Introduction
Hearing is assessed to determine how well a child or infant can hear various noises. Certain newborns are deaf from birth, and some infants have normal hearing at birth and develop hearing issues later in life.
Early-life hearing loss can impede a child's development of social skills, speech comprehension, and talking abilities. Early detection of issues through hearing exams enables children with hearing loss to receive treatment and assistance in language acquisition as soon as feasible.
How Does Hearing Loss Occur in Infants and Children?
The process through which sound waves are converted into electrical impulses that the brain interprets as sounds is what makes hearing possible.
Any of the following actions can result in hearing loss:
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The middle ear's eardrum receives sound waves that enter the outer ear.
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The eardrum vibrates in response to sound waves, which are then sent to small bones, where they intensify.
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Tiny waves are created in the cochlea's fluid by the vibrating bones. The inner ear's cochlea is a structure that resembles a snail. It is lined with sensory cells with structures resembling hair. Electrical signals are produced by the hair cells as they flow with the fluid waves.
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The inner ear sends electrical signals to the brain, which interprets them as audible stimuli through the auditory nerve (hearing).
Three primary categories of hearing loss exist:
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Insufficient sound waves entering the inner ear result in conductive hearing loss. A hole in the eardrum may prevent the eardrum from vibrating, or earwax or abnormal fluid may obstruct the route. In infants and early children, ear infections frequently cause this kind of hearing loss. Surgery or medical intervention can frequently enhance hearing.
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Sensorineural hearing loss, commonly called nerve deafness, results from injury to the inner ear's auditory nerve or the cochlea. This hearing loss might be severe (not hearing any sound) or mild (difficulty perceiving specific sounds). Although hearing loss is typically irreversible, it may improve with additional tools like hearing aids.
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Sensorineural and conductive hearing loss are combined to form mixed hearing loss.
Auditory neuropathy spectrum disorder (ANSD) is a term used to describe one kind of sensorineural hearing loss. In individuals with ANSD, the inner ear or hearing nerve's ability to transmit sound waves to the brain is compromised. This hearing impairment could develop if the child were unwell before, during, or after delivery. Premature birth (being born too soon), low birth weight, and jaundice are some of these issues. A genetic condition could be the cause of ANSD.
Why Does a Child Need a Hearing Test?
It is advised that all infants and kids have routine hearing screenings:
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By the time they are one month old, newborns should have a screening test for hearing issues.
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The screening test is typically completed in a hospital before the newborn is discharged.
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Ensure the baby is tested during the first month of life if the mother gives birth at home.
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Kids should have their hearing examined before starting school. Children in school may have hearing screening exams as part of routine physical examinations, which are often taken in school.
More thorough testing is required whenever there is a reason to suspect that a child may not be hearing properly.
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If the newborn hearing screening test is negative, the child will require comprehensive hearing testing as soon as feasible but no later than three months of age.
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The kid will require full hearing tests between the ages of 24 and 30 months if they pass the newborn hearing screening test but are at a high risk of developing hearing loss. If the baby experiences certain infections or hearing loss in childhood runs in the family, their risk may increase. Find out the baby's risk assessment from their healthcare provider.
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Contact the child's provider right away if the infant or youngster exhibits any signs of hearing loss.
What Are the Signs of Hearing Loss in Infants and Children?
Infant hearing loss symptoms include:
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Not flinching or flinching at loud noises.
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When six months old, not looking in the direction of a sound.
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Not able to say a few basic words by 12 months, like "dada" or "mama."
Children's hearing loss symptoms include:
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Unclear communication.
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Not adhering to instructions.
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Saying "Huh?" a lot.
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Increasing the TV's volume too much.
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Learning issues.
What Happens During a Hearing Test?
The following hearing tests rely on the age and instruction-following skills of the child:
Newborns, babies, and young children can assess their hearing with screening procedures that do not require cooperation. One can even administer these exams to the child as they sleep:
Auditory Brainstorming (ABR): These tests examine the inner ear, the hearing nerve, and the areas of the brain related to hearing.
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The ABR test involves the application of electrodes, which are tiny skin-attaching sensors, to the scalp by a healthcare professional. The computer is linked to the electrodes.
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The ears will be fitted with tiny, comfortable earbuds.
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The earbuds will produce audio.
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The electrodes record the brain's reaction to the noises. The computer displays the results.
Otoacoustic Emissions (OAE): These tests look for damage to the cochlea's hair cells.
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An OAE test involves the insertion of a tiny instrument into the ear. Both making and measuring sound is possible.
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The cochlea's fluid ripples in response to sound, moving the hair cells. OAEs are vibrations produced by moving hairs that have their own sound.
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The gadget measures OAEs to gauge the efficiency of the hair cells. The child may suffer from sensorineural hearing loss if the test reveals few or no OAEs.
Audiometry exams are typically used for older children's hearing screenings. These assessments determine which child's words or noises are the quietest. Regarding these exams:
Children will wear headphones. When a youngster refuses to wear headphones, audio can be played via speakers within a sound booth. In a pure-tone test, the child raises a hand, presses a button, or reports hearing the tone each time they hear it.
In a speech test (also known as a speech discrimination test), the child will be exposed to short, simple words at varying volume levels. There will be some spoken remarks over the din. The words youngsters hear, they will repeat.
Tests using audiometry can be modified for newborns and very young children. A game to assist young children in focusing on the noises may be included in the exams. A child might, for instance, place a block in a box whenever they hear a sound.
The caregiver will watch for any behavioral changes in newborns and toddlers that indicate they have heard a sound. An infant might, for instance, begin sucking on a pacifier or turn to investigate the source of the noise. As a reward for responding to a sound, the child gets to watch a moving toy.
What Does the Results Mean?
The child will not require additional testing until their next checkup if their hearing test results are normal. However, one should discuss concerns with their doctor if they have doubts about their hearing or risk factors. If the tests confirm the child's hearing loss, they will indicate the kind of hearing loss, the degree of impairment, and which ear is most impacted.
If it is conductive, therapy could help them hear again by removing obstructions like fluid or wax or by addressing problems with the eardrum or ear bones. If the hearing loss is sensorineural, cochlear implants or hearing aids may help. Learning effective communication techniques, utilizing specialized phone equipment, alarms, and support groups.
Conclusion
For prompt intervention and assistance, hearing problems in newborns and children must be identified as soon as possible. Healthcare professionals can accurately evaluate a young person's hearing ability by using a combination of screenings, specialized tests, and behavioral observation. This allows for timely intervention and, if necessary, access to appropriate therapies, such as cochlear implants or hearing aids. In the end, children's overall growth and well-being depend on maintaining their hearing health at its best, which enables them to flourish and realize their full potential.
