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Hearing Assessments for Detection of Hearing Loss in Children


Around 3 in every 1000 babies are born with hearing loss. Another estimate suggests that around 15% of schoolchildren have some degree of hearing loss. Congenital and early onset hearing loss presents a unique challenge to the child and their family in terms of speech, language, social, emotional and academic performance.

Here are some ways hearing loss can significantly affect children:

Speech & Language Development

Children with untreated hearing loss often struggle to acquire language and speech. Their development may be delayed when compared to normal hearing children. Additionally, they may miss out on certain high pitch consonants such as ‘s’, ‘sh’, ‘t’ and ‘k’. When they do not hear these sounds, they are unable to imitate them properly and this could lead to the formation of articulation disorders such as a lisp.

Academic Performance

Hearing loss makes following conversations and understanding spoken language more difficult. This effect is exacerbated in school where the child has difficulty learning new material due to noisy classroom environments. Unsurprisingly, children with untreated hearing loss do not do as well as children with normal hearing. Over time, the gap in academic performance grows. This will contribute to feelings of helplessness and frustration and eventually the child may lose interest in studies altogether.

Social & Emotional Development

Children with hearing loss may feel isolated or left out of social situations, particularly if they have trouble understanding what others are saying. This can impact their social development and interpersonal relationships. Hearing loss can also influence a child's emotional development. They may feel frustrated, anxious, or disappointed with their inability to hear and communicate effectively with others.

Types of Hearing Tests for Children

There are various tests that can be used to detect hearing loss in children. The type of test used depends on the age of the child and their level of physical and cognitive development. For infants, Automated Auditory Brainstem Response (AABR) is usually used to screen their hearing shortly after birth. AABR estimates hearing level in response to sound by measuring the neuronal activity in the brain with electrodes placed on the scalp. It is typically done when they are asleep. Some hospitals may prefer to use Otoacoustic Emissions (OAE) or a combination of both during hearing screening. If the child passes this stage, they can be discharged and brought home. However, if they fail the screening round, they are usually referred for further management.

In children aged between 6 months and 2 years, Visual Reinforcement Audiometry (VRA) is used. VRA is a procedure in which the child is conditioned to turn their head in response to sound. The test aims to find the lowest level of sound that elicits a reliable response, otherwise known as the hearing threshold. Normally we expect children to have hearing thresholds at or better than 15dB HL. This cut-off level allows the child to receive the full spectrum of spoken sounds and promote language development. At minimum, the child needs to be able to sit upright as a condition to perform this test.

When they have reached the age of 2 years, children can undergo Play Audiometry in which the child performs a simple task when they hear a sound. It often involves putting a toy in a bucket or placing a puzzle as a response to sounds from headphones or a loudspeaker. This can help audiologists diagnose the severity and type of hearing loss. If hearing loss is diagnosed, hearing aids can be prescribed and fitted based on the hearing thresholds obtained from the test results.

Possible Treatments for Hearing Loss in Children:

The treatments for hearing loss in children depends on the severity of the loss and the cause of the loss. Interventions range from hearing aids, cochlear implants, speech therapy, and auditory training. Since hearing loss is not always distinctly visible, it is important for all children to be tested to ensure they have access to these vital services.

The Joint Committee on Infant Hearing (JCIH) is an organization which provides guidelines for supporting infants and young children who are deaf or hard of hearing. According to JCIH 2019, children should have their hearing screened before 1 month of age, and those who do not pass should have a diagnostic assessment no later than 3 months of age. By 6 months, infants with hearing loss should have access to treatment.

Early detection of hearing loss in children is vital for their speech and language development. This is essential to ensure they can keep up with the developmental rates of their normal hearing peers and enrol in mainstream schools. Hence, it is critical for parents and healthcare providers to be proactive in identifying and treating hearing loss in children as soon as possible.Visit this page or call us at 1800-88-2032 if you would like to schedule a hearing assessment for your child today. Because every second counts.

Patrick Seow, Clinical Audiologist at 20dB Hearing

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