results from. It can be

caused by several things and there are frequent variations in the types of hearing loss a child can

have, so five children could all have hearing loss and they all could have differences in their

type.

The signs and symptoms of hearing loss will be different for each child, but the most

common signs to look out for will include delayed speech, unclear speech, frequently saying

“huh”, turning the TV volume up too loudly, or not following directions (CDC, 2018). These

signs do not present themselves as an urgent situation, so it may not always be obvious for the

adult to notice immediately. One symptom that may indicate whether a child has hearing loss is

if they experience tinnitus, described by the National Institute on Deafness and Other

Communication Disorders [NIDCD] as a ringing or buzzing sound in the ear. Tinnitus can be

frequent in one or both ears, and while it can be caused by many things, it is an indicator of

hearing loss (National Institute on Deafness and Other Communication Disorders, 2017). If

parents are to notice their child complaining of a constant ringing in their ears, they should take

their child to a doctor immediately. The other symptoms of hearing loss are typically children

failing to reach milestones in how they learn, communicate, play and act around others. The

American Speech-Language-Hearing Association [ASHA] describes how children develop in a

sequence and by specific ages, so when a child fails to reach these developmental milestones it
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indicates that they may have some form of hearing loss that is preventing them from learning

(American Speech-Language-Hearing Association, 2019).

Incidence and Prevalence:

ASHA discusses the prevalence of children who are born with permanent hearing loss,

with permanent meaning irreversible not fully deaf, reported as living with this condition at any

time. ASHA reports that the prevalence of children who are born with some form of hearing loss

are between one and three per everyone thousand children, and the prevalence of children

between the ages of three to seventeen with some form of hearing loss is higher at five per

everyone one thousand children (ASHA, 2019). The prevalence of children is higher than the

prevalence of babies born with hearing loss because it can be noise-induced or just develops

later, so the children who have developed hearing loss are creating higher prevalence rates for

kids aged three to seventeen. Looking at trends in hearing loss statistics, multiple studies

conducted by the CDC shows that for over the last two decades the rates have remained constant.

The CDC also states that studies conducted in Europe and North America are showing consistent

prevalence for this condition among children, so it has not had any large spikes in rates that

should be alarming for doctors and parents (CDC, 2018).

D. Treatment:

As mentioned, hearing loss is specific to each child, so there is not one perfect treatment

for all. Yet, there are a surplus of different treatments that can be found to aid hearing impaired

children. Treatments range from hearing aids and cochlear implants to counseling and working

with ASL language professionals to improve communication for and with the child. Beginning
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with early intervention for children of zero to three years, discovering a child’s hearing loss is

important for their speech, language, and social skills to succeed. The CDC suggests beginning

treatment as soon as possible to prevent any functional disabilities from occurring (CDC, 2018).

Hearing aids are one of the most commonly used forms of treatment for children with mild to

moderate hearing loss, and they can be used for all types of hearing loss; conductive,

sensorineural, and mixed. A hearing aid makes sounds louder, so children who have a hard time

understanding words and sounds may benefit from a hearing aid (CDC, 2018). The other

recommended form of treatment that the CDC suggests are cochlear implants. Cochlear implants

are different from hearing aids in that they do not make sound louder, but they send sound

signals directly to the hearing nerve. Cochlear implants are best for children with severe and

profound hearing loss. A cochlear implant involves surgery to place the implant inside the ear,

and the other part of the implant is worn outside the ear (CDC, 2018). Hearing aids and cochlear

implants can be used for babies and children and are an effective way in treating children with

hearing loss to prevent developmental effects from occurring.

For school aged children, wearing hearing aids may be embarrassing or may make them

feel different from everyone else, but it is important that all family members acknowledge,

respect, and encourage their child or sibling to show them how important their hearing aid is.

Getting children to consistently use their hearing aids is key in treating the condition. ASHA

provides information on the steps to get a hearing aid, beginning with seeing an Ears, Nose, and

Throat [ENT] doctor to get tested for hearing loss, then seeing an audiologist to determine which

types of treatment would be right for the child (ASHA, 2019). They also recommend counseling
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for the entire family, so all members know the proper techniques to care, maintenance, safety,

and expectations of using the hearing aids or cochlear implants.

E. Prevention:

Unfortunately, there is no way to prevent hearing loss in children when it is genetic. But,

noise-induced hearing loss can be prevented, and there are also preventative measures to keep a

child’s hearing from getting worse over time regardless of if it is genetic or noise-induced.

Firstly, screening is the best way to know if a child has some form of hearing loss. Screenings

should be conducted on babies preferably before they leave the hospital, but if not, then at least

one month after being born (CDC, 2018). This way families will know right away if their child

has hearing loss and treatment can be used so the child does not fall behind on developing speech

and communication skills. A study by the CDC has shown that from 2006 to 2012, there was an

increase in the number of infants that were screened for hearing loss. The CDC reports the

increase in screenings went from 95.2% to 96.6%, and while this is a small increase, it is

showing the push to get all infants screened for hearing loss. Screenings are imperative to early

intervention and for further prevention of developmental damage that can be caused by their

hearing loss. Other preventative measures that should be taken are to prevent the worsening of a

child’s hearing over time or to avoid the onset of noise-induced hearing loss are to avoid

exposure to loud noises for more than fifteen minutes at a time (NIDCD, 2017).

