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Does My Child Have Hearing Loss?

Childhood hearing loss comes in many forms. Find out about the signs to look out for and what to do about them.



Hi, I'm Jim Cuddy. And this is Ask The Hearing Doctors and I'm joined today by Dr. Jenna Valania, doctor of audiology with Hearing Doctors. The Washington DC area's highest-rated audiology practice with over 1,500, five-star reviews. Jenna, great to see you. Great to see you as well. Thank you so much. Absolutely.


So pediatric testing is what we're going to be talking about today. And, you know, childhood hearing loss comes in many forms, but when does testing begin?


Believe it or not before that baby leaves the hospital. As an infant? As an infant. So, it recently, I would say ever since 1995, it has become a law to have a hearing screening before, um, within one month of birth. And so ,a lot of them are getting that right at the hospital. Now, how that's possible, what it is is the baby obviously isn't sitting there completing your traditional hearing test. They're not raising their hand or anything like that. Um, it's measured using equipment that is part of a newborn hearing screening. And with that, the, the parents are the parents, nursing staff, caregiver team are able to know if the baby passes or fails their newborn hearing screening. And then that information is provided to the baby's pediatrician to know if further testing is needed.


All right. So, child is a little older now. They did fine with that test as an infant, but I'm starting to see some things that I'm not sure are there particular signs that, hey, maybe I need to have my child tested again?


Sure. If the child is not responding to his or her name, when they are called. Um, if the child is listening to their music too loud. We see a lot of kids with iPads now or tablets and if they are going like this, getting really close to that speaker, turning it up much louder than previously. Um, or if they are really congested. So, a lot of kids, uh, experience congestion that their bodies just can't clear out on their own. So, if you're really congested up here or in the throat, it's possible that some of that congestion is actually in the ears, too


What are some other signs of hearing loss in school age children?


Sure, if the child is seemingly not paying attention to the teacher. There are some teachers that have reported that they feel that the child is acting out and it could be because they just can't hear what's going on in the classroom. Um, the great thing about the child regularly going to a pediatrician is there are set years that the child's hearing is screened at the pediatrician's office. Now there are some areas where, um, the children don't have regular access to a pediatrician and some signs to look for are, in addition to just that music being too loud, asking for repetition. So, if it's like, oh, what did you say? Oh, I can't hear you. Or, oh, when I go like this, I can't hear as well as when I go like this. And the child is self-reporting whether they realize they're self-reporting or not. So, if they, if you're in the same room with the child and they're looking right at you and it's you have their attention. So, we've eliminated that the child is not paying attention to the caregiver. Um, but they look right at you and say, what did you say, I didn't hear what you said, or I feel like I've had a child tell me once. He's like, my friends are hearing more than I'm hearing. That's how I knew I needed to get a hearing test. And then at that point you have a child who is six years old advocating for their own hearing, but those are some signs to look for.


Do you start then as a parent in that situation, by calling your pediatrician or right to the audiologist?


So, for truly, for the sake of some insurances, they do go to the pediatrician first. Um, and a lot of times the parent or caregiver wants to eliminate, is there anything else that's contributing to this? Are they sick, congested? Do they have a sore throat? Things like that. Um, the pediatrician then can either complete a screening in office or direct them to their nearest audiologist. Um, if they do a screening in office, it's also likely that even if that child passes a screening in office, but is still having some problems or some concerns, that it is warranted to go straight to an audiologist. Okay.


Talk about why a child needs a hearing test anyway.


There are so many reasons why a child should have a hearing test. Part of it being good health. Keeping an eye on our health, just the same way that children have vision screenings or go to an eye doctor if they're having concerns. Um, a child should have a hearing test if they have a history of ear infections. Sometimes an ear infection can impact their hearing, sometimes it doesn't. But it's those times that we want to look into saying, okay, ear infection, you also can have fluid build-up behind your eardrum or pressure buildup without an infection. A professional is going to be able to put that parent or caregiver at ease. If we're able to identify a cause of their hearing loss. 


Now, just because a child fails a screening, a screening is a screening. A screening is not a diagnostic tool. I call a screening a gateway into an appointment. Whether that's a vision screening, a hearing screening, a dental screening. Everything that's a screening is not diagnostic. Meaning you cannot make a diagnosis from that screening. We sometimes see parents and caregivers get a little nervous that there is a hearing loss if they fail a screening. Um, what we want to eliminate that there weren't any distractors in the room during the screening. I have seen some screenings take place, um, where they're in the nurse's office at school, for example. But people are coming in and out. Or at a doctor's office when people are shuffling around in the hallway. It's not the best listening environment for a screening. So, we want to make sure there aren't any distractors, any noise distractors either. So, what is the environment nice and quiet and is the equipment appropriately functioning? And is it placed on the child's ears appropriately? Uh, we have found that sometimes the equipment isn't working for the child and the test is completed without knowing that. And then we find them in the audiologist and they're like, oh, my hearing's normal. Did I waste my time? You did not waste your time. It is never a waste of time to ensure that the child's health is where it should be.


You know, I, I kind of liken that to you, go to the dentist and the dentist says, everything's fine. That's a good thing. Absolutely. That's what you want to hear.


