Concerned Your Child Has Hearing Issues?
By Ronald Kennedy
February 14, 2023
Here’s an interesting story. Like with any first-time moms starting a new family, this woman (We’ll call her Monique), prays that her baby will be normal.
This is her first child. Of course, all new moms want this.
But unlike many of Monique’s other friends, who’ve experienced some ‘bad luck’ with the birth of their children, she was concerned about her own pregnancy.
They had issues with hearing loss among their kids (I think it ran in the family). So Monique would ask herself, “What are signs of hearing loss in children?”
Monique was a first-time parent, but was concerned that she will not be able to recognize symptoms relating to the health of her child.
Considering past issues regarding her ‘family tree,’ she was prepared for anything. Now the baby is born.
She had a bouncing baby boy! Slowly over time, she starts noticing something is not right. She couldn’t get her child’s attention.
Monique consulted with her doctor. After further testing with an ENT specialist, just to be sure, it was confirmed. Her little boy had partial hearing loss in one ear and completely deaf in the other.
ALL THE SIGNS ARE THERE
Here is a list of general warning signs regarding children. As a parent suspecting a hearing issue, please be very noticeable and aware of these signs:
- The child seems to respond inconsistently to sound, sometimes hearing and sometimes not.
- The child intently watches the speakers face.
- The child often says “What?” when spoken to.
- The child exhibits behaviors that seem to favor one ear, such as tilting the head to the left or right when listening.
- There is a history of hearing in the family.
- The child’s mother had rubella (German measles) during pregnancy.
- There is a history of blood incompatibility or difficulty in pregnancy.
- There child has had frequent high fevers.
- The child has a history of chronic ear infections.
- The child frequently complains of hurting ears.
- The child seems to respond better to low – or high – pitched sounds.
- There is a change in how loudly or how much the child babbles or talks.
STAYING ALERT 24/7
If you suspect a hearing loss, examine the child’s speech and language development. The speech of children who have a hearing loss may sound different or less clear because they will be imitating a distorted signal.
Many children have had a hearing impairment since birth and have therefore not heard speech and language of the same quality as that experienced by children with normal hearing.
As a result, their language acquisition is an ongoing, effort-filled sequence instead of a gradual, easy, natural to process.
Consider the scores of times small children hear a word before they can learn to actually say it.
Children with an impairment do not hear as many words in their surroundings as easily, and consequently they may build a vocabulary at a much slower pace.
Improving the vocabulary of children with hearing loss is so important. Also, expanding children’s hearing opportunities is a big ‘Plus’.
Their words may also be missing word endings (e.g., s, ing), and short words (e.g., the, is, it) may be missing from their speech. The children’s written work may also reflect their inability to hear.
These specific age-related behaviors can signal a hearing loss in infants and toddlers:
BEFORE SIX MONTHS:
- The child DOESN’T startle in some way, such as a blink of the eyes or a jerk of the body or a change of activity in response to sudden, loud sounds.
- The child DOESN’T initiate sounds such as cooing or babbling.
- The child shows NO RESPONSE to noise-making toys.
- The child DOESN’T respond to or is not soothed by the sound of his or her’s mother’s voice.
BY SIX MONTHS:
- The child DOESN’T search for sounds by shifting eyes or turning the head from side to side.
BY TEN MONTHS:
- The child DOESN’T show some kind of response to his or her name.
- He or she REDUCES their number of vocal behaviors, such as babbling.
BY TWELVE MONTHS:
- The child shows NO RESPONSE to common household sounds, such as pots banging, running water, or footsteps from behind.
- The child yells when imitating sounds.
- The child DOESN’T respond to someone’s voice by turning his or her head or body in all directions to search for the source.
BY FIFTEEN MONTHS:
- The child ISN’T beginning to imitate many sounds or ISN’T attempting to say simple words.
- In order to get the child’s attention, you consistently have to raise your voice.
What to do if you suspect your child to have some loss of hearing?
If you suspect that your child’s hearing is impaired or if you feel that sounds are not as loud as you need them to be, or that speech is muffled, it is a good idea to first have your family physician check for wax in the ear canals, infection, or a treatable disease.
Then arrange for a hearing test to determine how much hearing loss there is.
Get a complete hearing evaluation from a licensed audiologist who is a Fellow in the American Academy of Audiology (FAAA) and/or one with a Certificate of Clinical Competence in Audiology (CCC-A) issued by the American Speech Language and Hearing Association (ASHA).
Audiologists can measure hearing ability and identify the degree of loss.
They’ll design and direct a rehabilitation program, recommend and fit the most appropriate hearing aids, and measure the hearing improvement from the use of hearing aids.