F. Community Impact:

The Hearing Loss Association of America [HLAA] is a federally funded program that

caters to the needs of the hearing impaired (Hearing Loss Association of America, 2019). One

program they offer is free hearing aids for those without insurance or those in need of financial
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assistance. A child may be eligible to receive free hearing assistance technology if their

Individualized Education Program [IEP] specifies for one (HLAA, 2019).

The Early Hearing Detection and Intervention [EHDI] Program is a by state program that

works towards identifying babies and children who have some form of hearing loss. Every state

in the United States has an EDHI program to promote hearing loss awareness, follow-up testing,

services, and interventions necessary to ensure proper childhood development (ASHA, 2019).

The goal of the program is to ensure children are receiving care they need to be successful in life

and during school education. These programs offer support to any family who has a child with

hearing loss.

The John Tracy Center [JTC] is a Los Angeles based center that provides services to

“​children with hearing loss, offering families hope, guidance, and encouragement.” (John Tracy

Center, 2019). Their primary programs include full audiological services, so children can be

tested on site, preschool and kindergarten preparation, and counseling for families and children.

Their childhood family counseling is a great option for families who have had a child recently

diagnosed with hearing loss because their support groups give them a chance to hear from other

families who struggle with the same issues. While genetic hearing loss cannot be prevented,

these groups provide great information on how to create stronger relationships for everyone in

the affected family (JTC, 2019).

G. Implications for the Educator/Teacher:

In a school setting, it is especially hard for children with hearing loss to perform as well

as their peers. A study conducted by the CDC followed children with hearing loss from youth

(3-20 years) through adulthood (21-25 years) and found that 40% of them reported experiencing
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at least one limitation in daily functioning throughout their life (CDC, 2019). Being unable hear

creates limitations in learning that other students do not struggle with. Adjustments can be easily

made so that teachers can help their students with hearing loss maintain academic success.

Ferris State University [FSU] has a website that provides teaching strategies for students

with hearing loss. One of the first things they recommend is for teachers to encourage their

students to be open with them by inviting them to discuss any disabilities they have so they can

make appropriate accommodations (Ferris State University, 2019). Regardless of whether the

parents have already informed the teacher of the child’s hearing loss, this action makes students

feel more comfortable with their teachers and creates an open environment accepting of

everyone. Other adjustments teachers can make are having captions on when playing videos,

making time for questions after teaching a concept, speaking slowly overall during lecture, and

making time for smaller group discussions which gives children with hearing loss a chance to

learn by direct conversations in small groups versus large class discussions (FSU, 2019). The

best overall adjustment teachers can make to improve the learning environment for a

hearing-impaired student is to sit them in the front of the classroom. When children sit directly in

the front, they can watch the teacher as they speak and read their lips and connect what they see

with the words being said. Sitting in the front also makes the distance the sound must travel from

the teacher much shorter and more direct.

Since hearing loss is not a communicable disease, teachers and schools do not need to

worry about it being transmitted to other students. Teachers should still take precautions to avoid

loud noises in classrooms to prevent a child’s hearing from becoming worse. Teachers should

promote the classroom environment as a no yelling zone and should refrain from playing loud
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music and videos during class. FSU suggests curriculum adaptations be made, such as written

printouts that the child can read along with as the teacher teaches. This adaptation helps for

children to know exactly what is being said without having to listen as closely, so they do not

have to guess what is being said. They also suggest providing study guides for exams so students

will know what to focus on (FSU, 2019).

Hearing loss is unexpected for families and creates obstacles they never thought of

before, but with time invested into treatments for the child, positive outcomes can be achieved.
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References

American Speech-Language-Hearing Association. 2019. ​Permanent Childhood Hearing Loss.

Retrieved from

https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589934680&section=Incidence

_and_Prevalence

Centers for Disease Control and Prevention. 2019. ​Data and Statistics About Hearing Loss in

Children.​ Retrieved from https://www.cdc.gov/ncbddd/hearingloss/data.html

​ etrieved from
Centers for Disease Control and Prevention. 2018. ​Hearing Loss in Children. R

https://www.cdc.gov/ncbddd/hearingloss/facts.html

​ etrieved
Ferris State University. 2019. ​Teaching Strategies for Hearing Impaired Students. R

from

https://www.ferris.edu/htmls/colleges/university/disability/faculty-staff/classroom-issues/

hearing/hearing-strategy.htm

​ etrieved from
Hearing Loss Association of America. 2019. ​Prevention. R

https://www.hearingloss.org/hearing-help/hearing-loss-basics/prevention/

John Tracy Center. 2019. ​Primary Programs. ​Retrieved from

https://www.jtc.org/about-us/primary-programs/

National Institute on Deafness and Other Communication Disorders. 2017. ​Hearing, Ear

Infections, and Deafness. ​Retrieved from https://www.nidcd.nih.gov/

​ etrieved from
Palo Alto Medical Foundation. 2019. ​Types of Hearing Loss. R

http://www.pamf.org/hearinghealth/facts/children.html