Kids and Hearing Loss

What You Should Know

Hearing Loss
Ear Infections

Hearing Loss

Hearing loss affects approximately 17 in 1,000 children under age 18. Infants and young children with hearing problems can have difficulty developing speech and language skills. Some babies are born with hearing problems, while children born with normal hearing can sometimes develop hearing problems as they grow older.

Causes

Hearing problems can occur because of ear infections, injuries, or diseases. They can be temporary or permanent. Hearing loss falls into one of three categories:

• A conductive loss is caused by something that stops sounds from getting through the external or middle ear
• A sensorineural loss occurs when there is a problem in the way the inner ear or hearing nerve works
• A mixed hearing loss includes both a conductive and a sensorineural

Diagnosis

An early and correct diagnosis is critical for a child’s optimal speech and language development. Shohet Ear Associates offers a full range of diagnostic and treatment services for hearing loss in children. They include:

• Audiograms - measure how well a person hears
• Tympanometry - assesses the status of the eardrum and middle ear
• Otoacoustic emission testing (OAE) - gauges inner ear (cochlear) hair cell function
• Electrocochleography (ECOG) and Auditory brainstem response(ABR) - assess nerve signals in the inner ear
• Multiple auditory steady state evoked response (MASTER) - also known as ASSR, assesses multiple frequencies at the same time as well as binaurally, significantly reducing testing time

Our pediatric audiologist specializes in evaluating and assisting children with hearing loss and offers a full range of diagnostic testing and pediatric services.

Treatment

Treatment of hearing loss in children depends on each child’s unique needs. Hearing aids can be very effective in helping to restore or enhance hearing.

Fitting a child with hearing aids as early as possible as well as with the most appropriate hearing instrument is our goal. Accessories such as smaller earhooks (a way to secure the hearing aid to the child), a lock on the battery door to prevent a child from removing the battery, and audio input boots for FM compatibility are all ways to make pediatric fittings successful. We base our fittings on well researched algorithms that allow the child to make the most of their environment and maximize speech and language.

At Shohet Ear Associates, we try to make wearing hearing aids fun. We offer pediatric “care packages” that include a colorful backpack or pouch with tools needed to help kids and their parents care for their hearing aids, a stuffed animal, and an illustrated story to help children understand their hearing loss and hearing aids. In addition, we can provide support material for the child’s teachers and caregivers.

Children with profound hearing loss may benefit from a cochlear implant, which helps compensate for damaged or non-working parts of the inner ear. Even young children can be candidates for implants. Cochlear implants, coupled with intensive post-implantation therapy, can help young children to acquire speech, language, developmental, and social skills. Our goal is to implant children as soon as a severe to profound loss is identified and the child has failed to progress developmentally with traditional hearing aids. We value and invite input from the child's educators and speech pathologists in determining the child's candidacy and rehabilitation needs.

Ear Infections

Otitis media refers to inflammation of the middle ear and is the most common cause of earaches. When infection occurs, the condition is called "acute otitis media." Acute otitis media can occur when a cold, allergy, or upper respiratory infection--or the presence of bacteria or viruses--leads to a build-up of pus and mucus that blocks the Eustachian tube. The build-up provides a fertile breeding ground for bacteria that can cause inflammation or infection.

If otitis media lasts for weeks without clearing up despite treatment, it is called chronic otitis media. A fluid buildup in the ear without infection is termed serous otitis media.

Three out of four children will develop otitis media by the time they are 3 years old. In fact, ear infections are the most common illnesses in babies and young children.

Symptoms

The most common symptoms of ear infections are mild to severe ear pain, fluid draining from the ears, fever, and trouble sleeping or hearing. Babies may pull or tug at their ears. Otitis media may result in serious complications if it is not treated. An untreated infection can travel from the middle ear to the nearby parts of the head, including the brain. Although the hearing loss caused by otitis media is usually temporary, untreated otitis media may lead to permanent hearing impairment. Persistent fluid in the middle ear and chronic otitis media can reduce a child's hearing at a time that is critical for speech and language development. Children who have early hearing impairment from frequent ear infections are likely to have speech and language disabilities.

Causes

Middle Ear infections are caused by bacteria and viruses. They can occur as a result of another illness, such as a cold. During an ear infection, the eustachian tubes-- which connect the middle ear to the throat--can become blocked. This prevents fluid from draining from the middle ear and offers a perfect breeding ground for an ear infection.

Diagnosis

An ear examination using an otoscope or microscope will be conducted to determine the presence of an ear infection. A test called typanometry evaluates the movement of the ear drum. Children with chronic ear infections should also have a hearing test to determine if a hearing loss has occurred.

Treatment

Antibiotics may be used to treat ear infections and can be very effective. In cases where the infection continues despite antibiotic treatment, a procedure called tympanocentesis can remove the fluid temporarily and allow for identification of the bacteria.

Once the infection clears, fluid may remain in the middle ear for several months. Middle ear fluid that is not infected often disappears after three to six weeks. If the fluid persists for more than three months and is associated with a loss of hearing, surgery to insert "tubes" in the affected ears may be indicated. This operation, called a myringotomy, can usually be done on an outpatient basis. The tube ventilates the middle ear and helps keep the air pressure in the middle ear equal to the air pressure in the environment. The tube normally stays in the eardrum for six to twelve months, and is usually expelled spontaneously.

Hearing is usually fully restored once the fluid is removed. Some children may need to have the operation again if the otitis media returns after the tubes come out. While the tubes are in place, water should be kept out of the ears.