Height, weight, heartbeat and reflexes. These are all important measurements that your child’s pediatrician logs at every well-child visit. But when the doc asks how many words your child is saying and how clear their speech is, the physician is doing more than completing a developmental checklist. They’re also assessing your child’s hearing.
“In the state of Michigan, every child has a newborn hearing screening at birth, before being discharged from the hospital,” explains Dr. Bianca Siegel, a pediatric otolaryngologist at Children’s Hospital of Michigan. Known as an auditory brainstem response test, this screening measures the neural response to sounds presented in the ear. Babies born prematurely and those who spend time in neonatal intensive care are at a higher risk for hearing loss, Dr. Siegel says.
As a pediatric ear, nose and throat physician (ENT), Dr. Siegel sees a variety of types and causes of hearing loss among her patients. “Sometimes the hearing loss is a permanent sensorineural hearing loss, and sometimes it is a conductive hearing loss which can be due to things like pressure regulation issues or eardrum perforation,” she says. “Conductive hearing loss is also often caused by fluid in the ear and we can try medical treatments like nasal decongestants and allergy medications to dry up the fluid, or place tubes.”
If a baby passes the newborn screening, they may not have another hearing test for quite some time. Even though most public school districts still do hearing screenings, there is no mandated testing and therefore testing is somewhat inconsistent. Currently, with the disruption of COVID-19, these screenings may not even be taking place in many cases.
If parents are concerned about their child’s hearing, they can visit an ENT for a complete assessment, which would also include seeing an audiologist. “The ENT will evaluate the ears for things like ear wax or fluid build-up, which can affect the hearing. The audiology assessment may include testing with probes in the ears to monitor reflexes and eardrum mobility. It might also include sitting in a booth, wearing headphones and signaling when they hear beeps. For younger children, the sound is piped directly into the booth and the audiologist watches the child for a response,” Dr. Siegel explains.
What do you need to know about your child’s hearing?
Dr. Siegel shares these important points about your child’s hearing.
- Good hearing is critical for a young child’s speech and language development. “By far the most important time from a developmental standpoint is under the age of 3. There is so much happening at that time in terms of speech and language development,” Dr. Siegel says. “Parents and pediatricians should keep a close eye, and if there is any delay in speech, the first thing to check is the child’s hearing.”
- While every child mispronounces words from time to time, muffled or difficult to understand speech is more concerning. “If you have to repeat yourself often in order for your child to understand, or if your child continually asks to turn up the volume on the TV, these are signs that perhaps there is an underlying hearing loss and would warrant an evaluation to rule it out,” says Dr. Siegel.
- Early intervention is key, so trust your instincts if you feel something isn’t quite right. “If there is any hearing loss or hearing problems, the sooner they are identified, the sooner they can be treated,” Dr. Siegel says. “Within the first two years of life, neural development is happening so quickly. If a child is born completely deaf and gets cochlear implants early, they can catch up, but it’s not discovered until they are 2 or 3, the prognosis is more limited. Similarly, for more mild types of hearing loss, the sooner the child is fitted with hearing aids, the better the outcomes.”
- In the case of chronic fluid inside a baby’s ears, quick treatment is important, too. A pediatric ENT can surgically place tubes into a baby’s ears to provide fluid outflow and aerate the middle ear, Dr. Siegel says.
Healthy hearing should be protected throughout your child’s life, says Dr. Siegel. “Older kids often use earbuds which can cause chronic loud noise exposure directly to the eardrum, and this is a risk factor for hearing loss,” she says. Loud concerts, factory work, even sitting in the stands at car races can cause damage to hearing and all these activities warrant the use of earplugs, Dr. Siegel says.
“Especially if there is any known underlying hearing loss, it’s important to protect what hearing is left by being aware of volume and by wearing earplugs when needed.”