Around 50,000 children in the UK are deaf and in around 90% of cases, they are born to hearing parents. An awareness of how hearing difficulties present in children can help you, as a parent or carer, determine if and when it's time to seek help for your child.
Depending on the age of your child, you may notice hearing loss through a lack of responsiveness to sounds and/or speech problems.
In babies and young children that are not yet vocal, you may notice that they don’t startle in response to sudden, unexpected sounds eg the doorbell or something falling to the floor.
In older children, they may not respond to their name being called or may regularly ask you to repeat yourself, especially in noisy places or across a distance.
Speech development varies from child to child but in general starts from 12 months onwards with most children able to say 10–20 words around 18 months and 100–200 words at around two years. If your child’s speech is delayed or unclear, relative to what is expected at their age, they may have hearing loss.
Once children are in a school setting, struggling to meet age-appropriate educational goals could also be a sign that they are not hearing clearly.
If you have noticed any of these signs in your child, see your GP and request a referral to either your local hospital audiology department or to an ear, nose and throat doctor.
Hearing loss is diagnosed via a hearing assessment. How this assessment is performed varies according to the age of your child.
In babies, the assessment involves recording their brain signals while they sleep — this is called the auditory brainstem response (ABR). Recording wires will be attached to your baby’s head to monitor their brain’s response to sounds.
In young children, the hearing assessment is performed through play eg teaching your child to turn towards a sound. This is called visual reinforcement audiometry (VRA).
In older children, their hearing can be assessed using play audiometry, where they are taught to perform a given action (eg placing a peg in a board) when they hear a sound.
Depending on the results of your child’s hearing assessment and physical examination of their ears, your child may be diagnosed with temporary or permanent hearing loss.
Temporary hearing loss
The most common cause of temporary hearing loss in children is glue ear, which is medically called otitis media with effusion (OME). This refers to a build-up of fluid in the middle part of their ear, which is often caused by infections such as the cold or flu. Around 80% of children will get glue ear at some point in their lives, most commonly at ages two and four.
Glue ear most often gets better on its own, which is why your doctor will usually advise monitoring your child for three months to see if their glue ear resolves naturally.
If their glue ear doesn’t resolve and it is affecting their learning and development, your child may be referred for grommet surgery, where a tiny tube is inserted into their eardrum, or for temporary hearing aids.
Another common cause of temporary hearing loss in children is compacted earwax. This can usually be effectively treated with daily ear drops to soften the wax, which usually allows it to pass out naturally.
If their earwax continues to be a problem, after it is softened with ear drops, it can be removed via microsuction. This is where an audiologist or doctor uses a microscope and a tiny suction tube to suck the softened wax out.
Permanent hearing loss
The most common cause of permanent hearing loss in children is sensorineural hearing loss. This occurs when the cochlea, a delicate shell-shaped structure that sits within the inner ear and converts sounds into nerve signals, is damaged, or when the nerve that carries these signals to the brain is damaged.
Around two in every 1,000 children in the UK are born with permanent sensorineural hearing loss. In most cases, this type of hearing loss can be managed with hearing aids to allow the child to hear speech clearly.
However, if hearing loss is very severe (profound hearing loss), your audiologist may refer your child to a cochlear implant centre for consideration for a cochlear implant. This involves implanting a small electronic device into their inner ear, which bypasses the cochlear and directly stimulates the nerve that sends sound information to the brain.
Mr Adam Walker is a Clinical Scientist in Audiology at Spire Manchester Hospital. He holds an MSc in Audiology from The University of Manchester and completed his clinical training at South Manchester University Hospitals NHS Trust. Following this, he worked at the Manchester Cochlear Implant Programme, in 2011 he was appointed Lead Paediatric Audiologist for the Trafford Hospitals Division within the Manchester Foundation NHS Trust. Adam has gained significant experience in the field of paediatric audiology, assessing children of all ages, from newborn babies through to teenagers.
If you're concerned about symptoms you're experiencing or require further information on the subject, talk to a GP or see an expert consultant at your local Spire hospital.