Introduction
Hearing problems are relatively common in children but fortunately the majority of problems are not too serious and can be corrected. Most children with hearing problems will not complain that they can’t hear, rather it will be noticed by family, friends and teachers.
Poor hearing can lead to a number of problems. Good hearing is critical for speech and language development, thus children who demonstrate delayed speech or poor clarity in their speech may actually have a hearing problem. Equally, if you can’t hear, it becomes very hard to follow instructions, which can lead to behaviour and concentration problems.
Causes
By far the most common cause of hearing problems in children is what is described as “glue ear”. Basically, this involves the development of a fluid collection behind the eardrum within the middle ear. As a result, the eardrum can’t move properly, the hearing bones also fail to move properly, and the outcome is a reduction in hearing. This is especially common in smaller children.
Other causes of hearing loss can include problems with the development and function of the inner ear, hearing nerve and hearing bones. Many of these will be detected early by newborn hearing tests but some may only develop later in life.
Symptoms
In some instances, it can be difficult to decide whether or not the hearing of a young child is normal. Some of the symptoms of hearing loss in children include:
- Delayed speech and language development.
- Poor pronunciation.
- Failure to respond to sounds and voice.
Tests
Most children will have a basic hearing test at birth called and “Auditory Brainstem Response” or ABR, which will detect the presence of hearing, but can miss a mild loss.
As children develop there are multiple other types of hearing tests which can help to better identify and define the nature of any hearing loss and can then be used to guide and assess treatment options. In some cases, other scans or blood tests may be needed where there is a suspicion of an abnormality of the inner ear.
Diagnosis
The first step in the process is to discuss the possibility of hearing problems with a GP or an ENT specialist. An examination of the ear will help identify the cause of the hearing problem and may also provide reassurance regarding the structure and function of the ear. Subject to those findings, a hearing test may be ordered to clarify the issue.
Treatment
Ultimately the nature of the hearing problem will dictate the nature of the solution, thus a proper assessment and hearing test are vital in most cases.
“Glue ear” can be a transient problem which may correct spontaneously. Hence some children can be watched, but this is only appropriate where there is not a significant functional problem for the child. Simple measures at home and school can also improve things for the child with a mild hearing loss who is being observed. Positioning close to the front of the class at school helps hearing and attention while ensuring the child is facing you and paying attention improves communication.
Treatments such as nasal sprays, “auto-inflation” and other medical treatments are proposed to improve “glue ear” and may be helpful in some cases but results are inconsistent. Most are fairly harmless and perhaps worth a try but should be discussed with your doctor before commencing treatment to avoid causing further problems.
ENT surgeons commonly address “glue ear” with the use of grommets. This involves the placement of a small, hollow plastic or silicone tube into the ear drum to allow the drainage of fluid and to re-establish air in the middle ear. In most cases this is effective in clearing the fluid and improving the hearing. As with any surgical procedure, there are benefits and risks that can be specific to your personal circumstances, consequently this is best discussed with Dr Morrissey.
Once the hearing is corrected, it may be necessary to undertake speech therapy and utilise learning supports to help ‘catch up’ where there has been a problem with speech, language and academic performance.
Other hearing problems may require interventions such as hearing aids or surgery. The specific nature of the problem will guide the solution and is best discussed with an Ear, Nose and Throat (ENT) surgeon like Dr Morrissey.
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