Hearing Loss

What are the signs and symptoms of hearing loss in children? 

Symptoms of hearing loss can vary based on a child’s age. 

Hearing loss symptoms in newborns, infants and toddlers 

It can often be very hard to tell if infants have hearing loss because they may not show any obvious symptoms. They may coo and babble normally for the first 6 to 8 months of life even if they have hearing loss.  

For infants and toddlers, signs of hearing loss may include:  

• Not being startled by loud noises  
• No reaction to voices  
• Not trying to find the source of a sound  
• Delay in reaching developmental milestones  

Hearing loss symptoms in older children and teenagers 

As children develop, signs of hearing loss may include:  

• Speech delays or problems  
• Difficulty following or understanding instructions  
• Asking for things to be repeated  
• Frustration with communication 

Children with a speech delay should have a hearing test with an audiologist. Undiagnosed hearing loss sometimes looks like other issues, such as speech delay or autism. So it’s important to have clarity if children struggle with communication. 

What tests diagnose hearing loss? 

Various tests can diagnose hearing loss, depending on the age and ability of a child. Testing hearing in infants and children is very different from testing adults. Not all audiologists are comfortable or experienced in testing or fitting hearing devices for babies and children, so it’s important to see a pediatric specialist who knows which hearing test is best. If you think your child needs a hearing test, contact our Audiology Department.  

Newborn hearing screening (birth to 1 month) 

All newborns born in the United States should have a hearing screening shortly after birth. This is important because hearing loss may not be obvious in very young children. In fact, before newborn hearing screenings existed, hearing loss often wasn’t diagnosed in children until they were 2 to 4 years old.

Newborn hearing testing is quick and painless and does not require the infant to respond. They often sleep right through it. Screening may include several of these tests:

• Auditory brainstem response or auditory evoked potentials: The testing usually takes around 1 hour. Babies wear small earphones that send in different sounds. They will also wear small sensors on their skin that pick up responses from their body.
• Tympanogram: This test looks at the health of the middle ear. 
• Otoacoustic emissions: This test provides information about the inner ear.

The results of these tests together allow audiologists to diagnose any hearing differences. Audiologists may also use these tests for older children who can’t complete testing in the sound booth. 

Hearing tests for 6 months and older 

As children pass certain ages, different hearing tests are appropriate. 

• 6 months: In infancy, we start using visual reinforcement audiometry. The child sits on a caregiver’s lap, and hearing specialists teach them to look at where a sound comes from. Children receive a short video or light up toy as a reward. Sound comes from speakers or headphones. 
• Age 3: Conditioned play audiometry is a listening game where the child waits for the sound and then does a fun task such as pushing a car down a tube or throwing a ball into a basket.
• Age 5: Pure tone audiometry asks a child to raise their hand when they hear a sound. During the test, they’ll also be asked to repeat words they hear back to the audiologist.

How do we treat hearing loss?  

We can only treat hearing loss if it’s been identified. So the first and most important thing is to get your child tested by a pediatric audiologist as soon as you suspect a problem or it’s picked up on screening (newborn, school or pediatrician). It is very important to address hearing loss as soon as possible to minimize its impact on your child’s ability to learn and communicate.

Once providers diagnose hearing loss, the treatment varies, depending on the type, cause and severity. Here are some common hearing loss treatments that can help children: 

• Ear tube placement: This can help children who have conductive or mixed hearing loss due to fluid in their ears from ear infections. 
• Hearing aids: These can help children with any type of hearing loss to amplify sounds so they can hear better. 
• Classroom interventions: Schools have microphone and speaker systems that teachers can use to help children hear better.
• Cochlear implants: These can help children who have severe sensorineural hearing loss if hearing aids aren’t helpful.
• Bone conduction hearing devices: These are most often used for kids who have no outer ear or a small ear canal.

In addition to treatments that improve hearing, children with hearing loss often benefit from speech-language therapy to help improve their communication abilities. At Children’s Colorado, our speech-language therapists have expertise in caring just for kids.

Hearing loss can sometimes be a difficult diagnosis for families to manage. We have patient and family support services such as support groups, educational counselors and family therapists who specialize in caring for children and families with hearing loss. 

Why choose us for hearing loss treatment? 

We are one of the leading centers for pediatric hearing loss in the nation, with cutting edge diagnostic and treatment methods. The Bill Daniels Center for Children’s Hearing at Children’s Colorado was one of the first centers in the nation to provide comprehensive, multidisciplinary care for children with hearing loss and works closely with our Audiology Department. Instead of making multiple appointments, children and families can see all the different specialties who support them in one visit. This includes specialists in pediatric otolaryngology, audiology, genetics, speech-language pathology, educational counseling and family counseling.

At Children’s Colorado, all our audiologists have extensive pediatric experience and understand the importance of building care around the unique needs of children. Many are board certified in pediatric audiology and other audiology specialties, such as cochlear implants and vestibular conditions. We work with experts across our hospital to provide comprehensive care for children, as hearing loss can impact many aspects of life. 

We specialize in caring for children. Children are not little adults. Evaluating and managing hearing loss in children is very different. Because the first years of life are critical for language development, we make sure your child gets the best start possible.

Helpful Resources

• Hearing Loss FAQs