The early identification of hearing loss permits the initiation of treatment and rehabilitation of the hearing-impaired child at a very young age. The child can then learn more normal speech skills when hearing loss is identified early and intervention begins. Hearing loss can range from a mild impairment to profound loss. Many people think that hearing is only graded as normal or deaf. They may also think that the child is hearing normally if he or she is responding to sounds and voices.

However, there are many subtle gradations between normal hearing and deafness and a child’s hearing loss may not be apparent. A child with undetected hearing loss may not be able to develop normal speech and language or acquire the cognitive abilities (knowing, thinking, and judging) needed for learning.

There are a number of risk factors for hearing loss in children, so there are a number of special reasons why a child’s hearing may need to be screened or tested.

Common indications for a hearing evaluation include:

- speech delay

- frequent or recurrent ear infections

- a family history of hearing loss (hearing loss can be inherited)

- syndromes known to be associated with hearing loss (for example, Down syndrome, the Alport syndrome, and Crouzon syndrome)

- infectious diseases that cause hearing loss (for example, meningitis, measles, and cytomegalovirus [CMV] infection)

- medical treatments that may have hearing loss as a side effect, including some antibiotics and some chemotherapy agents
 
- poor school performance

- diagnosis of a learning disability or other disorder, such as autism or pervasive developmental disorder (PDD)

In addition, the circumstances surrounding the pregnancy and birth may be associated with subsequent hearing loss. If there is a history that includes any of the following, a child should have a hearing assessment.

- low birth weight (less than 2 pounds) and/or prematurity

- assisted ventilation (to help with breathing for more than 10 days after birth)

- low Apgar scores (numbers assigned at birth that reflect the newborn’s health status)

- severe jaundice after birth

- maternal illness during pregnancy (for example, German measles [rubella])

- hydrocephalus
Determining Hearing Loss in Children At A Glance

- Children can be tested for hearing loss at any age.

- There are several risk factors associated with hearing loss, including ear infections, prematurity, diseases, and syndromes.

- Early identification of hearing loss will permit effective intervention, allowing for speech, language and cognitive development that are on target with a

child’s peers.

- The ABR and the OAE evaluations are effective tests for infants and children who cannot cooperate for a traditional hearing evaluation.

- Visual reinforcement audiometry and play audiometry are two behavioral methods used for testing cooperative children, which can obtain results similar to

an adult evaluation.

- A test of the middle-ear system should be included in a diagnostic hearing evaluation for all children.

- When a hearing loss is detected, the child should be referred to an otolaryngologist or ENT to identify the cause of the loss. Further recommendations can

be made by the ENT.