Every parent is biased, but you always knew your kid was bright: early talker, thoughtful questions, accurate drawings in preschool. Why would they lag academically? Why would they be getting B’s, C’s, or D’s, with comments about disengagement and lack of effort? You reluctantly brainstorm possibilities: ADD, dyslexia, bullying, Asperger’s.
Some parents may be relieved, and others troubled, to add hearing impairment to the list.
To many, the diagnosis feels simplistic. But parents often look for signs of deafness, dismissing the symptoms of milder impairment, while unrealistically expecting small children to know that their hearing has gotten worse. And in a surprising proportion of cases, problems in school stem from this simple (and often treatable) source.
Small odds, big consequences
Normal hearing tests in infants are always a relief, but they can’t guarantee normal hearing through childhood. Untreated ear infections, mumps, measles, head injury, medication side-effects, perforated ear drums, loud noises, and rare congenital diseases with late onset can all affect hearing later in life. Younger ears tend to show less wear and tear but are by no means immune. Depending on how it is defined and measured, hearing loss from all causes affects .1–.5 % of all children.
This rate is reassuringly low, but for children with symptoms, testing is definitely in order. What’s more, untreated hearing loss can have serious developmental consequences. School-age children learn language, social skills, and mathematical concepts at an incredible pace. This learning may feed a virtuous cycle, where the capacity for learning gets a once-in-a-lifetime boost. Those who miss out, for any reason, may never catch up as adults.
Background noise
How could such a serious problem fail to get quickly noticed? The answer is simple and universal: the “signal” is low, and there’s plenty of “background noise.” The signs of mild or moderate hearing impairment are counterintuitive to many. A child may easily hear a parent’s voice in the kitchen but miss half of what the teacher says in a noisy classroom. They may also struggle to understand people with unfamiliar speech patterns.
Meanwhile, the relentless changes of childhood mean lots of confounding noise. Parents may blame ignored commands or odd pronunciation on normal development. Children, meanwhile, may not remember their old hearing abilities — especially if the decline was gradual. Adults often expect their kids to react to poor hearing with concern and frustration, and they expect them to complain at once. But kids are not adults. They may not notice a long-term trend, and they may not have a long-term baseline against which their current hearing seems abnormal. “Long-term” is a thin concept for someone whose age can be shown with fingers.
What to look for
Academic difficulties are just one of many signs that a child may have hearing loss. Here are some others:
•Unclear or unusual speech relative to peers
•Difficulty following simple directions
•TV or computer use with high volume
•Failure to respond to one’s name
•Need for phrases to be repeated
•Illogical responses to questions
•Watching other children for cues to appropriate behavior
•Complaints of ear ache, pressure, or pain
If any of these or other worrisome traits applies to your child, make an appointment with an audiologist. Just as you would never neglect your child’s nutrition, make sure their mental, social, and emotional diet isn’t compromised by poor hearing.
