Signs and symptoms of hearing loss in babies
Hospitals routinely perform newborn hearing screening on infants in the first day or two after birth. If a a newborn shows signs of infant hearing loss, he or she is usually scheduled for a second screening a few weeks later. However, sometimes newborns who pass both hearing screenings may exhibit signs of hearing loss as they get older.
If you think your child is having difficulty hearing you, visit your pediatrician right away.
One way to determine if your child’s hearing is developing appropriately is by monitoring important speech and hearing milestones, such as these from the American Speech Language Hearing Association:
Babies and infants
From birth to four months, your infant should:
- Startle at loud sounds
- Wake up or stir at loud noises
- Respond to your voice by smiling or cooing
- Calm down at a familiar voice
From four months to nine months, your infant should:
- Smile when spoken to
- Notice toys that make sounds
- Turn his or her head toward familiar sounds
- Make babbling noises
- Understand hand motions like the bye-bye wave
From nine to 15 months, your baby should:
- Make various babbling sounds
- Repeat some simple sounds
- Understand basic requests
- Use its voice to get your attention
- Respond to name
From 15 to 24 months, your toddler should:
- Use many simple words
- Point to body parts when you ask
- Name common objects
- Listen with interests to songs, rhymes and stories
- Point to familiar objects you name
- Follow basic commands
Signs of hearing loss in toddlers and school-age children
Older children sometimes develop hearing loss that wasn’t present before. Here are some things to look for if you think your toddler or preschool-age child might have hearing loss:
- Your child is being flagged for a learning disorder or ADHD—always make sure they get a hearing loss screening, too, since hearing loss can mimic learning disorders and behavioral conditions.
- Has difficulty understanding what people are saying.
- Speaks differently than other children her or his age.
- Doesn’t reply when you call his or her name.
- Responds inappropriately to questions (misunderstands).
- Turns up the TV volume incredibly high or sits very close to the TV to hear.
- Has problems academically, especially if they weren’t present before.
- Has speech or language delays or problems articulating things.
- Watches others in order to imitate their actions, at home or in school.
- Complains of ear pain, earaches or noises.
- Cannot understand over the phone or switches ears frequently while talking on the phone.
- Says “what?” or “huh?” several times a day.
- Watches a speaker’s face very intently—many children’s hearing loss escapes detection because they are very successful lip readers.
What caused my child’s hearing loss?
When a child is born with hearing loss
Some babies are born with hearing loss, which is known as congenital hearing loss. Many different things can cause this type of hearing loss, but it’s not always possible to pinpoint the precise cause. In about half of all cases, the cause is genetic—meaning, inherited from a parent.
Genetic factors cause more than 50 percent of all hearing loss in children, whether present at birth or developed later in life.
Genetic factors that might cause congenital hearing loss include:
- Autosomal recessive hearing loss – This is the most common type of genetic congenital hearing loss, accounting for about 56 percent of all genetic hearing loss cases. What this means is that neither parent has a hearing loss, but each parent carries a recessive gene that gets passed to the child. Parents are usually surprised when their child is born with this type of hearing loss because people typically aren’t even aware they have the recessive gene.
- Autosomal dominant hearing loss – This type of hearing loss accounts for around 15 percent of genetic hearing losses, according to the American Speech-Language-Hearing Association (ASHA). In autosomal dominant hearing loss, one parent carrying a dominant gene for hearing loss passes it to the offspring. This parent may or may not have hearing loss, but he or she might have other symptoms or signs of a genetic syndrome.
- Genetic syndromes – These include Usher syndrome, Treacher Collins syndrome, Waardenburg syndrome, Down syndrome, Crouzon syndrome and Alport syndrome. More on rare diseases and hearing loss.
Non-genetic factors that might cause congenital hearing loss include:
- Birth complications, including herpes, rubella cytomegalovirus, toxoplasmosis or another serious infection; lack of oxygen; or the requirement of a blood transfusion for some reason.
- Premature birth. Babies that have a birth weight of less than 3 pounds or that require certain life-sustaining drugs for breathing due to prematurity are at increased risk for hearing loss.
- A nervous system or brain disorder.
- The use of drugs that cause hearing loss by the mother during pregnancy. Known as ototoxic medications, these drugs are usually prescribed medications, including antibiotics and some pain relievers. Ototoxic drugs potentially cause damage to the auditory nerve or other hearing structures in a fetus.
- The mother had an infection during pregnancy, including diseases like toxoplasmosis, cytomegolavirus, herpes simplex or German measles.
- Maternal diabetes.
- Drug or alcohol abuse by the mother or smoking during pregnancy.
These non-genetic factors account for only around 25 percent of congenital hearing loss. For the remaining 25 percent, no cause can be found.
When a child develops hearing loss later
Children can also be affected by acquired hearing loss, meaning it occurs at any point after birth. There are various causes of acquired hearing loss, including:
- A perforated eardrum
- Otosclerosis or Meniere’s disease
- Infections like meningitis, measles, mumps or whooping cough
- Taking medications linked to hearing loss (see above)
- A serious head injury
- Exposure to loud noise, causing noise-induced hearing loss
- Untreated or frequent otitis media (ear infections)
- Exposure to secondhand smoke or other toxins
