By Amy Cranage
It was a gray October afternoon when our daughter, Emma, was a freshman in high school. Recently, she had been especially quiet; there had been some bumps in the road with friends and in extracurricular activities. “Mom,” she said, “I don’t think I’m hearing everything everyone else is hearing.”
I made an appointment with her primary care provider to test her hearing. The results spurred a referral to audiology where, a few months later, an afternoon of exhaustive (and exhausting) testing confirmed “mild to moderate sensorineural hearing loss bilaterally.” In other words, she had some permanent hearing loss in both ears. On the second day of summer vacation, she was fitted with hearing aids.
How can a healthy 14 year old who had passed every hearing test since birth — and always did well in school — suddenly begin to lose her hearing? More than a year after receiving the news, we still do not have a definitive answer to this question. But we have learned a lot about what it’s like to raise a kid with a disability.
“The hard of hearing population is both large and unseen,” says Linda Taylor, Ed. D., Teacher of Students who are Deaf or Hard of Hearing at Southeastern Regional Educational Service Center in Bedford, N.H. “It’s akin to the percentages of [visually-impaired] people you see using white canes [to walk] versus the number with glasses, contacts, Lasik, etc.”
“Nationally, hearing loss is identified in three out of 1000 children at birth, and another three out of 1,000 will develop permanent hearing loss by school age,” says Samantha Glover, Au.D., a pediatric audiologist at Dartmouth-Hitchcock Medical Center. It is safe to estimate that in a high school with 500 kids there are three students who are hearing-impaired.
Signs of possible hearing loss in children include:
• Delays in speech or language development
• Inconsistent responses to sounds or conversation
• Tendency not to follow directions
• Ignoring others
• Frequently saying “what”
• Difficulty or inability to locate the source of sounds
• Turning up the volume of the television, radio, etc., too high
• Frequently exhibiting fatigue
If your child exhibits any of these signs, it may be time to make an appointment with her primary care provider.
Audiologists use technology to establish details about hearing loss in children as young as one month old. Audiology can test for three types of hearing loss: conductive (when sound traveling to the inner ear is hindered by something in the ear canal, eardrum or middle ear), sensorineural (damage or congenital malformation of the inner ear or hearing nerve) and mixed (a bit of both conductive and sensorineural).
Conductive hearing loss may be caused by excessive ear wax, ear infections or middle ear fluid. It is not necessarily permanent. Sensorineural, on the other hand, is often permanent because the anatomy of the inner ear is not the way it should be. Mixed hearing loss is a combination of the two. Hearing loss may occur in only one ear or in both.
Soon after Emma’s hearing loss was confirmed, I asked myself, “Why didn’t I notice? Am I a bad mom?” Because she’s an only child, there was never a time when I might say, “Dinner’s ready!” and wonder why only she did not respond. Teachers and friends did not notice anything amiss. She looked like a perfectly normal, healthy teenage girl. But she knew something was not right.
When talking to others about her hearing loss, some asked me if she listened to loud music on her iPhone. Others wondered, “Did she have a lot of ear infections as a child?” No and no. And she was not preemie. “Sometimes we don’t ever know the reason for the hearing loss,” says Glover.
While genetics can be blamed for a large percentage of childhood hearing loss cases, other possible causes include illness (e.g. otitis media, measles, chicken pox, meningitis, and influenza), ototoxic drugs, head injuries, and exposure to excessive noise. According to the American Academy of Audiology, “approximately twelve percent of children ages 6 to 19 years have noise-induced hearing loss.”
If your family attends loud concerts, sporting events, movies, or auto races, it is not a bad idea to make sure everyone has protective ear muffs or plugs. Be a model of self-care — if your little one sees you wearing protective ear muffs when you mow the lawn, use power tools, or ride your snowmobile, he will follow your lead.
Even squeaky toys, hair dryers, and kitchen blenders can cause hearing damage. “Noise induced hearing loss is dependent upon both the intensity (volume) and duration (time) of the sound, thus making it difficult to state a single decibel level that might be considered unsafe,” says Glover.
Also, make sure your child receives all recommended vaccinations. Vaccines protect him not only from suffering preventable diseases but also guard against worse, corollary sickness or permanent damage such as hearing loss.
React and Reconnect
Once it was confirmed that Emma had hearing loss, the next logical step was to get hearing aids. The day she got them was a sort of rebirth. Suddenly, she heard the muffled sounds of conversation in the nearby examining room. “There are people in the room next to us!” Within minutes, she shushed me. “Stop yelling,” she said. I smiled, happy to be shushed for the first time in a long while.
As the summer progressed, her brain adapted to hearing things again. She became reacquainted with sounds and noises that most of us take for granted: the crackle of plastic packaging, water running, rain on the roof, and our dog’s talent for whistling through her nose when she wants attention.
The only remotely “cool” thing about her hearing aids is they connect via Bluetooth to mobile devices. She can watch shows and listen to music on her iPhone without getting tangled up in earphone cables. While there are times when I envy her option to turn off the hearing aids and retreat into a quieter world, I know she would gladly give it up in a heartbeat if she could hear normally again.
Amy Cranage lives in Grantham, N.H., with her husband, daughter, and two border collies.