Montana Medical Home Portal - Hearing Loss and Deafness

Introduction

Here you’ll find answers to some of the questions that parents often have about this condition. Additional resources are listed at the bottom of the page. Diagnosis and management information can be found in the Hearing Loss and Deafness module, which is written for primary care clinicians but also may be of help to parents and family members.

What is hearing impairment and what causes it?

Hearing loss and deafness refers to some degree of hearing loss in either or both ears or in the way the brain processes sound. There are many different causes of hearing loss including genetic and congenital conditions, illnesses, medication side effects, and trauma. Hearing loss may be temporary or permanent.

What is "minimal hearing loss?"

The amount of hearing loss is typically defined as the threshold (lowest level) of sound that can be heard, measured in decibels (dB). Normal hearing for children is 15 dB HL (decibels hearing level) or better at all frequencies with normal middle ear function; mild hearing loss is typically considered to start at 20 dB HL. Most people define a minimal or slight hearing impairment as one that occurs from 16 dB HL to 25 dB HL. Minimal hearing loss does put a child at risk for school failure and may require classroom accommodation such as preferential seating and frequency-modulation (FM) systems.

What are the symptoms of hearing impairment?

Hearing loss may be observed as the inability to respond to various sounds, such as calling a child’s name or hearing a plane overhead. Sometimes it can be difficult to tell if this lack of response is due to hearing loss, inattentiveness, or lack of social interest. Hearing loss may lead to speech difficulties and delays. When there is concern for speech delay or a lack of response to sounds, an audiology evaluation is recommended.

How is it diagnosed?

There are several ways to test different aspects of hearing. Some can be performed at the primary care office, through an Early Intervention Part C Program, or at school. More extensive testing is typically performed by an audiologist. Doctors who specialize in ears, such as ear, nose, throat (ENT) physicians or otolaryngologists, typically have audiologists who work closely with them. See Hearing Testing.

What is an audiogram?

An audiogram is a graphic display of the results of a hearing test. The audiologist completes the audiogram by recording the level of hearing at different frequencies (e.g. low and high pitch sounds). This enables the physician / audiologist to understand the level and type of a hearing loss and advise on the appropriate treatment options. Regular testing also allows the hearing levels to be monitored over time. See What is an Audiogram? (babyhearing.org).

What is the prognosis?

The prognosis, or long term expected outcome, is different for everyone, depending on the reason for the hearing loss. Certain types of hearing loss may improve or worsen over time. Knowing the type of hearing loss can help provide information about the expected outcome for the affected person. For young children, introducing hearing aids or other forms of augmentation early can help developmental outcomes, including speech and language development.

What is the risk for other family members or future babies?

The risk depends on the type and cause of the hearing loss. Some families have multiple family members with hearing loss, but in many cases the affected person may be the first family member with hearing impairments. A geneticist or genetic counselor can help determine the family’s overall risk if there is a possible genetic cause. If the hearing loss is caused by illness, medication side effects, or injury then it is unlikely that other family members would be affected.

What treatments/therapies/medications are recommended or available?

How will we decide what type of hearing support to choose for our child?

A wide range of technology options is available for amplification. Technology selection is individualized, based on factors such as age, level of hearing, and the needs of the child and family. An audiologist with expertise in childhood hearing loss will assist you in the decision-making process. See Hearing Aids.

What is a cochlear implant?

Cochlear implants may help some children who are deaf or hard of hearing and who do not benefit from hearing aids or FM systems. A wire containing electrodes is surgically placed into the cochlea (the organ of hearing). Sound is picked up by a receiver which is implanted behind the ear in the mastoid bone. An externally-worn receiver sends signals to the electrodes and this creates a sensation of sound. See Cochlear Implantation.

How will my child and our family be impacted?

Every child and family reacts differently to a diagnosis of hearing loss. In families where hearing loss is common, the child may feel welcome in a community that is supportive and nurturing. For families unfamiliar with the diagnosis, it is normal to feel many different emotions along the way, including denial, anger, and guilt, as well as frustration from not understanding the process and not speaking the same language as the specialists involved in the child’s care. It is important to work closely with the audiologist to monitor and care for the child, and to have good communication with the Early Intervention Part C Program and the school system to help provide appropriate supports for the child. If your child or another family member is struggling to understand and accept a diagnosis, ask your primary care clinician for suggestions or speak to a counselor to help provide developmentally appropriate insights.

What does a "false positive" result on a newborn hearing screen mean?

An infant receives a "false positive" result on newborn hearing screening when hearing is normal but the hearing test is not passed. This may be due to debris in the external auditory canal or transient fluid in the middle ears. Hearing screening tests do not diagnose hearing loss in infants; rather, they are designed to identify all infants who may have hearing loss. In the United States, between 10 and100 babies per 1,000 (1 to 10 percent) do not pass the screening test. Only one to three babies per 1,000 (less than 1 percent) actually have hearing loss. This means that most of the babies referred for diagnostic testing will be shown to have no hearing loss. Because acting early is critical for infants with hearing loss, it is very important for all infants who fail the initial hearing screen to have a complete audiological evaluation.

Resources

Information & Support

Where can I go for further information?

For Parents and Patients

Support

Family Support for Children Who are Deaf or Hard of Hearing (NCHAM)
Extensive compilation of resources and sources of support for families that have a child who is deaf or hard of hearing; National Center for Hearing Assessment and Management.