They will provide guidance and training on how to use the new hearing aids and recommend the use of other assistant technology, if it’s appropriate. They’ll also teach speech reading.
They’ll help you and your child to find solutions that reduce the effects of hearing loss by working with your spouse, family, employer, teacher, caregiver, or other medical specialist. In addition, audiologists evaluate balance, vertigo and dizziness disorders.
If a hearing aid is recommended, be certain to arrange for a trial of at least thirty days through a facility that assist you and your child in becoming oriented to the new experience of hearing with amplification.
“Remember, it is a learning to experience that does require time, practice, and patience.
Middle Ear Problems Accounts For Roughly One-Third Of All Pediatric Visits
For many children, earaches began in infancy. By the age of three, over two-thirds of all children have had one or more episodes of some type of ear infection including 33 percent who have had three or more episodes.
Nearly all children affected continue to have problems until the age of six or seven.
Otitis media does not become rare until after age 10, and persists in some children beyond 15 years ofage. Boys appear to be affected more often than girls in the younger age groups, while the trend reverses in older children.
In spite of vast increases in the pediatric use of antibiotics, the incidence of otitis media has risen sharply!
But before we continue and touch on remedies and preventive measures, let me first explain what Otitis media is.
Otitis media refers to inflammation of the middle ear.
When infection occurs, the condition is called “acute otitis media.” respiratory infection, and the presence of bacteria or viruses lead to the accumulation of pus and mucus behind the eardrum, blocking the Eustachian tube. This causes earache and swelling.
In regard to children under two affected with this disease, the rate has increased 224 percent. This substantial increase in otitis media has been attributed to everything from increased doctor awareness to improved diagnostic abilities.
There are even those who contend that the incidence of otitis media has increased, in part, because of the widespread use of antibiotic drugs.
Parents must also keep in mind that some antibiotics, not all, can cause permanent hearing loss.
To a degree, any of the above explanations may have merit. However, there are additional factors that have emerged during the past several decades that increase a child’s susceptibility to illness such as acute otitis media.
Introduction Of Solid Foods:
When beginning to introduce solid foods into a baby’s diet, it is important that only one food at a time be added.
This way, if your child is sensitive to that food, you can identify it and avoid feeding it.
Once your child’s digestive tract has matured somewhat, you may wish to introduce the food again. The first solids your baby eats should Not be from among the most common offenders. These include:
- Dairy products
- Peanuts and other nuts
Most children consume far too many fruit juice. A glass of juice is almost purely simple carbohydrates – in other words, SUGAR. Excess sugar leads to deficiencies in immune function, such as described above.
If you must give fruit juice, dilute it with water, and don’t give it cold right out of the refrigerator.
Most parents go to great lengths to make sure their baby’s formula is warm but think nothing of feeding a bottle of cold juice from the refrigerator. Cold juice can slow digestion in a child of any age.
Often, parents feel they are doing their child a service by feeding honey instead of sugar. This is a mistake if large quantities of honey are given, since honey contains the same sugar found in table sugar.
There is an interesting phenomenon surrounding honey. When beekeeper’s want to claim the hive, they mix a solution of sugar water and spray the bees.
A solution of water and raw honey also has a calming effect on the bees.
However, when pasteurized honey is used, all bees exposed will be found dead within 20 minutes.
It is unclear why this occurs, but it seems to suggest that raw honey may be a better dietary choice for humans than pasteurized honey. Almost all honey you find in the grocery stores is pasteurized.
You have to look specifically for raw honey. A good place to start is a local food co-op or health food store.
A recent study showed that consumption of refined sugar was associated with low intakes of vitamin E. Recall that vitamin E is important in immune function and for regulating inflammation.
It is also low in the diets of children living in industrialized nations.
Studies has shown that when sugar is ingested, the ability of white blood cells to destroy bacteria can fall by as much as 60 percent.
Excessive sugar inhibits fatty acid metabolism because it is high in calories but lacks the nutrients needed to make the enzymes work properly.
I suggest you read the labels carefully. Any time sugar appears among the top five or six ingredients, don’t buy the product.
Variety Of Foods:
Avoid feeding the same foods every day. Food sensitivity can be induced by over consuming a given food every day for a long period.
The solution is to rotate foods. Instead of feeding oatmeal every morning for breakfast, feed oatmeal one day, wheat cereal the next, fruit the next, and so on. With infants, rice is preferable to wheat.
If your child has known food allergies, don’t feed those foods more than once or twice a week. When you do feed them, give only small amounts.
