Progressive Hearing Loss in Children

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Progressive hearing loss in children can manifest with vague symptoms, such as behavioral issues or speech problems. There are many causes of childhood hearing loss, including infections, certain medications, and neurological disorders.

If you are concerned that your child may have worsening hearing loss, discuss your concerns with your child's pediatrician. Hearing tests can determine whether your child's sense of hearing is diminished, and other tests can help in identifying the cause. Treatment of progressive childhood hearing loss includes strategies aimed at improving hearing (if possible) and speech, as well as management of the underlying cause.

Symptoms

Progressive hearing loss is hearing loss that worsens over time. Most people are not able to detect subtle changes in hearing, and that holds true for young children who may also not be able to verbalize any symptoms that may experience in general.

As a parent, it's helpful to know the symptoms of progressive hearing loss in children so that you are better prepared to recognize them, should they occur. They include:

  • Not responding to speech, especially when your child cannot see the person speaking
  • Not reacting to noises
  • Raising the volume on the TV or a handheld device
  • Missing instructions in school
  • Behavioral or relationship difficulties
  • Frustration or agitation
  • A limited vocabulary for their age
  • An unusual speech and/or language pattern
  • Learning challenges
  • Complaining of a hearing deficit or ringing in the ears
  • Dizziness
  • Ear or head pain

There are a number of possible explanations for these symptoms, and hearing loss is just one potential cause. Children who experience and display and of the above issues can have hearing loss along with another problem (such as an infection) or may not have hearing loss at all.

Causes and Risk Factors

There are a variety of causes of progressive childhood hearing loss, including infections, congenital malformations, neurological disorders, tumors, toxins, medications, trauma, and nerve damage. Your child may have a genetic predisposition to hearing loss as well.

Babies who are born premature or who are born at a low birth weight are at a higher risk of developing progressive hearing loss. And if a mother has certain infections during pregnancy, that too can result in a child's progressive hearing loss.

Childhood hearing loss can be progressive because any damage to the structures that control hearing can worsen over time. Furthermore, as a child's hearing is developing, an impairment can prevent normal auditory development from occurring as it should.

Genetic and Developmental Conditions

Hereditary factors can lead to progressive hearing loss during childhood. For example, mutations of the connexin 26 gene and the PRPS1 gene have been associated with hearing loss.

Genetic conditions such as Pendred syndrome, Alport syndrome, Turner syndrome, and Usher syndrome are linked with progressive childhood hearing loss. Congenital (at birth) problems such as Mondini syndrome, a malformation of the inner ear, can also result in a progressive hearing loss.

Infections

Babies may be born with infections due to maternal transmission. Several infections, such as toxoplasmosis, syphilis, and Zika virus, can cause hearing loss that begins during the newborn years and can progress throughout childhood.

Some childhood infections, such as cytomegalovirus virus (CMV), rubella, and varicella (the virus that causes chickenpox), can cause hearing loss as well.

Ear and Nerve Damage

Injuries to the ear or the nerves that control hearing can cause progressive hearing loss at any age.

Trauma, brain tumors, and nerve disease can also interfere with the normal process by which the brain detects and recognizes sounds.

Furthermore, certain medications can harm the nerves that control hearing. Known as ototoxic medications, examples include aspirin, chemotherapeutic agents, and gentamycin, and antibiotic.

Diagnosis

The Joint Committee on Infant Hearing recommends that newborns who have any known risk factors for progressive hearing loss should have hearing tested before the age of 3 years, even if a newborn hearing screening (given to most babies before they leave the hospital) is normal. This is because a baby can have an undetectable mild hearing loss at birth that can deteriorate thereafter.

If you or your child have noticed or suspect a hearing loss, your child's pediatrician will need to take a thorough medical history and do a physical examination, including an ear exam. Your child may also have an audiogram, which is a specialized hearing test.

Sometimes, with progressive hearing loss, the audiogram changes for the worse over time. Fluctuating hearing loss—in which hearing declines then improves, only to decline again—is also possible.

Supplementary Tests

Your child may need additional diagnostic tests to identify the cause of their progressive hearing loss. The tests will be tailored based on your child's medical history and physical examination. For example, if your child has a rash, fever, or stiff neck, blood tests or a lumbar puncture may be needed to identify an infection.

When there is a family history of progressive childhood hearing loss, genetic tests may be helpful. And if the inner ear has an appearance that is not standard, your child may need imaging tests such as computerized tomography (CT) or magnetic resonance imaging (MRI).

Treatment

Children with progressive hearing loss may be able to use hearing aids, which are devices that a child can place and remove with ease. For some children, a hearing aid can help improve hearing while they are being worn.

Sometimes, a procedure such as a cochlear implant can help improve a child's hearing function and prevent it from worsening. And in some instances, such as when a child has a tumor, removal of the tumor may improve hearing.

Similarly, some anatomical defects can be corrected surgically, and this may prevent the progression of hearing loss or even improve hearing.

If your child has an infection, antimicrobial treatment is typically needed. While it might not improve hearing, eradicating an infection can prevent hearing loss from progressing in some cases.

If a pregnant mother is diagnosed with an infection, the mother and the baby may be treated with antimicrobials to prevent harm to the baby.

A Word From Verywell

There are many causes of childhood hearing loss. The appropriate treatment is determined based on the cause. It is extremely important that you seek medical attention for your child if you suspect hearing loss.

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