Childhood deafness (hearing loss in children): causes, symptoms and treatment

Many children live with some type of disability.. In particular, hearing impairment is relatively common in childhood, although until just a few years ago it was largely unknown. This has changed thanks to advances and research, which have allowed a much more advanced understanding of deafness.

Deafness, also called hearing loss, is defined as the total or partial inability to hear sounds in one or both ears. It is estimated that 2-3 babies per 1,000 live births have some degree of hearing loss at birth.

How to detect signs of the problem?

There are different types of hearing loss, since some are present from birth, others appear in children who initially heard adequately and others are transitory, as is the case of hearing loss due to otitis. Furthermore, not all hearing loss is equally intense, since it can be mild, moderate, severe or profound. Profound hearing loss is what is popularly known as deafness..

Most profound hearing loss are already present from birth. In addition, it is estimated that more than 60% of these deafness may have a genetic origin. However, congenital hearing loss can have many other causes, such as infections during pregnancy or malformations. Fortunately, knowledge regarding childhood deafness has increased in recent years.

Thus, it has been possible to better understand the importance of detecting it early to achieve the best therapeutic results and avoid irreversible sequelae in children who suffer from it. In this sense, it is key that parents can identify some warning signs in the first months of their child's lifeso that the corresponding intervention can be launched early.

When there are signs that something is wrong, it is essential that an ENT specialist perform a thorough evaluation to identify if, in fact, it is a case of childhood hearing loss. Due to the importance of diagnosing and treating childhood deafness early, in this article we are going to learn what deafness is, its causes, symptoms and treatment.

What is childhood hearing loss?

Childhood deafness, also known as hearing loss, is defined as the impossibility of perceiving sounds, so that hearing is impaired. Although deafness is usually spoken of in the elderly, the truth is that this problem is relatively common in childhood, so it is essential to know how to detect and treat it. This deficiency implies the loss or abnormality of an anatomical and/or physiological function of the auditory system and, although its immediate consequence is hearing disability, it also implies a significant deficit in accessing oral language.

About 1 in 1,000 live births is born with permanent and profound hearing loss. In addition, hearing impairment is somewhat more common in males. That is why the first months of life are crucial to observe and detect any signs that arouse suspicion that something is not going as it should.

Deafness of the newborn (known as prelingual deafness) it has negative consequences on the child's development, their thinking, memory, access to reading, learning, academic performance and even their personality. All these negative effects derived from hearing impairment can only be alleviated with interventions that stimulate hearing capacity as early as possible.

Thus, it is possible to make the most of the cerebral plasticity characteristic of the first years of life, stimulating communication and language development. Failure to recognize and treat a hearing impairment has serious consequences for a child's ability to speak and understand language. This leads to significant school, social and emotional problems.

Causes of childhood deafness

Knowing the causes that may be behind childhood deafness can be of great help in preventing this problem. 50% of childhood deafness have a genetic origin. To date, about 400 genetic syndromes involving hearing loss are known to exist. In these cases, the only possible preventive measure is to offer genetic counseling to the parents.

The other 50% of deafness in newborn children is associated with the presence of risk factors. It is especially important to identify infections that can affect the ear during pregnancy. In particular, cytomegalovirus is one of the most common acquired causes of deafness. This can occur in asymptomatic babies who develop late deafness that appears throughout evolutionary development.

Similarly, pregnant women should avoid any medication that could be aggressive to their baby's hearing, as well as alcohol consumption or excessive noise. It is also advisable as a preventive measure to vaccinate children against diseases such as mumps, measles or rubella, which can damage hearing.

Symptoms of childhood deafness

There are some symptoms that can alert us that a child suffers from hearing loss. Some of them are the following:

• The baby does not make sounds or babble at 6 months.
• The baby does not recognize his own name or respond to sounds in the environment, such as the telephone or the doorbell.
• The baby does not repeat or imitate simple words at 15 months.
• The baby cannot say at least 10 words at 24 months.
• The baby cannot make two-word sentences at 36 months.
• The baby cannot make simple sentences at 48 months.

Usually, parents often suspect a hearing deficit when their child does not respond to sounds or is unable to speak. However, when the hearing deficit is less profound, it may be less evident and this complicates the diagnosis. Many of his behaviors can be misunderstood, such as the child ignoring people who talk to him, but doing so only occasionally; or that the child speaks and hears well at home, but not at school.

This is explained because mild deficits only cause problems in noisy contexts, such as a class. If any of these signs appear, it is crucial that a professional examine the child to assess whether it is a case of hearing loss.

Treatment of childhood deafness

Currently, in the case of Spain, a universal hearing loss screening is carried out, so that all newborns are subjected to a rapid test that allows newborns with possible deafness to be identified. In this way, early treatment and rehabilitation can be applied that allow the child to enjoy adequate development.

The treatment in cases of hearing loss consists of an early stimulation of the baby, carrying out a speech therapy and audioprosthetic intervention adjusted to their particular needs. In cases where hearing loss is severe, cochlear implants are used. These consist of electronic devices that serve so that deaf people can receive sounds. This allows implanted deaf children to carry out their activities just like everyone else.

Being able to perceive the stimuli of the environment and the speech of those around you is of enormous help to improve your quality of life, reducing all the negative consequences mentioned above. Cochlear implants directly stimulate the auditory nerve, preventing the ear from deteriorating further. These are usually the best alternative to address severe hearing loss, since in these cases hearing aids are not effective.

The cochlear implant is essentially made up of two parts. On the one hand, an external one, which is placed just behind the ear. On the other hand, an internal one that requires a surgical intervention to be placed. All implants have the following structures:

• Microphone to pick up the ears.
• A processor that enables speech and selects and organizes sounds from the microphone.
• One transmitter and one receiver
• A stimulator that transforms the signals it receives from the processor into electrical impulses.
• Some electrodes that accumulate the impulses of the stimulator and are sent to the auditory nerve.

The most appropriate time to carry out the implantation in each child should be determined by the specialized otorhinolaryngologist. In some cases, complementary therapy may be necessary to support language development, such as the use of Cued Speech (LPC).

It is important to keep in mind that many deaf people feel satisfied with their condition and different way of communicating.. For many deaf people there is a kind of cultural identity, which is why some families may reject the cochlear implant to treat hearing impairment. This is because, in some way, they perceive this surgical intervention as a break with that feeling of belonging to the deaf community. All these aspects must be discussed with the doctor, in order to make a decision adjusted to each case.

Consequences of diagnosis in the delay of deafness

As we have already mentioned, in hearing loss it is essential to act promptly, since this way you can make the most of the brain plasticity typical of the first years of life, obtaining better results. The effects of a late diagnosis can be:

• Learning: deaf children without treatment can suffer significant delays in their education, with all that this implies for their future. There may be a lack of interest in subjects such as music, or in any subject that requires memorization. This can lead to isolation from peers at school, tiredness, inattention, or poor academic performance.

• Language: Development in deaf children slows down, as they use very basic linguistic structures. In addition, diction problems can lead to limitations in communicating with others, as well as problems with reading and writing.

• Social relationships: Deaf children can find it very difficult to concentrate, making it difficult for them to maintain long conversations, get involved in group games, follow stories or movies, etc. They may seem disobedient, but this is only a consequence of the hearing deficit.