Navigating Hearing Issues That Can Affect Development

Hearing problems in children can affect their learning and speech development, but unless you’re actually in your child’s ear, hearing everything exactly as they do, how do you know if there’s something wrong? It can feel like a daunting challenge since you’re unable to physically see an issue that may be the thing holding them back, but there are signs to look out for and specific hearing issues to note.


Fortunately in today’s world of newborn screenings, serious hearing loss in infants can generally be detected early, but a range of other hearing issues can develop later in adolescence, catching a parent off guard.


There are two types of hearing loss: sensorineural (function loss within the inner ear or connecting to the brain) and conductive hearing loss (when there’s an issue in the outer or middle ear during which sound waves aren’t correctly sent to the inner ear). Each of these types can either be present at the time of birth or acquired later in life, with the latter being the most common.


Common Hearing Problems


Every parent longs to have a child who is a good listener in the broad sense, but that means we have to watch out for warning signs that perhaps it’s not her attention span that’s the problem, but rather her actual ability to hear.


Maura Marks, Ph.D., of Speech-Language and Hearing Associates of Greater Boston, breaks down some common hearing issues in children, like serous otitis, or middle ear fluid as it’s also called, which you’ll find often in little ones ages 1 through 6. “In some children under the age of 2, the length and angle of the Eustachian tube, which opens and closes and brings air into the middle ear, may not allow for the muscles controlling the opening of the Eustachian tube to ventilate efficiently,” she explains. “Over time, the air in the middle ear space is used up, resulting in a vacuum or negative pressure. This vacuum draws out the fluid lining the middle ear space. The presence of fluid causes hearing loss. If the child gets an upper respiratory illness, the middle ear fluid can become infected, resulting in a true ear infection. This infection produces gas and distension of the eardrum associated with pain and possible eardrum rupture, as well as fluid and hearing loss.”


If your tween or teen is never without his earbuds or pricy headphones he just had to have for Christmas last year, check in regularly about the volume level of his music or video game.


“Mild high frequency sensorineural hearing loss and tinnitus is associated with noise exposure, such as listening to loud music with earbuds,” says Marks. “We have a mannequin in our clinic, Jolene, that allows patients to plug in their iPod earbud into a microphone in Jolene’s rubber ear. The microphone is connected to a sound level meter which measures the sound level of the user’s preferred listening volume and indicates whether or not it is dangerously high.”


Central auditory processing disorder is a third type of hearing problem often found in children, typically associated with normal peripheral hearing and difficulties listening in competing message situations. Marks describes red flags connected to central auditory processing disorder as difficulty with the following: understanding speech in noise, learning a foreign language, processing divided attention tasks, phonological aspects of reading and improving speech articulation despite long trials of therapy, particularly with the /r/ phoneme.


Speech & Learning


As parents, we tend to watch our kids like hawks, particularly when we’re brand new to the role. Chances are you’ve read a ton of what-to-expect-style books, outlining every moment of what experts say your child should be doing at any given time. While every so often these tomes can put us on high alert for anything that doesn’t play out exactly as written, it is important to look at the major developmental milestones your child should be hitting, and if you’re concerned, do not hesitate to contact her healthcare provider.


“Most children begin babbling at 6 to 9 months, say their first words at 12 months, and have a 50 word vocabulary and begin stringing words together by age 2,” says Marks. “Some children present with delays that are similar to, but not necessarily associated with, hearing loss known as slow early speech and language development. These children are at risk for specific language impairment and should also be followed.”


If you walk into a preschool or elementary school classroom, you’re likely to see tons of bright, colorful visual cues for learning strategically scattered about, but as children get older, these are less prevalent in classrooms. At this point, children with hearing problems may start to have more academic difficulties, explains Marks. “They may have difficulty following verbal directions and recalling verbal information. They may have smaller than usual vocabularies, slower processing speed, reading difficulties and problems comprehending more abstract language, such as humor and sarcasm,” she says.


What You Can Do


If you’re concerned that there’s an auditory issue, consult your child’s pediatrician, who knows her health history best and can offer up the best protocol to follow. But it’s important to note that if an issue is indeed detected, there is support out there to help your child thrive.


“For children with chronic otitis, serial tympanometry can help identify each bout of middle ear fluid and the need for tympanostomy tubes,” says Marks. “For children with central auditory processing disorder, a variety of recommendations may be appropriate depending upon the difficulties identified. For example, an FM system [a miniature radio station where a person speaks into a microphone which is then transmitted to the listener’s ears] might be recommended for someone who has significant difficulty hearing in noisy situations, such as the classroom.”


In terms of those children diagnosed with sensorineural hearing loss, a hearing aid may be necessary. The thought and the cost of acquiring a hearing aid for your child may feel overwhelming, but consistent use can help his speech and language skills tremendously. And, believe it or not, infants as young as 4 weeks old can be fitted with hearing aids. An audiologist will determine which type of aid works best for the individual child.


“Speech and language therapy can help to improve language delays, speech production errors that can become poor oral motor habits, vocabulary and comprehension, auditory memory and recall [listening], and can provide strategic, reading and writing training,” says Marks. “The key is early identification and intervention during stages of maximum brain, language, physical and intellectual development to maximize learning potential.”


Kelly Bryant is associate editor of Boston Parents Paper.
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