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Hearing loss in young children



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Hearing loss in infants and children is comparatively common. Many children will have episodes of temporary deafness.

Prevalence:

Hearing loss in infants and young children is comparatively common. Many children will have episodes of temporary deafness. In other children, permanent losses of varying severity may be overlooked. Unmanaged hearing impairment can result in delays to language and learning which may be irreversible. If such delays are to be avoided, disabling hearing loss should be identified, and management commenced, as soon as possible.

Degree of loss:

Fortunately, few hearing impaired children have complete hearing loss. Unfortunately, our present records suggest that moderate to severe hearing loss is not identified on the average until 30 months of age. Mild losses are frequently identified even later. Hearing is often not queried until obvious delays in speech and language development have already occurred. This may be as late as two, three or even four, years of age.

Risk Factors:

Approximately 50% of children with permanent hearing loss will ultimately prove to have an identifiable risk factor, however, this is not necessarily known before hearing is queried. In any event, it is clearly not appropriate to follow children at risk of hearing loss, waiting for signs of that hearing loss to occur. It is important to remember that hearing can be tested from birth.

It is never too early to test hearing... and, if there is any reason to suspect hearing loss, it is more important to refer than to wait.

Appropriate hearing tests for infants and young children:

Recommended screening tests:

Newborns and infants:

Otoacoustic emission (OAE) and/or automated auditory brainstem response (AABR).

Recommended diagnostic tests:

* Infants between 6-9 months adjusted developmental age:

Auditory brainstem response (ABR).

* Infants 6-9 months to 3 years:

Visual reinforcement (‘puppet show’) audiometry (VROA). This relies on a conditioned response to a frequency-specific stimulus.

* Children 3 years plus:

Play audiometry. This is standard threshold audiometry adapted to a child’s level.

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Last updated 4 May 2009

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