The 7th of November is internationally known as Children’s Day. In honour of the day, we’re highlighting the risks of hearing loss in children. We also look at the far-reaching implications of this condition going untreated.
According to the World Health Organisation (WHO) there are approximately 34 million children worldwide who have a disabling hearing loss. Disabling refers to hearing loss that is greater than 30 dB HL in the better ear (for children).
Sixty percent of hearing loss in children is preventable. In addition, early and appropriate intervention can ensure that a child with hearing loss is still able to reach their full potential.
Hearing is crucial in facilitating communication, social interaction, and verbal learning. In addition, hearing allows children to be alerted to danger and to participate fully in daily activities. In children, hearing is fundamental for speech and language development, mainstream academic learning, and engaging in social activities.
Causes of Hearing Loss in Children
These can be grouped into congenital and acquired causes.
- Congenital causes may lead to hearing loss that is present at or immediately after birth. This type of hearing loss can be caused by hereditary factors or non-hereditary factors such as complications during birth or pregnancy. These include the use of ototoxic drugs by the mother or the child having a low birth weight.
- Acquired hearing loss is that acquired during any age of a child. It can be caused by excessive noise exposure, use of ototoxic medications, and certain infections such as measles and mumps.
Although there are a variety of contributors to childhood hearing loss, the main contributor is otitis media with effusion (OME) or middle ear infection. The latter is a buildup of fluid in the middle ear cavity behind the eardrum leading to decreased hearing sensitivity.
Impact of Untreated Hearing Loss in Children
Unidentified and untreated childhood hearing loss has been shown to dramatically delay a child’s speech and language development. This affects their academic achievement and vocational opportunities later in life. Even mild hearing loss may result in poor educational performance and a difficulty with self-esteem, social and emotional abilities.
Difficulties to hear and communicate one’s needs results in children having feelings of loneliness, stress, frustration and anger. In addition, a child might not be alerted to dangerous situations such as a car driving towards them.
In a distal sense, untreated childhood hearing loss, over time, affects social and economic development in a country. Why? Because these children may not be able to effectively contribute to the society and economy.
The Impact of COVID-19 and Changes to Traditional Learning Settings
Hearing loss is an invisible condition as it might be difficult for parents and hearing care professionals to recognise. Appropriate tests are therefore necessary. At times, children continue with life and schooling while their parents, teachers and community are unaware of their hearing loss.
One study by Watkin and colleagues showed that only 25% of parents of children with significant hearing loss suspected that their children had difficulties.
This is especially true in cases of slight, mild and moderate hearing loss. In these cases, children might be able to hear loud voices, noises and sound sources, but not particular parts of the speech.
The issue of unidentified and untreated hearing loss in children and its impact on their academic progression is especially concerning as a result of COVID-19. During this pandemic, modifications have been made to traditional school and learning to facilitate control of the spread of COVID-19. For example, education has in many cases switched to online classes, which sees children attending lessons via video conferencing platforms. Another change is the increase in physical distance between the teacher and the children, and between the children themselves.
These changes result in children with unidentified hearing loss struggling even more to hear the teacher and their friends speak. This is the result of the distance in class or the use of computer speakers for online learning. One could view this as a blessing in disguise. For example, allowing teachers and parents to finally be aware that their children could have hearing difficulties. However, this is not a given as parents and teachers may not be able to accurately pinpoint the issue.
The high prevalence of hearing loss and the concern with unidentified childhood hearing loss during the COVID-19 pandemic calls for several solutions. These include mass screenings, early detection, identification and appropriate intervention to minimise hearing-related difficulties, and facilitating optimal learning in an educational and social setting.
Early Identification of Hearing Difficulties: Challenges and Solutions
Early identification and timely appropriate intervention of childhood hearing loss can facilitate educational and social development, and communication. Research has shown that children born with hearing loss, or those who have acquired it at an early age and have received intervention within six months of age, are on par with their hearing peers in terms of language development by the age of five years.
For children who acquire hearing loss at a later age, regular school hearing screening programmes, timely identification and intervention can significantly reduce the negative impacts. Most children presenting with hearing loss at birth are potentially identifiable by newborn hearing screening programmes.
In developing countries, such as South Africa, where more than 80% of people living with hearing loss reside, there are limited prospects of early detection of hearing loss. This is due to the lack of hearing healthcare professionals, expensive audiological equipment and legislation or mandates in place to conduct newborn hearing screenings.
As a result, in most cases, school-age hearing screenings are the first point of hearing assessments for most children. However, effective implementation of school-based hearing screening presents with a number of challenges.
One of the challenges is the continued use of otoscopy and pure tone audiometry as the golden standard for school-aged hearing screening programmes. The diagnosis of OME using an otoscope has been shown to be unreliable and ineffective. The reason? Its accuracy depends heavily on the operator.
Additionally, pure tone audiometry can confirm hearing loss, however, it is a subjective test and often unreliable. Various factors are to blame, including:
- The children’s inability to understand the test.
- The audiometer operator not being adequately skilled.
Tympanometry is an objective and reliable method of diagnosing OME. Research has shown that the use of otoscopy, pure tone audiometry and tympanometry in combination offers a powerful method of diagnosing OME.
Therefore, effective and efficient medical technology such as the Kuduwave should be used to identify hearing loss in children earlier and more accurately. It also helps to provide effective and timely intervention.
To find out how eMoyo’s range of portable Kuduwave audiometers can help, contact us to book a free consultation and product demo.