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Kids ENT Health Month – Hearing Health and Loss in Children

There are many ways that Ear and Hearing Health are important for a child’s development. Despite being important for learning and communicating, children’s hearing issues are often overlooked or undetected. If you haven’t assessed your child’s ears and hearing recently, here are a few areas to consider.

Hearing Deficits from Birth

In the United States, all babies are required to pass a Newborn Hearing Screening within several days of birth. The screening is a pass/fail hearing test that measures hearing at only a few pitches or tones. Although these screens may identify mild to severe hearing deficits within the range tested, it is not a diagnostic test and does not apply to the range of human hearing. It is possible for children to have hearing loss from birth that is not identified early on.

Ear Infections

Outer Ear Infections (commonly called Swimmer’s Ear) and Middle Ear Infections (caused by infected fluid behind the eardrum) may cause ear discomfort, swelling, and hearing loss in children. It may be difficult to determine which of these is affecting your child. Always take your child to an ENT doctor for evaluation and treatment if you think there may be an infection. Here are some things to look out for:

Outer Ear Infections – Your child’s ear may feel warm to the touch. You may notice swelling at the entrance to the ear canal. To note, ear wax is a good barrier against infections that target the outer ear, so if you notice excessive wax buildup, don’t try to remove it yourself. You may risk damaging the eardrum or causing other skin tears in the ear canal, leaving the ear canal open to infection.

Middle Ear Infections – Especially for younger children, you may notice them tugging on their earlobe. Children may cry despite being well-rested, fed, and otherwise healthy. If the eardrum ruptures, you may notice blood or drainage from the ear canal. To note, the Eustachian Tube is a tube that allows any fluid buildup behind the eardrum to drain. In adults, this tube is close to vertical, which allows the fluid to drain naturally. In children under 6 years of age, this tube is horizontal, which makes it harder for the fluid to drain and makes young children more prone to middle ear infections.

Auditory Processing Disorders

Sometimes a child with normal hearing will have difficulty processing sound by the time it reaches their brain. These children may have difficulty listening with background noise, such as in the classroom or when playing sports. They may need instructions repeated multiple times in order to complete a task. Central Auditory Processing Disorder (CAPD) is often confused with Attention-Deficit/Hyperactivity Disorder (ADHD) as the two share many similar symptoms. Specialized testing can be performed by an audiologist to evaluate for Auditory Processing Disorders.

Noise Exposure

The world we live in is getting noisier. More children than ever have access to earbuds or headphones that deliver loud noises straight to their ears. Surprisingly, hearing loss due to loud noises is not likely to be measured in children, even if damage has been done. Noise-related hearing loss is described as a combination of noise damage and time. In other words, if we are exposed to noise in childhood, we don’t notice the effects of this damage until we are older.

CDC Recommendations for acceptable noise levels can be found here: What Noises Cause Hearing Loss? | NCEH | CDC

Important Note – If you use earbuds or headphones in a quiet room, you may set the volume to what is clear and comfortable. When you use those same earphones in a noisier background environment, you may notice that you can no longer hear your content clearly and comfortably. Whenever you raise the volume to overcome background noise, you are increasing your chances of doing damage to the ears. If there is a lot of background noise, such as on an airplane or train, this is not a recommended time to use earphones.

Tinnitus – Buzzing or Ringing in the Ears

Tinnitus is a sound in the ears that you can hear that no one else can. Because of this, it often goes overlooked in children. Tinnitus may occur as a result of hearing loss, noise damage, ear infections, or other non-ear-related issues. Children are likely to under-report tinnitus because they may hear these sounds and not realize that no one else can hear them. You can ask your child if they hear a ringing, buzzing, whooshing, or static noise. Nearly everyone experiences some degree of tinnitus in complete quiet. However, if they notice this sound regularly, in multiple locations, or throughout the day, this may warrant further audiologic evaluation.

This month is Kids ENT Health Month! Use this as a time to check in with your child’s ears and hearing. If you have any concerns, you can schedule an appointment with your ENT doctor. If you don’t have any concerns at this time, annual hearing tests are recommended to make sure your child’s ears stay healthy as they grow.

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