Hearing Loss in Children: Early Detection and Treatment
Before a baby鈥檚 first babble, language development begins through exposure to voices, music, and everyday sounds. But what happens when that connection to sound is missing from the start? For thousands of newborns each year, hearing loss is a hidden challenge. If left untreated, it can impede speech learning and development to the point that your child may struggle socially and academically. Fortunately, early intervention can significantly improve quality of life for children with hearing loss.
Causes of Hearing Loss and Types
鈥淜nowing the cause of your child鈥檚 hearing loss can be very important, because it can dictate the best treatment and prognosis,鈥 says Albert H. Park, MD, director of the pediatric hearing center at 91麻豆天美直播 and Primary Children鈥檚 Hospital.
Hearing loss in children can be (present at birth) or acquired. About 50% of such cases are caused by genetics, while the second-leading cause is cytomegalovirus (CMV), a viral infection passed from a pregnant mother to her unborn baby.
There are three types of hearing loss:
- Conductive: This is the most common type of acquired hearing loss, which is usually caused by ear infections or the buildup of excessive earwax. Less common causes include cholesteatoma, a type of skin tumor in the middle ear or hearing bone abnormalities. Conductive hearing loss happens when sound cannot travel through the outer and middle ear.
- Sensorineural: This hearing loss affects the inner ear or cochlea and can be either congenital or acquired. It has a range of causes, including CMV infections, genetic mutations, ear injuries (meningitis), and prolonged exposure to loud noise or acoustic trauma. High-intensity sound through earbuds or headphones is a common cause of acquired hearing loss. An estimated 15% of teens may experience some level of high-frequency hearing loss as a result.
- Mixed: When a patient has conductive and sensorineural hearing loss.
Ongoing clinical trials suggest gene therapy may be effective for one of the genetic causes of hearing loss (otoferlin). If a genetic mutation is the cause of hearing loss in an infant, then gene therapy may be used in the future to improve or even cure the condition.
Screenings and Intervention
The most effective way parents can protect their child鈥檚 hearing is to take any signs of hearing loss seriously and get help without delay. When it comes to early intervention in hearing loss, pediatricians should follow the 1-3-6 rule. This means the following:
1- The first hearing screening should occur within the first month of a child鈥檚 life. Fortunately, 98% of all infants are tested through universal newborn screenings.
3- Those who don鈥檛 pass the newborn screening should undergo a diagnostic evaluation before reaching three months of age.
6- If an infant is diagnosed with a permanent hearing loss, they should start receiving early intervention by six months of age.
Studies show that treatment within the first six months of life is essential for speech and language development.
鈥淚f your child fails a newborn screening, take that seriously,鈥 Park advises. 鈥淚f your child is found to have a permanent hearing loss, it is essential to make that diagnosis as soon as possible. It鈥檚 not something you want to ignore.鈥
Diagnosis and Treatment Plans 聽
Outside of the usual screenings, the signs of hearing loss in babies can be difficult for parents to detect. Parents may notice that their baby does not startle at loud noises or turn around in response to sounds. Any concerns parents have about their child鈥檚 hearing should be brought to the attention of their pediatrician, who can refer the child to a pediatric audiologist to test their hearing. If any hearing loss is detected, children are referred to a pediatric otolaryngologist, who specializes in treating pediatric cases of hearing loss.
As a child grows older and starts attending school, they may exhibit subtle behavioral changes associated with hearing loss. Their teacher may notice the child is not as attentive to instructions, or there鈥檚 an academic drop-off. Experts in the hearing field often mention the term auditory fatigue.
鈥淚n school, kids with hearing loss have to use more visual or other ancillary cues to understand the context of what is being spoken,鈥 Park says. This extra workload often exhausts a child mentally and emotionally.
Treatment plans will vary based on the kind of hearing loss a patient has, but may include:
- Follow-ups with the otolaryngology or audiology team for close monitoring
- Assistive devices, such as hearing aids
- Cochlear implants for sensorineural hearing loss or other types of hearing loss in patients who have not benefited from hearing aids
- Speech and language therapies
- Antiviral medications such as valganciclovir for severe CMV disease
Hearing shapes how children connect with the world around them. Early detection and timely treatment of hearing loss can impact how they hear, grow, and learn.
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