Hearing Loss in Children: The Kit & Caboodle

Children develop their speech vicariously by hearing others speak and imitating the sounds in their environment. Thus, a child who is hearing-impaired finds difficulty in their speech development. They cannot hear the all of the sounds in their environment, so they find difficulty understanding, communicating, and learning about the world.

The causes of hearing loss in children vary from genetics, infections, or even injury. Children could be born with hearing loss or acquire the loss during infancy or childhood. A hearing specialist or ENT doctor can possibly determine the significance of a child's hearing impairment and suggest the appropriate treatment.

(((((How We Hear)))))

I learned the function of the ears during Biopsychology at SUNY Buffalo (where I received straight A's). When I say "it's complicated," I truly mean it. I'll abridge the current and most widely accepted theory about how the outer/inner-ears take in sounds as well as how the brain processes them. Sound waves first hit the outer ear, continuing on through the ear canal causing the ear drum to vibrate. This vibration triggers the bones in the middle ear to move up and down, creating waves in the fluid of the inner ear, AKA the cochlea (pronounced kɒk.lɪə or coke-leah; coolest word EVER). The microscopic hair cells inside the cochlea (yes, there's microscopic hair inside your ear and no, do not apply Nair) bend and stimulate the auditory nerve, which then transmits this auditory information to the brain to be further processed. This all happens within fractions of a second. Any single breakdown in this system (ie: Nairing your cochlear hair) can result in hearing loss. In all seriousness, hearing impairment in a child can drastically hinder their speech development, emotional development, intellect, and life in general. Luckily, large strides have been made over the past few decades in treating and even fixing hearing impairment. But, before we get into that, let's talk about the different types of hearing loss.

(((((Types of Hearing Loss)))))

Conductive hearing loss constitutes a signal breakdown near the outer or middle ear. Temporary conditions such as fluid build up in the middle ear, ear infections, or wax build up in the ear canal can cause conductive hearing loss. Malformations of the ear or ear canal can also cause breakdown of auditory signals.

Sensorineural hearing loss can result from damage or malformation of the inner ear or cochlea. This type of hearing loss is typically permanent, and often medical or surgical treatment cannot fix the issue. Children who have sensorineural hearing loss can sometimes benefit from wearing hearing aids or cochlear implants that amplify auditory signals or bypass the damaged inner ear.

Mixed hearing loss is a combination of both conductive and sensorineural components of hearing loss.

(((((Severity of Hearing Loss)))))

To determine the severity of a child's hearing impairment, an audiologist creates a graph called an "audiogram". The severity of hearing loss can vary from mild, to moderate, to severe, to profound. An audiologist can create a measurement of a child's hearing loss on an audiogram by measuring a child's detection for sound at a slew of different pitches ("frequency") and loudness levels ("intensity"). The lines on an audiogram create a "shape" that represents the child's hearing loss. A flat shape indicates that the child hears at about the same intensity level across all frequencies. A sloping shape indicates a need for more intensity as sound movers across the different frequencies. A "cookie bite" shape refers to a hearing loss milder in the low and high frequencies, with a more significant loss in the middle frequencies.

(((((Treatment of Hearing Loss)))))

Regardless of the type and severity of a child's hearing loss, it CAN be managed. Professionals such as audiologists or otolaryngologists devote their careers to this. Amplification systems are constantly being improved upon, and medical or surgical treatments can sometimes help increase a child's hearing ability. Hearing is directly related to a child's development of speech, reading and writing. So parents who suspect a hearing impairment in their child should seek testing and treatment immediately. Difficulties with speech can be treated by a Speech-Language Pathologist.

 

Resources

National Institute on Deafness and Other Communication Disorders, NIDCD, from the National Institute of Health, http://www.nidcd.nih.gove/health/statistics/hearing.asp retrieved September 26, 2013.

Super Duper Handy Handouts!. "Hearing Loss in Children" by Susie Lorraine, M.A., CCC-SLP

ADHD vs. CAPD: Know The Difference

At Suffolk Center for Speech, we believe it's so important to know the difference between ADHD (Attention Deficit Hyperactivity Disorder) and CAPD (Central Auditory Processing Disorder). The two share similar symptoms, and so CAPD is many times misdiagnosed as ADHD. ADHD is a well recognized disorder among psychologists and physicians and the quick fix is medication regiments such Ritalin or Adderal. Parents who suspect their children may have ADHD bring them to their regular doctors who most likely are more aware of ADHD and its symptoms rather than CAPD. Therefore, many children are misdiagnosed with ADHD, and their CAPD goes untreated. There have been implications that stimulant-like medicines may help children with CAPD, but they are not the treatment a child with CAPD fully needs to overcome or live with this disorder. The information in this post should help parents decide whether or not to bring their child for an evaluation at their regular pediatrician office and/or a Speech Pathologist office.

Central Auditory Processing Disorder involves a child with normal hearing (a child that does not require a hearing aid) who finds difficulty in processing or understanding what he/she hears. Our ears take in the information, the information travels to two seperate sections of the brain: one to simply be absorbed (heard) and one to be processed (understood). Treating this problem at an early age is best, as it becomes more and more difficult as a child grows and his/her brain continues to develop.

Symptoms of CAPD may include:

• Academic and/or behavior problems
• Frequent distraction from tasks, especially in a noisy environment
• A need for increased time and/or multiple cueing to answer questions
• Difficulty recognizing and/or discriminating between acoustically similar sounds

You can see how a child with CAPD can easily be misdiagnosed with ADHD...

Symptoms of ADHD may include:

• Frequent and easy distraction
• Impulsivity (acting without planning for consequence)
• Inability to focus
• Difficulty following directions, poor organizational skills, and tendency to forget things
• Stubborness, temper, defiance, or a diagnosis of a specific language disorder*

What if your child is misdiagnosed? It really can depend on who evaluates a child with these similar symptoms first. ALWAYS get a second opionion. A child with CAPD who is misdiagnosed with ADHD can experience major trouble in his/her academic life, social life, and even career life in the future. Therapy for CAPD should start early in life, but the child must be motivated in therapy. Here at Suffolk Center for Speech, motivation is our middle name. We've got a whole room filled with gizmos and gadgets, dolls and figurines that children can win and take home after successful sessions. Our therapist are highly qualified and experienced, our establishment is a ball of fun (with a serious cause) and children enjoy coming here. It's not a trip to the dentist, or a checkup at the doctor. We make Speech Therapy a fun, engaging happening. We're a party with a purpose.

So, if you believe your child is displaying symptoms of either of these disorders, we implore you to explore both evaluations: one from a Psychologist/Physician and one from an Audiologist/Speech Pathologist. It's so important that children with these disorders tackle them early in life, before they become harder to treat, and cause problems in teenage and adult life.

Written by: Tim Strampfer