In the US, infants have their hearing tested at birth in most states, and usually pediatricians inquire about and check a child’s hearing at regularly scheduled ‘well visits.’
Most children also undergo hearing screenings as part of a national program while in elementary school. From that point on however, it is up to the child to verbalize hearing problems, or parents, teachers or doctors to recognize a problem with the child’s hearing. Some signs that may indicate some loss of hearing are if the child’s schoolwork is suffering, if they have problems keeping up with conversations in a noisy environment or don’t respond when their name is called. It is always best to err on the side of over-screening for hearing loss rather than ignoring the signs.
Children with hearing loss can be affected in many ways. Hearing loss causes delay in the development of receptive and expressive communication skills. The language deficit causes learning problems resulting in reduced academic achievement. Communication difficulties often lead to social isolation and poor self-concept. It may even have an impact on vocational choices.
Specifically, the following areas of learning can be compromised:
* Vocabulary develops more slowly in children who have hearing loss.
* Children with hearing loss learn concrete words like cat, jump, five, and red more easily than abstract words like before, after, equal to, and jealous. They also have difficulty with function words like the, an, are, and a.
* The gap between the vocabulary of children with normal hearing and those with hearing loss widens with age. Children with hearing loss do not catch up without intervention.
* Children with hearing loss have difficulty understanding words with multiple meanings. For example, the word bank can mean the edge of a stream or a place where we put money.
* Children with hearing loss comprehend and produce shorter and simpler sentences than children with normal hearing.
* Children with hearing loss often have difficulty understanding and writing complex sentences, such as those with relative clauses (“The teacher whom I have for math was sick today.”) or passive voice (“The ball was thrown by Mary.”)
* Children with hearing loss often cannot hear word endings such as -s or -ed. This leads to misunderstandings and misuse of verb tense, pluralization, nonagreement of subject and verb, and possessives.
* Children with hearing loss often cannot hear quiet speech sounds such as “s,” “sh,” “f,” “t,” and “k” and therefore do not include them in their speech. Thus, speech may be difficult to understand.
* Children with hearing loss may not hear their own voices when they speak. They may speak too loudly or not loud enough. They may have a speaking pitch that is too high. They may sound like they are mumbling because of poor stress, poor inflection, or poor rate of speaking.
* Children with hearing loss have difficulty with all areas of academic achievement, especially reading and mathematical concepts.
* Children with mild to moderate hearing losses, on average, achieve one to four grade levels lower than their peers with normal hearing, unless appropriate management occurs.
* Children with severe to profound hearing loss usually achieve skills no higher than the third- or fourth-grade level, unless appropriate educational intervention occurs early.
* The gap in academic achievement between children with normal hearing and those with hearing loss usually widens as they progress through school.
* The level of achievement is related to parental involvement and the quantity, quality, and timing of the support services children receive.
* Children with severe to profound hearing losses often report feeling isolated, without friends, and unhappy in school, particularly when their socialization with other children with hearing loss is limited.
* These social problems appear to be more frequent in children with a mild or moderate hearing losses than in those with a severe to profound loss.
Recent research indicates that children identified with a hearing loss who begin services early may be able to develop language (spoken and/or signed) equal to their hearing peers. If a hearing loss is detected in your child, early family-centered intervention is recommended to promote language (speech and/or signed depending on family choices) and cognitive development. An audiologist, as part of an interdisciplinary team of professionals, will evaluate your child and suggest the most appropriate audiologic intervention program.
The American Speech-Language-Hearing Association (ASLHA) has a wealth of information regarding hearing loss in children and the effect it has long term.