Most children hear and listen from the moment they are born. They learn to talk by imitating the voices of their parents and caregivers. But not all children – two or three out of every 1,000 children in the United States are born deaf or hard-of-hearing. More lose their hearing later during childhood.
Jose Manaligod, MD, pediatric otolaryngologist at University of Iowa Children's Hospital, talks about pediatric hearing loss:
In Iowa, when is the first time a child's hearing is tested?
In Iowa, we have universal hearing screenings, so all children are tested shortly after birth, or if they're hospitalized for an extended period of time in the intensive care unit, or before they get discharged.
Do all states have hearing tests required as part of the newborn screening process?
Most states do have universal screening now, but some are still voluntary. Iowa has had universal screening since 2003.
What is the most common cause of deafness children? Of hearing difficulties?
There can be a number of reasons and it depends on their age as far as what's most common. For school age children, ear infections become a big part of hearing loss—it's just fluid that's persistent despite antibiotics.
If you look at the newborn population, there can be a number of other reasons that can cause central neural hearing loss—problems with the inner ear such as viral infections and certain medications can cause problems with the inner ear development and hearing.
A larger number of patients who do have hearing loss, have genetic origins for their hearing loss.
As a child ages, what are some of the environmental things that may cause hearing loss?
Certainly environmental things such as excessive noise exposure over time can cause damage to the inner ear. Things like head trauma, infections such as meningitis, or even persistent ear infections can also cause some permanent hearing loss, as well.
What are the signs of hearing loss in a child?
In a newborn, this can be very difficult to figure out since you don't have a lot of clues. Basically, if they don't startle to loud noises, if they don't respond the way you would expect to a parent's voice, those are the things that can be a sign of hearing loss. As children get older, you see things like problems with language development, speech, and problems with school or behavioral issues.
How does undetected hearing loss affect a child in school?
School performance can be significantly affected by hearing loss. In school, the classroom can be very noisy and it's in noisy situations that hearing loss can be most significant as far as affecting a child. A number of studies have shown that even mild cases of hearing loss can have a big impact on how a kid does in school.
How often should a child's hearing be tested?
Other than the universal hearing screening, in Iowa they usually check children when they're preschool age. As far as school age children, they're usually tested by the schools every year.
What does testing include for a child?
For a newborn screening, we do what is called an automated ABR test where they place some sensors on the child's head and see how the brain waves respond to normal auditory stimulus. As kids get older, this involves behavioral testing, where you see how a child responds to hearing tones and the normal sound frequencies for a child.
How is hearing loss treated in children?
For kids that have hearing loss related to fluid or ear infections, they are treated first with antibiotics or sometimes time will resolve the fluid. If that doesn't work, children may need tubes to remove the fluid and restore the hearing.
A newborn or a child may have delayed hearing loss from inner ear problems. Those children may need hearing aids to improve their hearing. For severe cases of hearing loss where hearing aids can't help, sometimes those children will need cochlear implants.
Is UI Children's Hospital involved in any research with regard to hearing loss in children?
Oh yes. We have a number of research projects involving hearing loss in children. We have probably the largest pediatric cochlear implant program in the country that's headed up by Bruce Gantz, MD, and his team. Richard Smith, MD, pediatric otolaryngologist, heads up a laboratory that looks into the genetic causes of hearing loss. He has a clinical screening laboratory that does a lot of genetic screenings for patients in Iowa and around the country.
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