Causes of Hearing Loss in Children

Congenital hearing problems in children are very efficiently picked up at the neo-natel screening that is routinely undertaken with a few weeks of birth.  This screening measures the automatic reaction to a sound presented into the ear canal, if the reaction does not occur the child will be referred for more thorough testing.  It is therefore unusual for a child with a sensorineural hearing loss from birth not be diagnosed early on, which is a great step forward in the management of such a  hearing loss.

Wax or Foreign Objects in the Ear

Children are not adverse to putting things into there ears that shouldn’t be there – anything from seeds to peanuts or beads.  A common reason for conductive hearing loss in children is a perforated eardrum, which can sometimes be as a result of cleaning the ear with cotton buds.  Cotton buds should never be used to clean ears, particularly not children’s ears.

Syndromes and Pathologies

Childhood conductive and sensorineural hearing loss can result as a symptom of different syndromes and pathologies. Children with this type of hearing loss are normally well looked after as part of their overall care strategy.

Otitis Media

Otitis media is the most common hearing problem that effects by far the largest group of children is treatable and usually temporary and if managed correctly does not present a problem beyond childhood

Otitis media is an inflammation in the middle ear (the area behind the eardrum) that is usually associated with the build-up of fluid. The fluid may or may not be infected.  Symptoms, severity, frequency, and length of the condition vary. At one extreme is a single short period of thin, clear, non-infected fluid without any pain or fever but with a slight decrease in hearing ability.   At the other extreme are repeated bouts with infection, thick “glue-like” fluid and possible complications.

Fluctuating conductive hearing loss nearly always occurs with all types of otitis media. In fact it is the most common cause of hearing loss in young children.  Otitis media is the most frequently diagnosed disease in infants and young children.  Otitis medis is very common in children, largely due to physiology.   The eustachian tube, a passage between the middle ear and the back of the throat, is smaller and more nearly horizontal in children than in adults. Therefore, it can be more easily blocked by conditions such as large adenoids and infections. Until the eustachian tube changes in size and angle as the child grows, children are more susceptible to otitis media.

Otits Media often causes a problem to hearing because the fluid that is present in the middle ear cavity limits the transfer of vibrations via the three tiny bones in the middle ear through to the eardrum then on to the inner ear. When fluid is present, the vibrations are not transmitted efficiently and sound energy is lost. The result may be mild or even moderate hearing loss. Therefore, speech sounds are muffled or inaudible.

Generally, this type of hearing loss is conductive and is temporary. However when otitis media occurs over and over again, damage can be caused to the eardrum and the bones of the ear, presenting a longer term problem.

Otitis Media will often hit a child at a critical time in their development of speech and language, which can present problems for the future, even beyond the time when condition has improved, which is why we believe a child with otitis media should be pro-actively dealt with, rather than simply left to “grow out” of the condition.  The first few years of life are especially critical for development of speech and language.  If a hearing loss exists, a child does not get the full benefit of language learning experiences.

Otitis media without infection presents a special problem because symptoms of pain and fever are usually not present. Therefore, weeks and even months can go by before parents suspect a problem. During this time, the child may miss out on some of the information that can influence speech and language development.

Even if there is no pain or fever, there are other signs you can look for that may indicate chronic or recurring fluid in the ear:

• Inattentiveness
• Wanting the television or radio louder than usual
• Misunderstanding directions
• Listlessness
• Unexplained irritability
• “Huh”
• Pulling or scratching at the ears

If you suspect your child is suffering from otitis media you should contact your GP.  Ear infections require immediate attention.  If your child has frequently recurring infections and/or chronic fluid in the middle ear, then you maybe required to involve an audiologist and speech and language therapist.

As a parent, you are the best person to look for signs that suggest poor hearing.  Parents should not be afraid to let their instincts guide them in requesting or independently arranging for further evaluation whenever they are concerned about their children’ s health or development.