Introduction
Hearing loss in children is important to diagnose and treat promptly as it can affect speech and language development as well as impact on learning and behaviour.
Causes
Children born in Australia undergo newborn hearing screening called SWISH (Statewide Infant Screening of Hearing) in NSW. Genetic or congenital (present at birth) causes of hearing loss may be picked up during this screening and referred on for further investigations.
The most common cause of hearing loss in children is otitis media with effusions (fluid behind the ear drums). It develops due to poor Eustachian tube function (the tube connecting the ears to the nose), or after ear infections. This causes a conductive hearing loss where sound cannot travel properly through the ear to the brain. Wax impaction can also cause a conductive loss. Rarely, children may have problems with the cochlea (hearing organ) or hearing nerve, causing a sensorineural loss.
Symptoms
Hearing loss in children may go undetected for some time as they often do not complain of hearing difficulties. Children with hearing loss may have no issues one on one, but then struggle when there is background noise e.g. in the classroom. Sometimes children will speak very loudly or have the television turned right up.
Speech delay or learning difficulties should always prompt investigation of hearing, as normal hearing is critical for speech and language development. Other signs such as frustration, poor concentration or behavioral problems may also prompt investigation of hearing.
Diagnosis
The diagnosis relies on an audiogram (hearing test) after Dr Levin has taken a detailed history and performed a physical examination. This will give information about the type of hearing loss (conductive versus sensorineural) and the degree of the loss (e.g. mild, moderate, severe). Part of the audiogram will also test the function of the Eustachian tubes and determine whether there is fluid behind the ear drums.
Dr Levin has a paediatric audiologist on site in his Macquarie street rooms who is fantastic with children and should be able to perform accurate testing for your child in a stress-free environment.
Treatment
Hearing loss due to Eustachian tube dysfunction is often temporary and Dr Levin may advise to observe your child and repeat the audiogram in approximately 3 months.
When there is associated speech delay, or when hearing loss has also been associated with several middle ear infections, then grommets may be indicated. Dr Levin will be able to discuss whether your child is likely to benefit from grommets or can be managed conservatively.