Category Archives: Hearing loss in children

Music is Increasing Risk of Hearing Loss in Teenagers

Every time you hear loud music you are increasing the risk of damaging your hearing. Repeated exposure to loud music can permanently damage the inner ear and can cause permanent hearing loss.

music hearing loss

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 According to a February 2015 news release, the World Health Organization has reported that about 1.1 billion teenagers have been found to be at risk of developing hearing problems. The primary reason attributed to this alarming statistic is the frequent use of Ipod, MP3 players and smart phones, and also the high exposure to noise pollution at public entertainment facilities like discos or nightclubs.  Musicians are also at increased risk of hearing loss.

WHO’s report has particularly singled out the 12-35 years age-group from middle-class and affluent families who routinely listen to loud music are developing hearing loss.

By definition, any individual exposed to over 85 db of noise for more than 8 hours at a stretch is a high-risk individual for hearing loss.

The risk of damage to hearing from music depends on:
  • Loudness of the music
  • Closeness to the source of music/ speakers
  • Duration of exposure to loud musi
  • Family history of hearing loss
  • Individual susceptibility to noise
The adverse effect of noise on the teenager’s ears

 Typically during New Year parties or other similar festivities, sound levels are very high before people realize, they may experience a sudden numbing sensation in the ears followed by a deafening silence! This experience differs from person to person, but teenage party-goers frequently complain about hearing problems after attending a rock concert or a whole-night party. Many of these teenagers who complain about temporary hearing loss from time to time may develop serious problems later in their lives, as indicated in Noise induces hearing loss.

Teenagers from low-income groups working at mines, construction sites, oil drills are at same risk of developing hearing loss because of the nature of their occupational environments.

How to know noise is harmful:
  • If you have to shout to be heard
  • You have pain in the ears be cod noise
  • If there is ringing in the ears
  • If ears feel muffed or reduced hearing
What are some practical solutions to reduced music related damage?

Protect your ear from the new year’s noise suggests some practical ways to avoid hearing problems.

  1. Turn down the volume of personal music systems
  2. Take regular breaks from loud music or go to less noisy areas from loudest areas in club or
  3. Stand away from the sound source or music speakers
  4. Use noise cancelling head phones
  5. Wear ear plugs. This solution is recommended for young, professional musicians too.
  6. Custom-fit musician earplugs can be used.

The deafening volumes of music played at nightclubs, discos, and parties are simply exposing the young adults to life-threatening sound pollution, which will sooner or later, become an uncontrollable malady of teenage lifestyle all over the world.


If any teenager experiences noise-induced irritability, ear block, buzzing, or ringing in the ear, he should immediately consult an ENT Specialist and Hearing test by audiologist is to be done.


Poor performance in school! Could it be hearing loss?

Your child performing poor in school! You may have to visit an ENT specialist and Audiologist for his Hearing Test.   Even a slight hearing loss in a child is often a reason behind poor performance in class.

Hearing loss doesn’t essentially mean complete inability to hear. It may be slight hearing disorder, only one sided hearing loss, conductive loss caused by recurrent ear infections or problem with sensory auditory processing skills (where even hearing tests may show normal hearing)

 Most parents and teacher may not be aware of Spectrum of pediatric hearing loss and many years can pass before a student is diagnosed and treated. Sometimes it will be taken as attention deficit disorder or normal childhood behaviour or ignorance.

hearing-loss school performance Vashi, Navi Mumbai

Even mild hearing  loss can compromise communication skills and school performance.

Specific effects of Hearing Loss on children-

  • Children with untreated hearing loss may have lower self esteem, they have tendency to isolate themselves and there is lack of class participation.
  • Have difficulty in understanding complex sentences.
  •  There could also be slow vocabulary development and Problem with sentence structure as compare to children with normal hearing.
  • Children may have unclear speech and their speech may be difficult to understand.

 Treatment Of Hearing Loss-

ENT Specialist can treat some types of hearing loss, (conductive hearing disorder which involves outer or middle ear). Such as most ear fluid and Ear infections are managed with medication or simple surgery  to drain the fluid out from middle ear by putting tiny tubes/grommets.

For other types of hearing loss (Sensorineural hearing loss) Hearing aid or cochlear implant, Bone Anchored hearing aids are provided which does not cure hearing loss but may help a child

Children who received early intervention at 6 month of age have been shown years later to have language skills similar to those of children of the same age who have normal hearing.

 Knowing early regarding childhood hearing loss and initiating early treatment- medical, surgical or use of hearing  aids /cochlear implants are critical for the development  of speech, language, and communication skills in children with hearing loss and shown to increase school performance.

 Even mild hearing loss can compromise academic performance. And You should visit an ENT specialist to find out condition of external and middle ear and an audiologist for hearing test and to manage hearing problems.

Screening tests are screening tests

Screening tests are screening tests

originally posted on The Pediatric Insider  © 2014 Roy Benaroch, MD

All of these children, who fail the initial screen, need more evaluation to make sure there isn’t something important going on.

Sometimes we do a poor job explaining this to parents. If your child failed our hearing screen, it doesn’t mean he is deaf, or that he even definitely has a hearing problem: It just means he might have a hearing problem, and needs further evaluation. Maybe a retest, or a more-thorough hearing test at an audiologist. The follow-up testing might be normal, and that would be good news.


The Pediatric Insider

The Pediatric Insider

© 2014 Roy Benaroch, MD

In pediatrics, almost all of our patients are healthy. We’ve got some doozies of special-needs kids, but by-and-large your ordinary pediatric patient is doing well, and does not need extensive testing or elaborate procedures to ensure good health.

