Recognizing hearing loss in children – Can my child hear properly?

Definition

In order for a child to develop according to its age and learn to speak correctly, intact hearing is extremely important. Temporary hearing loss, for example due to infections, is very common. However, 2-3 out of every 1000 children are born with a hearing impairment in need of treatment. Since untreated hearing disorders have serious effects on the development and later life of the child, they should be diagnosed and treated as early as possible.

Causes

The most common causes of hearing loss in children are colds, acute middle ear infections and an enlarged pharyngeal tonsil. The middle ear cannot be properly ventilated because the tuba auditiva, a tube that connects the middle ear to the throat, is blocked. Accumulated fluid cannot drain off and sound is not transmitted properly.

Other causes can be congenital, acquired during or after birth. These can lead to permanent hearing loss or even deafness. Congenital causes include genetic defects, genetic mutations and defective mitochondria.

Furthermore, hearing disorders can also occur in combination with other diseased organs. This is called syndromal hearing loss. During pregnancy, infections, metabolic disorders and alcohol or drug abuse can cause damage to the child’s ear. During childbirth, premature births, cerebral hemorrhages, jaundice due to blood group incompatibility, injuries caused by childbirth and lack of oxygen can lead to hearing damage. Other causes that can occur during childhood are meningitis, infectious diseases such as mumps, measles, rubella or an inner ear infection.

How do I know if my child hears correctly?

Especially with small children it is often difficult to tell if the child is hearing properly. An objective test is newborn screening, in which all children should participate within the first 2 to 4 days of life. The screening includes examination for the most common congenital hearing disorders.

The examination takes a few minutes and is completely painless. During the examination, sounds are played into the ear of a sleeping child and the reaction of the ear or brain is measured. If the first test is conspicuous, further examinations are carried out.

Nevertheless, it may not be possible to detect rare or later occurring hearing impairments. To detect these, it is important to observe the child closely. It is important to observe whether the child is frequently ill, how he or she reacts to loud sounds and speech, and how speech development compares with other children of the same age, for example.

Later on, it is important to pay attention to school performance and the ability to establish social contacts. It is noticeable when the child constantly has infections in the ear, nose and throat area and is susceptible to middle ear infections. A further sign is when the child reacts weakly or not at all to acoustic stimuli, for example when there is a loud noise, does not get frightened or does not turn its head in the direction from which the noise comes.

Delayed, incorrect or nonexistent speech development is also an indication of hearing impairment. If the child is aggressive, has problems developing social contacts or difficulties at school, such as a dyslexia problem, hearing should be tested. If the hearing disorder is caused by a syndromal disease, other symptoms appear on other organs.

For example, eye symptoms, pigmentation disorders and malformations of the face (Waardenburg-Klein syndrome), kidney disease (Alport syndrome), thyroid disease (Pendred syndrome) or heart defects (Jervell-Lange-Nielsen syndrome) may occur together with the hearing problems. In addition to hearing loss or deafness, delayed or even absent speech development usually occurs. This can result in difficulties with the formation of sounds or even complete muteness. A dyslexia can also be caused by a lower understanding of language and grammar.