Avoid feeding raw food to your infant. Fruits need not be cooked, but vegetables and other foods should be. Raw foods are more difficult to digest. They’re also more apt to contribute to allergy.
Also, cold food should not be fed to a child. When food is eaten cold the body must first warm it to almost 100 degrees before it can be properly utilized.
For an infant or child whose digestive system is immature, this can spell trouble.
If you choose not to breastfeed, you should know a few things about infant formula. Powdered formula mix is higher in oxidized fats than is liquid formula.
As I once stated before, oxidized fats in the diet can set the stage for inflammation and immune function problems.
Some infant formulas contain aluminum in concentrations 30 to 100 times greater than that found in human milk.
Aluminum is a toxic metalloid that has been implicated in brain and kidney damage.
For healthy infants this may not be a serious problem since the blood levels of aluminum following ingestion of formula are no higher than that of breastfed infants.
In regard to cow’s milk, if this is your choice, studies have shown it causes allergic reactions in a large percentage of children.
Cow’s milk and most milk-based formulas (except Enfamil) contain insufficient amounts of the amino acid taurine.
If you do choose to feed cow’s milk to your child under-age two, use whole milk rather than skim or low-fat milk. Low fat milk has a high protein-to-fat ratio, which is not suitable for infants and toddlers.
Recognize that the American Academy of Pediatrics recommends that no child under the age one receive whole cow’s milk.
Also recognizes that cow’s milk products are found to be the most common provoking foods in children with middle ear problems and have been associated with an increased prevalence of type 1 diabetes in children at risk.
Childhood Infections Sometimes Common
By definition, otitis media is a disease of the ears. If not treated, chronic ear infections have potential serious consequences such as temporary or permanent hearing loss.
Fluid accumulates in the middle ear, pressure develops in the middle ear, and pain occurs in the middle ear.
Quite naturally then, doctors should directly treat the ears by whatever means possible. Or should they?
One great weakness in modern medical practice is failure to view the patient as a whole.
When a problem arises in one area of the body, this is often the only area that receives attention.
This is why antibiotics and surgery are used with such great frequency. What happens if we ask, “What has occurred to render the child’s defenses unable to cope with a viral or bacterial insult?”
In epidemics of strep throat, up to 60 percent of children are considered “carriers.”
Carriers of the bacteria but are not sick. In studies of stress and infection, those under high stress are much more likely to become sick than those under low stress, even though both may culture positive for bacteria such as strep.
What is unique about the individuals who remain well?
That is, they have positive strep cultures, but do not get sick. Very strong immune systems head the charts, as possibly one thing that helps.
If one child test healthy from an elementary school classroom, it might be discovered that up to 40 percent of them culture positive for mycoplasma in their lungs. But in regard to school, you still may ask yourself, “Why my child get sick in daycare?”
I’m convinced the differences lies in immune defenses or host defenses. In 1994, there were over one thousand written research papers reviewed entitled; ‘Beyond Antibiotics.’
It became clear that the immune system could be positively or negatively influenced by at least six factors:
Neuro musculoskeletal factors
Balancing Out the Scales
Imbalance in one or more areas might tip the scales in favor of the bacteria or virus. Maintaining balance in these areas often allows one to remain well despite exposure to bacteria or viruses.
The principles set forth Beyond Antibiotics have now been used successfully by hundreds of thousands of patients of all ages around the world.
The growing consensus is that by improving host defenses one can reduce the rate of infection and reduce reliance on antibiotic drugs.
Can the same principles be applied to childhood otitis media? Can the same principles be applied to prevention as well as treatment?
It has been determined that, through overwhelmingly positive feedback, the suffering of middle ear problems can be reduced through improved overall health and vitality.
Otitis media is an inflammation of the middle ear. All the events that occur in the middle ear – swelling, pain, infection, complications – are important and must be addressed. However, these events may only be the sequel to events that occur elsewhere in the body.
Killing bacteria may at times, be necessary. Air born pathogens are all around.
But as you read this information, keep in mind that optimizing immune function is highly desirable regardless of age or condition.
The cause of otitis media is not fully understood. What probably occurs is a multiplicity of events that interact to take advantage of lowered immune function, underdeveloped eustachian tube muscles, respiratory congestion, excessive mucus production, nutritional inadequacy, or any number of other factors.
Now, let me present a synthesis of the major contributing factors involving middle ear issues. In each case, prevention and treatment solutions are available that take advantage of our understanding of the causes presented here.
The four main causes of ‘otitis media’ (which contributes to hearing loss) are:
- Allergy and Environmental Sensitivity.
