In 1999, Congress passed legislation requiring newborns to be screened for hearing loss. In the years since, early intervention aids and therapies have enabled numerous hearing-impaired children to develop normal language skills at the same age as their peers with hearing that isn't compromised.

Today, 97 percent of newborns are screened for hearing loss but passing the test at birth doesn't guarantee hearing problems won't develop later. Experts say children who had normal hearing as infants can still develop hearing loss especially if they were born with the following risk factors:

  • A family history of hearing loss
  • Low birth weight
  • Childhood illness such as meningitis, chicken pox and the flu
  • Frequent and untreated ear infections
  • Head trauma
  • Exposure to very loud noise

Additionally, measles, mumps or any of the so-called TORCH (toxoplasmosis, rubella, cytomegalovirus or herpes) infections contracted during pregnancy can put a child at increased risk.

Defining Hearing Loss

Each year, 12,000 infants are born in the U.S. with permanent hearing loss, according to the American Academy of Pediatrics (AAP), and 1.3 million children with hearing loss are under the age of 3. Many deaf children have two hearing parents—both carriers of a recessive gene.

Hearing loss can occur in one or both ears and can be mild, moderate or severe. It can be caused by a problem in the part of the ear that we see (called the outer ear) or in the middle ear.

There are two kinds of hearing loss:

Conductive. Certain birth defects that change the structure of these areas as well as anything that prevents sound waves from passing through unimpeded like an injury or rupture to the eardrum or objects stuck in the ear canal can affect hearing. This type of hearing loss—known as conductive hearing loss—can usually be corrected by medication or surgery. These individual also do well with a hearing aid.

Sensoineural. When there is damage to the inner ear or the nerve pathways (auditory nerves) that lead to the brain, sensorineural hearing loss may result. Children with this type of hearing loss may benefit from a hearing aid, cochlear implant, communications therapies and medication depending on the degree and cause of the loss.

Diagnosing Hearing Loss

If you suspect a problem, don't hesitate to bring it to the attention of your pediatrician. "Parents—rather than the doctor—often see the problem first so trust your instincts and have your child's hearing evaluated by a doctor," urges pediatrician David Levine, MD, FAAP, member of Quality Health medical advisory board.

Check for signs of speech delay. Older infants should react to familiar voices. By 15 months children should be using single words. By the age of 2, toddlers should be using simple, two-word sentences to communicate.

Using an instrument called an otoscope, a doctor can get a good look inside a toddler's ear canal. The exam may show bone problems or signs of genetic changes that can cause hearing loss. Older babies and young children can be taught to respond to sounds through play to determine the child's range of hearing.

Trained professionals can work with the family to limit the effects of hearing loss on a young child's development. It's essential that appropriate services begin as soon as possible—preferably before six months of age—so speech and language development is not delayed, negatively impacting social and emotional growth.

David Levine, MD, FAAP, reviewed this article.