Hearing loss(impairment) in children
Summary/Definition
Hearing loss(impairment) in children is a condition in which a child has problems with acoustic perception. These disorders are considered symptoms rather than reflecting a definitive diagnosis and can be caused by a variety of factors. Hearing loss in children is one of the common symptoms resulting from a variety of conditions, and because the methods of diagnosis and remedial treatment are virtually similar, they are often considered together and explained together. Children do not have the ability to self-report their symptoms and hearing loss can go unnoticed unless there is obvious pathology, which can lead to late detection. Given that hearing is the primary sense in the development of children’s native language skills, the treatment of hearing impairment is essential for normal speech development.
Sound waves first enter the outer ear, then travel through the cochlea and nerve structures to reach the brain, where they are perceived. Hearing loss is an abnormality in this complex process. The causes of hearing loss vary, but usually fall into two main categories, depending on where problems occur in the process of perceiving sound from the outside world. Problems related to the transmission of sound from the outer ear to the inner ear (cochlea) are called conductive hearing loss. These problems can include inflammation of the external ear canal, wax build-up in the ear canal, damage to the eardrum, exudative otitis media, chronic otitis media and dysfunction of the ossicles in the inner ear. Another type of hearing loss is called sensorineural hearing loss or inner ear hearing loss and involves problems with the transmission of sound information through the cochlea and sensory nerve cells to the brain. This type of hearing loss can be caused by a number of factors, including congenital hearing loss, prolonged exposure to loud sounds and noise, sudden hearing loss, age-related hearing loss, use of certain medications, and complications associated with Meniere’s disease and nerve damage caused by tumors in the brain. Hearing loss is usually diagnosed based on the results of pure tone audiometry.
Hearing loss in children can be classified depending on when it occurs. A distinction is made between congenital hearing loss, which is present from birth and may be due to hereditary factors, congenital viral infections, genetic mutations or developmental abnormalities, and acquired hearing loss, which develops after birth and is associated with diseases or injuries that occur during postnatal development. Causes of congenital hearing loss may include viral infections, genetic mutations and developmental abnormalities, while acquired hearing loss may be due to factors such as meningitis, ototoxic medications, trauma or diseases including otitis media, wax plug formation and inner ear abnormalities.
Symptoms
In most cases, young children do not properly understand their hearing loss symptoms and have difficulty expressing them. Very young children may show reduced interest in toy sounds compared to other children, and may have delayed speech and language development, not attempting to pronounce sounds. Older children may show signs such as moving closer to the TV to better perceive the sound, increasing the volume, not reacting to sounds when the source is not visible, and other similar symptoms.
Diagnostics
Hearing impairment is diagnosed using pure tone audiometry, which measures the lowest audible sound in terms of its frequency, and phonemic hearing tests, which assess the level of understanding of words if certain sounds are omitted. However, it should be noted that these methods are only applicable to children who are of an age where they are able to understand the purpose of the tests and express themselves. Comprehensive auditory neonatal screening is performed for newborns and the OAT (otoacoustic test) for children under three years of age. This test records the ear’s otoacoustic responses to sound stimuli. In addition, the auditory brainstem response test is also used to measure brain activity in response to acoustic signals.
Treatment and course of the disease
Treatment methods for childhood hearing loss vary depending on the degree and cause of the hearing loss, but the common goal is to restore hearing to an appropriate level so that the child’s development is not impaired. Audiological screening of newborns is carried out in the first month of life and if a hearing loss is confirmed within the first three months of life, a detailed hearing assessment can determine the degree and nature of the impairment. If a child is found to have a hearing loss, hearing rehabilitation is recommended to begin at around six months of age to avoid developmental delays. Hearing rehabilitation options include the use of hearing aids and, in some cases, cochlear implant surgery. Childhood is a time when children are actively learning listening skills and language development, so even with a mild hearing loss it is important to ensure that your child receives appropriate treatment so that their language development is not compromised. Active auditory rehabilitation and regular monitoring of progress through regular check-ups are important elements of caring for children with hearing loss.
After birth, a child actively learns to hear and perceive speech sounds by imitating the pronunciation of adults around them. Therefore, it is important to remember that even a mild hearing loss can have a negative impact on a child’s speech and language development, and in the long term can lead to difficulties in learning and general development. For this reason, young children with hearing loss are particularly in need of active auditory rehabilitation. Even if the hearing loss is mild, it is important to have regular check-ups and to monitor the recovery process.
