Hearing Loss

Signs and Symptoms

Hearing can be tested at any age. Infants are screened for hearing loss shortly after birth, before leaving the hospital. However, hearing loss is not always present this early and can develop at any time.

There are three main types of hearing loss:

• Sensorineural Hearing Loss — This is hearing loss that is the result of a disorder of the inner ear called the cochlea, or the auditory nerve that transmits an auditory signal. There are many different causes of sensorineural hearing loss including congenital infections, medications, over-exposure to noise and genetic factors. In half of the cases of hearing loss present at birth, called congenital hearing loss, the cause is not determined. Sensorineural hearing loss is usually permanent.

• Conductive Hearing Loss — This type of hearing loss is the result of a disorder affecting the outer or middle ear, such as ear infections associated with fluid in the middle ear space. Middle ear infections are the second-most common reason children visit a doctor. Generally, when children have middle ear infections with fluid in their ears, they have an accompanying hearing loss. Other common causes of conductive hearing loss include excess wax, foreign bodies or problems with the three bones in the middle ear. In many cases, conductive hearing loss can be treated either medically or surgically, and may not be permanent.

• Mixed Hearing Loss — Some children have a combination of both sensorineural and conductive hearing loss.

Review Signs of Normal Hearing to find a list of normal hearing behaviors and key signs to watch for as your child grows. If your baby's hearing was not checked at birth, talk to your pediatrician about scheduling a hearing screening test.

If you have concerns regarding your child's responsiveness to sound, discuss your concerns with your pediatrician and request that an evaluation be completed by a hearing specialist called an audiologist. Most importantly, parents should trust their intuition. If you feel that something just "isn't quite right" about your baby's responsiveness to sound, talk to your pediatrician.

Diagnosis

Children are evaluated for hearing loss based on developmental abilities. Various tests are available to assess:

• Whether hearing loss has occurred
• Degree of hearing loss
• Type of hearing loss

The evaluation is tailored to each child and to make the test as efficient as possible. To learn more about the audiologic tests used for infants and children, please see Hearing Tests for Children.

Treatment

A few causes of hearing loss are treatable in infants and children. If a child has a temporary loss of hearing due to an ear infection, fluid behind the eardrum or excessive wax in the ear canal, it is likely that their pediatrician or otolaryngologist, an ear, nose and throat specialist, can successfully treat the condition. Other cases of hearing loss are caused by problems with the bone structures in the middle ear and these sometimes can be treated surgically when a child is older, around 7 to 9 years old.

Permanent Hearing Loss

In infants and children, sensorineural hearing loss — typically permanent hearing loss that is the result of a disorder affecting the inner ear, called the cochlea, or the nerve that transmits auditory signals, called the auditory nerve — usually cannot be medically or surgically treated, but can be managed successfully with help from an audiologist and other experts. In addition, it is imperative that doctors fully evaluate children with hearing impairment for other disorders, including visual or kidney defects.

There are many options in the management of permanent hearing loss, and your audiologist will provide you with information and resources to help you make the best decisions for your child. Some of these options include:

• Amplification
• Communication options, such as oral language, sign language or a combination of both
• Educational options, such as programs emphasizing listening and speaking, sign language or a combination
• Speech and language therapy

There is no correct choice when it comes to managing your child's hearing loss. The pediatric audiologists at UCSF Children's Hospital will help you make choices with all the information possible. It's important to remember that the choices you make for your child may change as your child develops.

Corrective Options

Hearing aids and cochlear implants are two options available for some children, depending on their degree of hearing loss.

In general, children with mild to severe hearing loss are candidates for using hearing aids. For more information on hearing aids, please read Hearing Aids.

If your child has a severe to profound hearing loss and doesn't obtain adequate benefit from hearing aids, he or she may be a candidate for a cochlear implant. To learn more, please visit the Cochlear Implant section.