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Hearing Loss

Dear Debi,
Iíve noticed that a 4-year- old girl that I am caring for isnít speaking very clearly. Could this be due to a hearing loss?
Jessica, San Clemente, CA
Debi's Tips
Debi Gutierrez
Debi Gutierrez
  • Diagnose and treat childhood hearing problems as early as possible
  • Hearing impairment can impact social and academic development
  • Any suspicion of hearing loss warrants immediate attention
  • Treat ear infections immediately Share any concerns with parents
Expert Advice
Janice Myck-Wayne
Janice Myck-Wayne
Los Angeles Unified School District
Thereís more than one kind of childhood hearing loss. Thereís congenital hearing loss, which occurs during pregnancy or immediately after birth. Thereís post congenital and pre-lingual hearing loss, which happens before a child develops language skills. Thereís also post-lingual hearing loss, which occurs after 2 years of age. Meningitis is a major cause of pre-lingual hearing loss. Meningitis can happen any time in a childís life, but we have several children who got meningitis at age 2, and it wiped out their hearing all together.

Two to three percent of the total population has a hearing loss, and the same percentage applies to kids. The good thing is, now California has a hearing screening program for newborns. Now parents can have their kids screened right away at childrenís hospitals in the state. If a provider was worried about a child, they can automatically ask the parent, ďDid they have a newborn hearing screening?Ē It may detect just a mild hearing loss, but itís up to the parents to follow up on it.

I strongly believe in testing for hearing at birth. I wasnít diagnosed until I was 8 years old, so my parents missed all that time in between to help me. Unfortunately, a lot of pediatricians still believe the myth that a hearing impairment canít be detected until the child is three years old, which simply isnít true.

There are different types of hearing loss in children. Otitis media, or middle-ear infections, is the most common form of temporary hearing loss. Chronic ear infections are when the middle-ear fills up with fluid. Itís like being under water. They usually clear up with antibiotics. This is usually considered a conductive loss.

Otitis media, or middle-ear infections, are so common in children because kids get colds and itís just another form of a cold. Part of the cranial structure goes from your nose to your middle ear. With some kids, thatís flat and itís like bad plumbing. Usually when kids get to about 5 years of age, ear infections become fewer and fewer.

Hearing does impact speech and language development. If a child canít hear all the sounds, the childís speech will reflect that. If a child canít hear, theyíll have a speech delay and need some other way to communicate.

There are lots of different types of professionals who can help you deal with hearing loss of a child. An audiologist assesses and treats hearing loss through testing and other services including managing and providing hearing aids when necessary. A speech and language pathologist diagnoses and treats speech and/or language disorders. An otolaryngologist diagnoses and often provides surgery for hearing losses. These doctors are frequently also called ENT (Ear, Nose and Throat doctors).

If a parent suspects their child might be experiencing hearing loss, I tell parents and providers to talk to their pediatricians first. With HMOs, you need to get a referral to see a specialist. Most childrenís hospitals have speech and language and audiology clinics. You also might have a provider contact their local school district. California Early Start Services has an 800 number and a great website too.
Child Care provider Comments
Darlene Patterson
Darlene Patterson
Family child care provider for 22 years and mother of three
I noticed that a child in my cared could have been experiencing hearing loss. When the baby was 3 months old, I noticed her cry was really low. By the time she was 7 months old, she wouldnít flinch if there was a loud, sudden noise Ė nothing could startle her. Then the mom took her to the doctor and they said she was only picking up muffled sounds, so they tried a hearing aid. She ended up taking sign language classes.

I had to keep my eye on her so she could show me what she was trying to say. Now at 7 years of age, she can sign well and sheís attending a school for the hearing impaired. Her parents were really thankful to me because they had noticed things, but were in denial. I always tell providers to watch the children. If you see something that could be a problem, keep an eye on it, and tell the parents.
Family child care provider for 5 years
A child I care for has a hearing problem. He had a lot of ear infections as an infant. I took him to treat the infections, mainly through the first year and a half and they stopped being so frequent, so I thought everything was OK. Then I noticed that his response was different on the right side than on the left side. One night I was bathing him and I asked him a question in several voice levels and he wouldnít respond until I used a loud voice. He said he hadnít heard me at all.

I took him in and the doctors gave him a hearing test. It turned out that he has a minimal hearing loss on the right ear. Because there wasnít really a family history of hearing impairment, the doctor attributed it to ear infections. He told me there wasnít really anything I could have done differently. Some children are just prone to infections. The doctor recommended a yearly hearing evaluation to make sure it doesnít worsen.
Provider for 10 years
There is one boy I care for that we noticed had a hearing loss. I noticed a lot of times when I would call for him; on one side he was OK, but on the other side he wouldnít respond at all. I talked to the parents and gave them my observations and concerns. The mother said she had noticed it, too. The mother then took him to be checked out and they figured out he couldnít hear in his left ear. Once I knew that he had a hearing loss, I would only speak to him on his right side or stand right in front of him when talking to him so he could read my lips.

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Hearing Loss
Topic: Special Needs
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