- Mechanical Obstruction.
- Nutrient Insufficiency.
Allergy and Environmental Sensitivity
Allergy is called the great masquerader because it can contribute to and mimic, many illnesses with which we don’t usually associate allergy.
From recurrent colds to bronchitis, bed-wetting to headaches, enlarged tonsils to diarrhea, allergy can play a significant role.
To children with recurrent middle ear infection, allergy is indeed the “great masquerader.”
Not all children with allergies develop middle ear problems, and not all children with middle ear problems have them because of allergies.
But in children whose earaches are due to allergy, neglecting to treat the allergy (or the underlying factors that lead to the development of allergies) often results in recurrent infections.
Evidence demonstrating the role of allergy in middle ear problems has been steadily accumulating over the past four decades.
A study of 540 children by W. Leonard Draper, M.D., showed that secretory otitis media was more than twice as frequent inallergic children than in non-allergic children.
Dr. Draper also noted, in a study of 100 allergic children, that approximately 50 percent had fluid in the ears. Poor eustachian tube function – believed to be one of the prime factors leading to the development of middle ear infection – has been found to occur in almost one-third of allergic children.
Under certain conditions, bacteria present in the upper respiratory tract find their way up the eustachian tube into the middle ear. Once in the middle ear chamber, they contribute to the damaging events with which we associate infection.
When middle ear fluid is cultured for bacteria, the most common bacteria found are Haemophilus influenzae and Streptococcus pneumoniae. These are called pathogenic organisms, which refers to their ability to produce disease.
Cases of otitis media in which S. pneumoniac is involved tend to occur with severe pain and fever, but more commonly affect both ears.
Otitis media can when the eustachian tube is blocked, or obstructed, by physical or mechanical means. The most common factors associated with mechanical blockage of the eustachian tube are swollen tonsils or adenoids.
It was this association that prompted the widespread use of tonsillectomy and adenoidectomy in the early days of treating ear infections.
The cause of swollen tonsils or adenoids is not fully understood, but many doctors believe they can be caused or aggravated by allergies. Thus, allergies can lead to the development of one form of mechanical obstruction.
There is another form of mechanical obstruction that further contributes to the development of middle ear problems (and quite possibly the tonsillar and adenoid swelling in some children) called bio mechanical obstruction.
Biomechanical obstruction refers to blockage that is due to problems involving the structural components surrounding the ear and eustachian tube.
Over the past two decades, our understanding of nutrition has expanded rapidly. For instance, we know that a child’s intake of dietary fats can either enhance or impair immune function.
Intake of the wrong types of fats not only predisposes a child to developing recurrent infections, but to inflammatory conditions as well.
Deficiency of certain trace elements and vitamins causes a child’s metabolic machinery to go awry, even if essential fats are taken in proper proportion.
If all is well, regarding the intake of vitamins, minerals, and fats, there are still a host of dietary factors that can upset the balance.
These are important considerations in childhood ear infections. Understanding them can allow you to avoid some things that put your child at risk to ear infections, and to things that will optimize your child’s resistance to disease in general.
You Got That Loving Feeling
From the moment babies are born, these tiny human beings start communicating with the world around them. The vital connection between you and your infants depends on this communication.
Infants will use extensive body language, facial expressions, and all sorts of verbal sounds to interact with you. These movements and sound will eventually evolve into ‘bonding’ language.
But until they do, you may have an incredibly difficult time understanding your infant’s’ attempts to tell you things.
How many times have you wished you could look into your babies’ minds and know what was going on in there? How many parents have felt the instinctual longing to bond, extract a thought, or a word from their troubled infants?
The inability to understand your infant is certainly there because you don’t try hard enough, nor is it because the infants abandon their attempts to express themselves.
Infants have an instinctual need to communicate with you, just as you have an instinctual need to understand them.
Infants are born with abundant intelligence. However, they have a limited means to let you know what their thoughts and needs are. The muscles that allow speech to form are undeveloped, restricting the infant from participating in verbal language.
Imagine how it must feel to be a baby, who has many specific needs, thoughts to express but has no effective way to make those specific needs or thoughts understood.
At times, it must be frustrating for these small and socially dependent beings to live with these limitations.
Communication Is One of The Highest Forms of Social Interaction.
Leading researchers in infant behavior have determined that social interaction is crucial to all infants’ development.
They have further concluded that for a caregiver to withhold social responses to an infant’s attempts to communicate is one of the most disruptive things that can occur in the infant’s learning to process.
What can you do to encourage this learning process? Here is where SIGN with your BABY contribute to your infant’s development.