Hard of Hearing and Deaf Services (Easter Seals)
Offers a range of services to assist people with hearing impairment or hearing loss, including hearing aids, audiology, speech and hearing therapy, or referral to a specialist.

Organizations of and for People who Are Deaf and Hard of Hearing (LCNDEC)
From the Laurent Clerc National Deaf Education Center at Gallaudet University

General

Hearing Loss in Children (CDC)
Information for families, clinicians, public health departments, and others; including questions that families may want to ask various professionals (under the FREE MATERIALS link); from the Centers for Disease Control & Prevention.

Learning About Hearing Loss - A Roadmap for Families (NCHAM) ( PDF Document 347 KB)
Graphic representation of the path to learning about hearing loss, from a positive newborn hearing screen to 6 months of age; National Center for Hearing Assessment and Management.

Learning about Hearing Loss - A Roadmap for Families (NCHAM) (Spanish) ( PDF Document 287 KB)
Spanish language graphic representation of the path to learning about hearing loss, from a positive newborn hearing screen to 6 months of age; National Center for Hearing Assessment and Management.

Newborn Hearing Screening (My Baby's Hearing)
Information about specific aspects of newborn hearing screening; Boys Town National Research Hospital.

Glossary of Hearing Terms (My Baby's Hearing)
Definitions of more than 110 terms related to hearing and hearing loss; Boystown National Research Hospital.

Hearing Tests (My Baby's Hearing)
Overview of hearing testing in children; Boys Town National Research Hospital.

Nonsyndromic Deafness (Genetics Home Reference)
Wealth of information, and links to more information, about hearing impairments that are not associated with genetic syndromes; sponsored by the National Library of Medicine.

Hearing Problems in Children (MedlinePlus)
Overview and extensive links to vetted sites with more information; National Library of Medicine.

American Society for Deaf Children
Independent nonprofit organization whose purpose is to provide support and information to families raising children who are deaf or hard-of-hearing.

ASLCONNECT (Gallaudet)
From Gallaudet University; offers a variety of American Sign Language training resources, including free online videos, college level ASL classes, and Deaf Studies courses.

Trauma Treatment Needs of Deaf Children and the Hearing Children of Deaf Parents (NCTSN) ( PDF Document 430 KB)
2006 white paper focusing on helping deaf and hard-of-hearing children who experience traumatic stress receive care that is tailored to their individual, cultural, and communicative needs; includes an extensive list of related resources; from the National Child Traumatic Stress Network.

Alexander Graham Bell Association
One of the oldest and most comprehensive organizations focused on pediatric hearing loss. Educates the public about technological advances for the deaf and hearing impaired and advocates legislation.

Hearing Health Foundation
National organization whose goal is the cure and prevention of all forms of hearing loss.

National Association of the Deaf
Advocates the civil rights of the deaf and hard-of-hearing in areas including education, employment, health care, social services, and telecommunications.

National Theatre of the Deaf
Information about upcoming performances, workshops, and classroom visits.

World Federation of the Deaf
International organization with goal of eradicating discrimination against the deaf community.

American Speech-Language-Hearing Association
Information for professionals working in audiology, speech-language pathology, and the speech and hearing sciences. Advocate for people with communication disabilities.

American Sign Language Teachers Association
Provides ASL professionals with information on deaf culture, instructional methods, materials, and evaluation techniques.

Council on Education of the Deaf (CED)
Dedicated to the exchange of information about deaf education, from recommended teaching strategies to curriculum materials.

American Sign Language Dictionary (handspeak.com)
Online ASL dictionary, reportedly the largest on the Web, offers 3,090 animated signs, from "accounting" to "zen."

SignWriting
Award-winning site offers extensive information on how to read and write in signed languages.

Patient Education

'Just in Time' Hearing Resources for Families (NCHAM) (Spanish) ( PDF Document 639 KB)
Two-page compilation of valuable resources for families with concerns about hearing loss in their child; National Center for Hearing Assessment and Management.

'Just in Time' Hearing Resources for Families (NCHAM) ( PDF Document 574 KB)
A two-page compilation of valuable resources for families with concerns about hearing loss in their child; National Center for Hearing Assessment and Management.

Parents' Guide to Hearing Loss (CDC)
Website with comprehensive information on hearing loss in children, including intervention options, building language, decision making, resources, and a glossary of related terms; from the Centers for Disease Control and Prevention.

Services in Montana

Select services for a different state: ID, NM, NV, RI, UT

Prenatal Genetic Counseling/Diagnosis

We currently have no Prenatal Genetic Counseling/Diagnosis service providers listed; search our Services database for related services.

Public Special Schools

See all Public Special Schools services providers (1) in our database.

Speech - Language Pathologists

See all Speech - Language Pathologists services providers (45) in our database.

For other services related to this condition, browse our Services categories or search our database.

Studies

Childhood Hearing Loss (ClinicalTrials.gov)

Cochlear Implants and Children (ClinicalTrials.gov)

Authors & Reviewers

Initial Publication: October 2012; Last Update: December 2015

Current Authors and Reviewers (click on name for bio):

Author:

Jennifer Goldman-Luthy, MD, MRP, FAAP