Of all the senses, hearing has the greatest impact on language development. Today, infants are tested at birth in hospitals so that if a hearing loss is detected, no time is wasted in providing amplification for the hearing-impaired child. The child’s first three years is a critical time for receiving sound, before the auditory cortex begins to deteriorate – so early intervention is essential for a good hearing/language prognosis.
There are two types of hearing loss: Sensori-neural (permanent) or conductive (usually treatable). For those born with a sensori-neural hearing loss, hearing aids or Cochlear implants can provide the appropriate level of amplification.
For those with conductive losses, medical intervention is usually required with excellent success rates after treatment. A GP visit is the starting point and referral to an Ear, Nose and Throat (ENT) specialist may follow. Conductive losses can be caused by malformations in the anatomy of the ear (e.g. atresia), eustachian tube dysfunction (colds, allergies, adenoids), or from middle-ear infections (otitis media, sometimes referred to as glue ear). Ignoring middle-ear infections can result in a rupture of the tympanic membrane (burst eardrum), which makes recovery more complicated.
In the initial stages, a conductive hearing loss may be mild; but if ignored, the fluid in the middle ear thickens and the hearing loss can become much more significant.
A mild hearing loss is often difficult to detect. Perhaps the child asks for repetition frequently, cannot hear when the television is on, may not be attentive in classroom settings, or may have trouble participating in conversation from the back seat of a car. When this is not detected, after a while the hearing drops and it can result in a child who can no longer hear speech at normal conversation levels.
Hearing loss will impact the child’s learning and language development. Speech therapists can provide guidelines for language development and whilst there can be great variation between children, there are age-appropriate levels that are recommended. If a child has not reached a milestone, a hearing check and/or visit to a speech therapist is recommended. Remember, with early intervention, a successful outcome is easier to achieve.
Whilst language is the overt outcome of hearing, in the preschool years there is also the development of phonemic awareness taking place, where the brain learns to perceive the phonemes of speech which impact on later literacy skills. Often children around age seven with a history of early conductive hearing loss, are found to have poor auditory processing skills when they are learning to read. This can manifest as a poor auditory memory, inability to differentiate pitch, or difficulty hearing amongst noise – all skills needed for learning and reading.
Another precaution for children with a hearing loss is the need for extra care when crossing a road, as they cannot hear the low frequency sounds of a motor car approaching.
If a parent, carer or teacher has any concerns regarding a child’s hearing, a simple visit to a paediatric audiologist is recommended. Hearing testing for children, when carried out well, is a painless, fun procedure using age-appropriate games and puppets. It usually takes no longer than 30 minutes and can be a pleasant experience.
Signs your child may need a hearing test
- They commonly ask you to repeat what you’ve said
- They find it hard to hear with background noise, e.g. television
- It’s difficult for them to participate in conversation from the back seat of the car
- They may not be attentive in classroom settings
Lindsay Reinhardt, BA, MASA CC, dip Special Education, Dip Audiology, is Director of Northside Audiology, an audiology clinic located in Sydney. From their purpose-built, state-of-the-art facility in Chatswood to their clinics in Bella Vista, Neutral Bay and Gladesville, Northside Audiology makes the process of hearing assessment and hearing management as straightforward as possible.