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The Most Common Causes of Hearing Problems in Children

Published: 5th January 2024 11:42

Hearing loss in children can have significant impacts on their development, including problems with speech, language, learning, and social skills. Unfortunately, hearing problems in children are relatively common, but many of them can be managed with early identification and intervention. This article explores some of the most frequently occurring causes of hearing impairment in children.

Congenital Hearing Loss

One major cause of hearing difficulties in children is congenital hearing loss, meaning the child is born with some degree of hearing impairment. This type of hearing loss occurs in approximately 1 in every 1,000 births in the UK. The reasons for congenital hearing problems can include genetic factors passed down through families, complications during pregnancy or childbirth, viral or bacterial infections in the womb, and premature birth. In many cases, a specific cause for congenital hearing impairment cannot be identified. The severity of congenital hearing loss can range from mild to profound.

Ear Infections

Ear infections, either acute or chronic, are another prevalent source of hearing loss in children. The most common type is called otitis media with effusion, which refers to a buildup of fluid deep inside the ear due to an infection or inflammation. This fluid blocks sound from passing through the middle ear area. Ear infections tend to be most frequent between ages 6 months and 3 years when the eustachian tube that connects the nose/throat to the middle ear is still developing. Childhood ear infections can cause temporary hearing difficulty during the active infection or longer-lasting problems if they recur and lead to other complications. Prompt antibiotic treatment and ear tube surgery are often helpful interventions.

Noise Exposure

Loud noises can damage the delicate hair cells inside children’s ears, causing noise-induced hearing loss. Noises above 85 decibels (about as loud as heavy city street traffic) are considered potentially harmful. Some toys, fireworks, loud music through headphones, vehicle sounds, and other noise sources pose a risk to kids' hearing. Noise exposure typically triggers gradual hearing reduction over time, but extremely loud bursts of sound can even rupture eardrums. Watching volumes and limiting duration around noisy activities can help safeguard children’s hearing. Earplugs or protective earmuffs are useful too.

Otitis Externa

Sometimes called “swimmer’s ear,” otitis externa is marked by infection, swelling, or irritation of the ear canal skin. This outer ear infection is often sparked after water gets trapped in the ears. Too much moisture allows bacteria and fungi to breed, triggering inflammation. Otitis externa is most prevalent in the summer months when kids spend more time in pools or lakes. In addition to pain in the ear, symptoms can include fullness/blockage sensation, discharge, headaches, and slight hearing changes. Careful drying of the ears after swimming along with ear drop antibiotics usually clears up otitis externa infections.

Medications & Chemotherapy

Certain prescription drugs and chemotherapy agents have ototoxic side effects, meaning they can bring about hearing loss or other ear problems. Antibiotics like gentamicin, cancer medications like cisplatin, and loop diuretics like furosemide are some of the top offenders for ototoxicity risks. The hearing loss these drugs trigger might emerge right away or gradually over the course of treatment. Sometimes the ear damage continues to progress even after stopping the medication. Close monitoring of hearing function is wise during and after rounds of potentially ototoxic therapies.

Wax Blockage

Earwax protects kids’ ears from damage and infections. But an excess buildup of wax can harden inside the ear canal and block sound waves from moving through, causing temporary conductive hearing loss. Kids who wear hearing aids or ear tubes/grommets are especially prone to wax blockages. Using cotton swabs to try removing the clogging wax tends to just push it in deeper. Ear irrigation performed by a doctor is usually the most effective wax removal technique. Over-the-counter wax-softening ear drops can help facilitate the wax’s breakdown and drainage too.

The Importance of Early Identification

While pinpointing the exact reason for a child’s hearing loss is helpful, promptly detecting that hearing difficulties exist is most vital. Identifying congenital or early childhood hearing impairment by 3-6 months of age has huge implications for kids’ development. Early detection allows for earlier intervention through hearing devices, speech therapy, or sign language training during crucial learning periods.

In the UK, all newborns are offered the Newborn Hearing Screening test, which uses automated technology to check hearing responsiveness. Extra diagnostic audiology testing follows a “refer” result. For older toddlers and children, hearing challenges often become apparent through delayed speech development or improper responses. Seeking paediatric audiology referrals to examine any suspected problems is key.

Managing Childhood Hearing Loss

Once hearing loss is uncovered in a child, the focus shifts to management. Many of the causes of hearing impairment discussed above are receptive to treatments that restore some or all hearing function. But permanent sensorineural hearing loss usually necessitates ongoing assistive interventions:

Hearing Aids – These electronic amplification devices help children utilise as much of their remaining hearing ability as possible. Different styles like behind-the-ear, in-the-ear, and completely-in-canal models are programmed to a child’s exact loss pattern and needs. Most hearing aids can be synced with classroom speakers/microphones and other audio sources too.

Cochlear Implants – Children with severe-profound sensorineural hearing loss who get little benefit from traditional hearing aids may be candidates for cochlear implants. This system uses an implanted receiver and electrodes to directly stimulate the auditory nerve. The external parts include a microphone, speech processor, transmitter coil, and remote. With intensive speech therapy, cochlear implants often enable children to understand speech solely through hearing.

FM Systems – Older children using hearing aids or cochlear implants commonly utilise FM systems at school. The teacher wears a small microphone that transmits their voice directly to the student’s listening devices through radio waves rather than acoustically. This reduces background noise interference and makes understanding lessons easier.

Speech Therapy – Most deaf/hard-of-hearing children can gain oral language abilities with sufficient speech-language therapy guidance. Specialists work on sound production, listening skills, conversational turn-taking abilities, and expanding vocabulary.

Sign Language – For profound hearing losses unlikely to improve with amplification, learning British Sign Language gives children full access to communication and social connections. Families often learn alongside children as well.

While frightening at first, childhood hearing loss is often quite manageable, especially when identified early.

 

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