Absolutely. Hearing across the lifespan is so important for our brain development and our overall development. So, by making sure that our brain, especially in our language learning years, that we have access to that sound. Because if we don't, we want to do something about it. We want to look into making sure that the child does have access to those sounds, whether that's their manual communication or potentially a hearing aid. But we want to make sure that we are checking off everything we can for that child to ensure that they have access to what they need for that development.


Now it depends on the child's age. What age does Hearing Doctors set for seeing children?


Sure. We say children aged five and up. So, children, school age, teenagers into adulthood. Now, if you need a hearing test and you are under the age of five, you absolutely can get one, just not at our office. And I encourage you to check with your pediatrician to see the best place to go.


Okay. And what types of tests are we talking about that you offer five and up?


Sure. So just like a baby, isn't sitting there raising their hand and doing a hearing test, kids test differently than adults. Um, so we typically do what we call traditional testing and then we modify it. So, there is a type of test called visual reinforcement audiometry. We don't do that here just because it's typically used for patients under the age of five, but what we do have and it’s called condition play audiometry, meaning we keep it fun. So, a hearing test can be fun. Um, even if you're just listening to plain old beeps. My favorite one is, um, there's a bin of toys and there are some little birdies. And you have a bin that's full. What you do is you pick it up and while that child is holding it, I say, okay, listen for the birdie to tweet. And we do it at a loud level.


We'll be like, okay, let's pick one up at a level that I know they can hear it. Okay. Tweet, tweet, tweet. Oh, put it in the bucket. That birdie was that birdie was talking to you, put it in the bucket. Okay. Let's pick up another one. Let's do it together. Oh, I heard that birdie tweeting. Let's put it in the bucket. Okay. Now it's your turn. At a nice loud level that I know they can hear it to make sure they understand my game. Once I know that they understand my game, I make that, that birdie tweeting even softer to a level where I get threshold or the softest level that they can hear. 


We also make it fun where you can point to pictures. So, if there are any concerns with the parents saying, well, their speech isn't clear. I don't want them to repeat words back to you because they may not have clear speech and have normal hearing. So, we also can point to pictures to say, okay. Point to the sun. Okay. That's great. That's great. All right. Let's point to the next one. Okay. Point to the rainbow. Oh, yep, yep, yep, you've got it. And it's really, we keep it fun. There's a lot of energy that goes into pediatric testing and we keep it fun for them.


You know, what I love about that is they're involved in it. They, they get to be a part of it, and they walk away from that office feeling good about it. And perhaps that carries on into adulthood where, you know, for years you always went to the dentist twice a year. You always went to the optometrist once a year. That kind of thing, but not everybody goes to the audiologist, uh, regularly. And that's something that that's becoming more and more evident the importance to do. So, it's great that you're doing that. 


Now, obviously just because a child fails a hearing test, it doesn't necessarily mean there's a long-term problem. I think a lot of parents would be concerned, oh my gosh, my child failed a hearing test, but it's not necessarily a long-term bad problem.


Absolutely. The best thing to do is to follow up with your audiologist. I have seen where they get a screening at their school and it's like, oh, okay. Like, I'll take care of that when I have time. The most important thing is, is to make sure that there isn't something deeper that we need to look into. The best and only way to do that is to follow up with your hearing care professional. And that would be an audiologist. And let us look into those deeper reasons for why we could be seeing a failed hearing screening. When you fail a hearing screening even if you only feel it in one ear, we're going to test both ears and we're going to do a really in-depth test. A screening tends to be, you hear a series of four beeps at a predetermined level. If you respond. Yep. Okay, great pass. If you don't respond, fail. We get that report and then we look even further into it. We want to find the softest levels that they can hear. 


Also, there are some kids that get bored with that screening. So that's why it goes back to, we want to make it fun. So, we want to make sure that boredom didn't play a part or tension didn't play a part. Let us be the ones to figure that out and determine if that was the root cause. We also see during school age, that ear infections could be contributing to a pass or fail on a hearing screening. And there is that possibility that we are catching a hearing loss with these screenings. And the best thing to do is to get in our office and have that hearing test. And then let us determine if further action is needed.


As with anything the earlier you detect it, the easier it is to overcome it or fix it?


Absolutely. And something that I also want parents and caregivers to know is that you're not alone. If there is a failed hearing test, it is not something to worry about. Sometimes, sometimes people like to Google and that's great because hopefully it'll lead you to this podcast and come in for a hearing test. But we also want to be the ones to talk about this information with you. It's always best to talk about information with the professional that works with this on a daily basis. And let us walk you through those steps. If further testing is needed, we're going to direct you to where you need to do that. If we find that intervention is needed, we are the ones that are here for you, and we're going to provide that information and that support every step of the way.


Jenna it's wonderful information. The most important thing here is get your hearing tested, start young, do it often. And if something's detected, you see the professionals and they get it taken care of.


Absolutely. We are here for you, and we truly believe hearing health is across our lifespan. So, we are more than happy to answer any questions that you have, and also determine if your child needs a hearing test.


Great. Jenna, thanks so much. Thank you for having me, appreciate it.


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