Causes of hearing loss in children & symptoms to watch out for

Many people believe that hearing loss affects is merely a sign of ageing but this assumption could not be further away from the truth.

The World Health Organisation estimates that over 5% of the world’s population (360 million people) has disabling hearing loss, with 32 million (9%) of these being children under the age of 15 years. In fact, 17 babies are born with hearing loss in South Africa every day.

Undetected hearing loss in babies can lead to irreversible language, speech and cognitive delays and thus early intervention (hearing aid fitting and supportive services) before the age of six months is crucial for babies to develop and maintain normal language and cognitive development.

What are the main causes of hearing loss in children?

Middle ear infection

Middle ear infection is very common in young children because the tubes that connect the middle ear to the nose (Eustachian tubes) are not fully formed.

Fluid builds up behind the eardrum and can become infected. Even if there is no pain or infection, the fluid can affect hearing if it stays there, at least for a short time. In severe and long-lasting cases, a middle ear infection can lead to permanent hearing loss.

Problems at birth

Some children are born with hearing problems. Most of the time, the hearing loss is due to genetic factors. Others happen during pregnancy or from prenatal care. A baby born prematurely is at higher risk for hearing loss.

Illness or injury

Children can lose their hearing after they get some illnesses including meningitis, encephalitis, measles, chickenpox and high fevers. Head injuries, very loud noises, and some medications can also cause hearing loss.

Why is newborn hearing screening important?

Out of every 1 000 children born, there may be two or three who cannot hear properly. This prevalence is considerably higher than any other birth defect.

Because there are no visual indicators, most hearing-impaired children who are not screened at birth are not identified until between 18 months and three years of age, which is well beyond the critical period for healthy speech and language development.

However, with the help of newborn hearing screening, a hearing-impaired child can be identified and treated early. It has been shown by various studies that in such a case the child will most likely develop language, speech and social skills comparable to their normal-hearing peers and thus avoid a lifetime of hearing-loss related disabilities.

When should I have my child’s hearing tested?

All babies should receive a newborn hearing screening. Ask your birthing facility about available hearing screening services or to refer you to the nearest screening programme.

Despite hearing loss being one of the most prevalent conditions at birth, hearing screening is not yet part of the birth package.

You should also immediately consult your doctor, paediatrician or ENT specialist if your child complains of pain in the ear; observe discharge from their ear, hearing loss, improper speech development or when the child does not understand what you say properly.

When to suspect hearing loss in a child

If your child is not achieving these milestones, it is best to be referred to a medical professional to determine whether hearing loss is a factor.

0-3  months

• Respond to very loud sounds
• Blink in response to a bang
• Wake up when there is a sudden noise near them

3-6  months

• Turn towards the sound of mother’s voice
• Show any interest in any new sounds
• Try to localise the sound source by their head or eyes

6-12 months

• Understands small words like ‘come’, ‘bye’.
• Show interest in squeaky toys
• Make any babbling sound

12-15 months

• Respond to their name
• Start speaking small words like ‘mama’, ‘baba’, ‘dada’
• Try to imitate word they hear

15-24 months

• Puts two or more words together to make short sentences, for example, ‘more milk’

“17 babies are born with hearing loss in South Africa every day.”

Myths about hearing and speech development in children include: “If my child had a hearing loss, my family doctor would have told me.” “Family doctors do not screen for hearing loss.”

“It can be virtually impossible for your doctor to recognise hearing loss in children without hearing screening devices.” You may also have heard the following:

• Only children of deaf parents will develop hearing loss: Most children with hearing loss are born to parents who have normal hearing.
• All children who are born with hearing loss will use sign language: Many studies have shown that early diagnosis and intervention makes it possible for children to develop spoken language comparable to normal-hearing peers.
• Earbuds are for cleaning ears: The correct term for earbuds is actually cotton buds. Cotton buds are dangerous when used in ears and can cause punctured eardrums and super impacted wax. There are many negative consequences associated with DIY ear cleaning.
• Boys talk later than girls: Although boys produce their first words and sentences slightly later than girls, these differences are only of a matter of a few months. There is a normal range within which children acquire certain language milestones.
• Late talking children, who are otherwise developing normally, always “catch up” to other children their age: Research indicates that up to half of children who are late talkers do not catch up on their own. Therefore, if you are concerned about your child’s language development, don’t listen to people who tell you to wait and see. Consult an audiologist or speech-language as the earlier a child receives help, the easier it is to catch up, and the better the prognosis.

Information supplied by the Western Cape Department of Health

NEXT READ: Common causes of speech & language delays in children