Imagine how your babies might feel if one day you started using simple hand movements to communicate.
Let’s say you make a particular motion during a certain daily activity, such as eating.
Soon your infants associate that movement with the situation or activity that was taking place when the motion was introduced. They begin to experiment with their own hands and discover they can replicate the movements you make.
Receiving reinforcement from you, babies quickly learn that by making this motion, they can communicate their needs and wants.
The time between newborn birth and when your infants utter their first recognizable words can be a time of miscommunication or a time when your communication is less than precise.
This does not have to be the case. These precious months can be rich in meaningful and effective infant/parent interaction.
Using manual communication with your infants can help build a solid foundation for mutual understanding, dramatically contributing to the bonding to process.
The complexity of the ear means that it is vulnerable to damage from a wide variety of sources – disease, genetic disorders, infection, noise, or accidents.
Each age has its unique susceptibility: the fetus, because the ear mechanism is undergoing rapid development; the child, vulnerable to a host of ototoxic diseases; the adult, prey to the disintegration of the ear due to normal aging.
Prenatal Causes of Hearing Loss
Loss of hearing from prenatal causes occurs in between 7 and 20 percent of deaf and hard-of-hearing people.
Significantly, most of these prenatal causes are preventable. The three major threats to the hearing mechanism of a woman’s unborn baby are viral diseases, ototoxic drugs (drugs that can harm hearing), and the woman’s health during pregnancy.
Of these, the biggest threat to prenatal ear development is viral disease contracted by a pregnant mother.
The most dangerous of all the viral diseases from the standpoint of hearing is rubella, though damage also can be caused by the mother’s infection with influenza, mumps, toxoplasmosis (protozoan infection), cytomegalovirus (CMV), and herpes.
In fact, almost any severe infection can damage the developing fetal hearing mechanism, especially during the first trimester, when the fetus seems to be especially vulnerable.
Only the common cold appears to carry no threat to an unborn child’s ears.
GERMAN MEASLES (Rubella):
A mother who contacts German measles during the first three months of pregnancy may give birth to a child with some degree of hearing loss.
Typically, the pregnant woman experiences just a mild rash and fever, but she may have no symptoms at all and not even realize she has been infected.
About one third of children born to children born to mothers who contract rubella may be deaf; especially if it occurs in the first few months of pregnancy.
However, there have been cases in which a baby sustained hearing loss when the mother contracted rubella as late as the seventh month of pregnancy.
The mother can also infect her baby long after she contracts rubella, since the virus may linger in her body and go on to injure an embryo that is conceived weeks or months after the infection appears to have subsided.
In some cases, the child’s deafness may be progressive, because the virus persists in the child’s body after birth.
Prenatal infection by toxoplasmosis can also lead to a hearing loss. Up to 45 percent of American women of reproductive age carry this organism, usually passed on by infected cats and their waste, and one baby out of every 800 will develop toxoplasmosis in the womb from an infected mother.
An infected pregnant woman’s doctor can’t confirm the disease unless they’ve had a negative toxoplasmosis test early in their pregnancy and subsequently test positive for the infection.
Most babies born with toxoplasmosis don’t show evidence of the infection immediately, but many physicians advise drug treatment anyway.
Up to half of all children infected with CMV in the womb will have a bilateral, sensorineural hearing loss of varying severity.
Discovered in 1956, cytomegalovirus (CMV) is a member of the herpes virus family; it’s the largest, most complex virus known to infect humans.
Remember, this Cytomegalovirus doesn’t usually cause any symptoms in healthy people, but it may set off symptoms like the common cold in a pregnant woman. Hearing loss in infants is most often profound, although some babies sustain milder losses.
Cytomegalovirus infection in the womb is now considered a possible cause of many previously unknown cases of non-genetic hearing loss.
2 Replies to “What Are Signs Of Hearing Loss In Children?”
You are killing it with these articles Ronald and my discovering them couldn’t have been more timely. I can’t wait for my 8 month old granddaughter to actually start talking to us with real words(she’s already orating with her own brand of confidently espoused gibberish) but I was astounded to learn that she could communicate about common tasks with us right now using sign language. Your list of general warning signs if your child has a hearing impediment would be critical to a parent looking for confirmation or just trying to get to the bottom of what might be ailing their little one. My daughter was delayed in sight as an infant and a guide like this would have been invaluable at that time as we just had to take cues from what we’d witnessed. I commend you greatly for writing the kind of important articles.
Thank you Joseph for finding some value in my writings and appreciating my work. Parents concerned about the hearing health of a child can, like you stated, benefit from this info and decrease their fears and worries.