Hearing Loss in Children

Hearing loss can affect kids of all ages. And often, it comes with signs. With babies, you may notice loud noises don’t startle them or that they aren’t turning toward something making noise. Older kids may say, “Huh?” They may not speak clearly or be slower to talk than other kids their age. You may also notice they don’t always follow directions.

Types of hearing loss in children

Your child may experience hearing loss in only one ear (unilateral hearing loss) or both (bilateral hearing loss). And there are several different types of hearing loss:

• Conductive hearing loss: Something keeps sound from moving through their ear canal (outer ear) or middle ear.
• Sensorineural hearing loss: Damage to their inner ear over time causes progressive hearing loss or babies may be born with abnormal inner ears and hearing loss.
• Sudden sensorineural hearing loss: Sudden hearing loss in their inner ear can happen instantly or over only a few days.
• Mixed hearing loss: This combination of conductive and sensorineural hearing loss affects their outer or middle ear and their inner ear.

Causes of hearing loss in children

There are many reasons why your child might have hearing loss. Some things that can block or damage hearing are:

• Ear malformations.
• Ear tumors.
• Earwax, fluid buildup or other blockages.
• Eustachian tube or eardrum problems.
• Head injuries and other trauma.
• Loud noises.
• Middle ear infections (otitis media).

Before we craft your child’s treatment plan, we’ll want to meet with them (and you) to learn more about what’s going on. We call this an evaluation, and it can help us learn more about what’s causing your child’s hearing loss. Finding the cause is the first step to getting them the care they need.

What to expect

During this visit, your child’s provider will take time to get to know them. They’ll ask a lot of questions about how you noticed your child’s hearing problems and what kind of symptoms they have. They’ll talk with you about your child’s medical history and ask about your family’s, too.

Your child will get a physical exam, and their provider will also look at their ears. They’ll keep an eye out for signs of infection or other problems that can cause hearing loss, and they’ll review the hearing test results. The provider may then order imaging tests like a CT scan or MRI, which may reveal the reason for your child’s hearing loss.

Hearing tests

Your child will also meet with a pediatric audiologist to get hearing tests. These tests let our team check how well the various parts of your child’s ears work. Their audiologist will use age-appropriate tests to evaluate their hearing levels. In older children, they can do pure-tone testing with a tool (audiometer) that checks how well they hear quiet and loud sounds. They’ll also see how your child responds to pitches that are high (like a whistle) and low (like thunder rumbling).

Your child may also have tests to check their eardrum and middle ear (tympanometry). Their audiologist may also see how well they understand speech. All of these test results will help our team figure out what kind of hearing loss your child has and how severe it is. This could range from slight to profound.

Meet Our Hearing Loss in Children Team

Cleveland Clinic Children’s team-based approach to care means your child will see several different healthcare providers. This lets us make sure their treatment meets their needs every step of the way. Their experienced care team could include providers like:

• Pediatric otolaryngologists (ENT specialists).
• Pediatric audiologists.
• Pediatric nurse practitioners.
• Pediatric speech-language pathologists.
• Child life specialists.
• Pediatric social workers.

This team works together to build a plan to treat and manage their specific hearing loss.

Your child’s treatment will depend on the kind of hearing loss they have. Their care team uses what they learn from the evaluation and test results to make sure your child’s plan meets their needs.

Medications

Some medications can help treat hearing loss. If a severe ear infection contributes to it, we’ll prescribe antibiotics. If we suspect inner ear damage caused by exposure to loud noises or infections, we may recommend corticosteroids.

Minimally invasive procedures or surgery

If earwax or other objects block your child’s ear canal, we can usually remove the blockage without surgery. It’s important to let us handle removal and not try to remove anything from your child’s ear at home. Never put anything inside their ear canal, including cotton swabs.

Sometimes, your child may need ear surgery to do things like:

• Fix congenital (born with it) conditions like abnormal middle ear bones.
• Remove benign cysts, like cholesteatomas (middle ear growths).
• Treat chronic ear fluid or infections (myringotomy and tubes).
• Repair a ruptured ear drum (tympanoplasty).
• Insert ear tubes (tympanostomy).

Hearing aids and implants

Different hearing devices may help your child’s condition. Depending on the type of hearing loss they have and its severity, we may recommend:

• Hearing aids: There are different types of these small, electronic devices. We place them on your child’s ear to help amplify sounds if they have mild to severe hearing loss.
• Cochlear implants: These surgically implanted devices stimulate the nerve that connects your child’s ear and brain (auditory nerve). They’re often used for severe to profound sensorineural hearing loss.
• Bone-anchored auditory implant: We may recommend this surgical implant for conductive hearing loss, unilateral hearing loss or other reasons. It sends sound as a vibration to your child’s ear that works best.
• Auditory brainstem implant: If your child has hearing loss because their auditory nerve is missing, we may recommend an auditory brainstem implant. It can help them have better sound awareness and recognition by stimulating electrical signals to create sound sensations in their brainstem.

Specialized therapy

Whether your child with hearing loss wears a hearing device or not, they may benefit from working with therapists to learn how to understand and practice their speech. Some types of therapy include auditory-verbal therapy and speech therapy.

Helping Your Child Live With Hearing Loss

Hearing loss isn’t easy for anyone. For kids, it can affect how they learn and interact with others during an important time of growth and development. Our pediatric hearing loss providers, child life specialists and social workers are here to help you and your child navigate life with hearing loss. From regular checkups to mental and emotional support, you can count on us.

This personalized care continues into adulthood. When your child ages out of care at Cleveland Clinic Children’s, we’ll help them make a smooth transition to Cleveland Clinic’s adult hearing specialists.

Financial assistance

If cost is an issue, our social workers can put you in touch with state and federal government agencies or nonprofit organizations designed to help children with hearing loss get the treatment they need. If you’re enrolled in Medicaid, we can help you work with your insurance provider to find out if your child’s hearing device and testing are covered.

Taking the Next Step

When you learn your child has hearing loss, you may worry what their life will be like — and what to do next. Cleveland Clinic Children’s expert providers can help remove a lot of this guesswork. Our team will help uncover why your child has hearing loss and build a treatment plan focusing on correcting or managing their condition. We’re here to help them keep learning, growing and thriving through childhood and beyond.