Hearing Loss

What Is Hearing Loss?

Kids who have hearing loss, or hearing impairment, have trouble hearing or understanding some or all sounds. This can happen when there is a problem with:

• one or more parts of the ears
• the nerves that send sound signals from the ears to the brain
• the part of the brain that makes sense of these signals

What Are the Types of Hearing Loss?

Types of hearing loss include:

• Conductive hearing loss. This is caused by something that blocks sound from traveling to the inner ear. Ear infections, ear wax buildup, and problems with the tiny bones of the middle ear are common causes of this type of hearing loss.
• Sensorineural hearing loss (SNHL). This happens when the inner ear (cochlea) or hearing nerves are damaged. SNHL may run in families, be part of a genetic syndrome, or be caused by certain infections or medicines that damage the inner ear or nerves.
• Mixed hearing loss is when a person has both conductive and sensorineural hearing loss.
• Central hearing loss. This happens when there is damage to the part of the brain that controls hearing.
• Auditory processing disorder (APD). This is when the ears and brain don’t work well together. Kids with APD have normal hearing but something interferes with the way the brain recognizes and makes sense of sounds, especially speech.

What Causes Hearing Loss?

Many things can lead to hearing loss, but often, no cause is found. Hearing loss is more likely if a child:

• has birth defects of the ears or family members with childhood hearing loss
• was born early and/or stayed the neonatal intensive care unit (NICU)
• had newborn jaundice with a bilirubin level high enough to need a blood transfusion
• had many ear infections, a perforated ear drum, or was exposed to loud sounds
• has an infection like meningitis or cytomegalovirus
• was given medicines that can lead to hearing loss

What Are the Signs & Symptoms of Hearing Loss?

It can be hard to tell if a child has hearing loss, especially in young children. Those with hearing loss may not respond to sounds or speech. Language development may be delayed. Talk to the doctor if your child does not reach these hearing milestones in the first year of life:

• For newborns, startling or "jumping" to sudden loud noises.
• By 3 months, recognizing a parent's voice.
• By 6 months, turning the eyes or head toward a new sound and repeating sounds (like “ooh” and “aah”).
• By 12 months, making babbling sounds, responding to their name, imitating words, and saying a few words, such as "mama" or "bye-bye."

As your child gets older, signs of hearing loss may include:

• limited, unclear, or no speech
• not seeming to pay attention or follow directions
• not responding to conversation-level speech or answering inappropriately
• being easily frustrated when there's a lot of background noise
• needing a higher TV volume
• learning problems

Some hearing problems come on gradually after birth or show up later in life. If you are concerned about your child’s hearing, talk to your doctor. Your child may need to see a hearing specialist called an audiologist (od-ee-OL-uh-jist) for a complete hearing evaluation.

How Is Hearing Loss Diagnosed?

It’s best to catch hearing problems early, because treatment is more successful if it starts before a child is 6 months old. That’s why every newborn has a hearing screening test before leaving the hospital. 

If your baby doesn't have a screening before going home, or was born at home or a birthing center, get their hearing checked within the first 3 weeks of life. Not passing a hearing screening doesn’t mean a baby has hearing loss, but it does mean that the baby should be retested as soon as possible, ideally within a month of birth. If hearing loss is found then, treatment should begin right away.

Kids with typical hearing should continue to have their hearing checked at their regular checkups. Hearing screening tests are usually done at ages 4, 5, 6, 8, and 10 years, and during preteen and teen years. The doctor will also check hearing any other time there's a concern.

How Is Hearing Loss Treated?

Treatment depends on the type of hearing loss, what caused it, and how bad the hearing loss is. Children with permanent hearing loss should be seen by a team of specialists that includes an audiologist, ear, nose, and throat (ENT) doctor, speech-language therapist, and education specialist.

Medical treatments, therapy, and surgery can help kids with some kinds of hearing loss. These include:

Hearing aids.Hearing aids make sounds louder. Babies with permanent hearing loss who get hearing aids before 6 months of age have a better chance of improving their language development. No single style or manufacturer is best for every child. Your audiologist will help you choose a hearing aid based on your child's needs. Most kids with hearing loss in both ears wear two hearing aids.

Frequency modulation (FM) systems: An FM system helps reduce background noise and makes a speaker's voice louder. The person talking (like a teacher) wears a tiny microphone and a transmitter. The transmitter sends an electrical signal to a wireless receiver that the child wears either on the ear or directly in a hearing aid. It's portable and can also be used at home or other places where there is a lot of background noise.

Cochlear implants may help children with severe hearing loss when a hearing aid can’t. This surgically placed device bypasses the parts of the ear that are not working properly. It stimulates the hearing nerve directly. With training and therapy, kids with a cochlear implant can learn to hear and speak well.

Hearing habilitation helps children born with hearing loss learn how to listen and communicate. This may include auditory-verbal therapy (AVT), speech therapy, speech (lip) reading, or learning American Sign Language (ASL). Your audiologist and doctor will work with you and your child to find the best way for your child to communicate. Kids who lose their hearing when they are older also learn these communication techniques through what’s called hearing rehabilitation.

What Else Should I Know?

Even mild hearing loss can cause problems with speech, language, learning, and social skills. That’s why babies and toddlers with hearing impairment should be enrolled in early intervention, a service that offers free therapy in each state to children who qualify. Older kids may qualify for special education services once in school. Getting this help early is the best way to prevent delays and improve a child’s development.

You also can find more information and support online at:

• CDC: Hearing Loss in Children
• American Speech-Language-Hearing Association (ASHA)