"Hears" to the New Year, 2012,
and to learning more about hearing!!
Have you ever wondered, what is a "conductive" hearing loss? What is a "temporary" or "fluctuating" loss? What is a "sensorineural" loss? What is a "permanent" loss? How do I know what kind of hearing loss a child has?
These are questions that Early Head Start staff find themselves asking as children they've identified through screening go on for audiological assessment. Having a working knowledge of the terms used by audiologists to describe different types of hearing loss will allow you communicate well with the audiologist and assist the family in understanding the appropriate intervention.
Hearing loss can arise from problems in the outer, middle or inner ear.
A hearing loss can occur in both ears (bilateral) or only one ear (unilateral). A child with a unilateral loss (one ear with a hearing loss and one ear with normal hearing) experiences difficulty in many listening situations.
When there is a hearing loss because of a problem in the outer or middle ear, it is called a "conductive" hearing loss. This means that the sound waves are weakened as they move through the outer and middle ear on their way to the inner ear. Examples of conductive hearing loss include wax blockage in the ear canal, fluid in the middle ear caused by infection (otitis media), or a perforation (hole) in the eardrum. Conductive hearing loss is commonly associated with wax blockage in the ear canal, fluid in the middle ear caused by infection (otitis media), or a perforation (hole) in the eardrum. Conductive loss can also be caused by a malformation in the three small bones in the middle ear that transmit sound from the outer ear to the inner ear. In all cases, diagnosis of a conductive hearing loss is made by an audiologist. A conductive loss can be mild or moderate, making it difficult to hear speech in many situations. When a child has otitis media and the middle ear alternately fills with fluid and then clears, the hearing loss is called "fluctuating conductive." Most types of conductive hearing loss are temporary, or transient, and can be treated with medicine, pressure equalization (PE tubes) or surgery.
When there is a problem in the inner ear (cochlea), it is called a "sensorineural" hearing loss. This type of loss can be caused by genetic factors, head trauma, or certain infections. Sensorineural hearing loss (especially when identification and/or appropriate intervention is delayed) can be detrimental to a child's development, because it is usually permanent and cannot be completely corrected medically.
The amount of loss can range from mild, where the child can hear many environmental sounds but cannot hear quiet speech, to severe or profound, where the child cannot hear any speech, and may not even be able to hear many loud sounds in the environment. Even though the hearing loss is permanent, in most cases amplification, such as hearing aids or cochlear implants, and therapy, can help a child to hear and understand speech better.
It is also possible for a child to have a permanent, sensorineural hearing loss along with a fluctuating or temporary conductive hearing loss. This is usually referred to as a "mixed" hearing loss.
Providing periodic hearing screening, so that a permanent, sensorineural hearing loss can be identified at the earliest possible time, is one of the most important roles an Early Head Start provider can play in a child's life.