Still, we do run across some occasional problems. Some children have poor vision, or hearing problems, or kidney disease, or hypothyroidism. Or autism, or Tay-Sachs Disease, or a penny up their nose. A whole lot of what we do in our “check ups” are easy, cheap, and quick tests to screen for these and many other problems. Just a taste:

  • We look at height. If Junior is gaining height as expected, he almost certainly doesn’t have hypothyroidism.
  • We look at blood pressure. If it’s normal, kidney disease is less likely.
  • We look in noses. Usually you can see a penny up there.
  • We test…

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School Hearing Tests do not Detect Noise Exposure Hearing Loss

School hearing tests cannot effectively detect adolescent high-frequency hearing loss, which is typically caused by loud noise exposure, according to researchers at Penn State College of Medicine.

The Pennsylvania Department of Health mandates school-administered hearing screens for children in kindergarten to third, seventh and 11th grades.
The school screenings primarily focus on low-frequency hearing loss. This is logical for young children, who are more likely to develop low-frequency hearing loss due to fluid in the ear after a bad cold or an ear infection.

Adolescents, however, are more susceptible to high-frequency hearing loss, usually brought on by exposure to loud noises, but the same tests are used on adolescents and young children.

Deepa Sekhar, assistant professor of pediatrics, compared the results of a special hearing screening designed to detect noise-related high-frequency hearing loss with the results of the standard Pennsylvania school hearing test. The researchers reported their findings in the Journal of Medical Screening.

Both screenings test the ability to hear a tone at a specific loudness. The tone is played at different frequencies, or pitches. The screening for noise-related hearing loss tests the ability to hear higher pitches, up to twice the frequency of the Pennsylvania school screen.

Screening participants were 11th grade students at Hershey High School. Researchers administered both the statewide school screening and a high-frequency screening. Of the 282 participants, five failed the Pennsylvania school test and 85 failed the noise-related test. Of the group of 48 students returned for testing by an audiologist in a soundproof booth, nine were diagnosed with hearing loss.

“More participants failed the initial screening than we predicted,” said Sekhar. “Even with the effort and care put in by school nurses across the state, the current Pennsylvania school screen just isn’t designed to detect high-frequency hearing loss in adolescents.”

One in five adolescents experiences hearing loss, and most of this is high-frequency hearing loss related to continued exposure to noise hazards. Early detection and avoidance of loud noises can prevent hearing loss from progressing.

To efficiently detect adolescent hearing loss, schools across the U.S. may need to consider alternate tests that are better designed to detect noise-related high-frequency hearing loss.

“The results of this study have the potential to reach schools across the nation, as many use screens similar to those used in Pennsylvania schools,” said Sekhar. “We are currently working on a follow-up study at Lebanon High School in partnership with Penn State Nursing to further improve the high-frequency school hearing screen for use in the school.

Other Penn State College of Medicine researchers on the study were Tonya King, professor of biostatistics; Beth Czarnecki, audiologist; Shannon Grounds, audiologist; Ashley Barr, audiologist; and Ian Paul, professor of pediatrics and public health sciences.

Other researchers include Soha Ghossaini, associate professor of otolarynglogy, University of Illinois, Chicago; Thomas Zalewski, Bloomsburg University; Julie Rhoades, Impulse Monitoring, Inc.; and Barry Deese, Summit ENT & Hearing Services.

The Academic Pediatric Association/Maternal and Child Health Bureau Young Investigator Award funded this research.


Read More About hearing tests.

Music from the ear: Researchers show how an objective audiometric test can become even more reliable

Music from the ear: Researchers show how an objective audiometric test can become even more reliable.

Physikalisch-Technische Bundesanstalt (PTB). ,ScienceDaily, 10 Jan. 2013. Web. 11 Jan. 2013. 

Not only can the human ear detect sounds, it can also generate them. If the ear hears the two upper tones of a major triad, it produces the fundamental of the chord which can then be measured. This phenomenon, called “otoacoustic emission” (OAE), is used by otologists for objective audiometric tests, e.g. in newborns. Investigations at the Physikalisch-Technische Bundesanstalt (PTB) have shown that an OAE audiometric test becomes even more reliable if the two sounds are transmitted to the ear not via a loudspeaker, but by bone conduction.


image from PTB

Combined stimulation of otoacoustic emissions: the first tone is transmitted via air conduction (probe speaker in the ear), the second tone is conveyed via bone conduction (bone vibrator behind the ear).

Regardless of where people come from, whether they are Europeans or Asians, the human ear is always tuned to a major scale. If the ear hears the two upper tones of a major triad, the ear itself produces the third, lowest, tone of the chord. This tone is called “distortion product otoacoustic emission (OAE)” and is generated due to anatomic and physical laws:

if the hair cells in the inner ear are healthy and sound, they are stimulated by the two matching tones to vibrate at a third frequency. This lower tone comes out of the ear again and can be measured by means of a highly sensitive microphone. With the aid of this phenomenon, it is possible to check objectively whether the hearing of newborns or infants is intact.

Such a test used to be performed using two tiny loudspeakers, each of which emitted a tone into the ear, as well as a miniaturized microphone, which recorded the third tone (if it came out at all).

If this tone is not generated, physicians have a first inkling that the baby might need therapy or a hearing aid.

However, it may be that the ear is healthy but does not “hum”. This can be caused by a badly calibrated loudspeaker, or due to the fact that the loudspeakers which are placed close to each other emit standing waves into the auditory canal which weaken one of the two tones.

To preclude such malfunctions, alternative tone generation methods have been investigated at PTB within the scope of a DFG project: so-called “bone vibrators” which, in analogy to a tuning fork set onto the bone, convey the tone directly to the bone located behind the ear.

The results have shown that both with two bone vibrators and in combination with a loudspeaker, correct otoacoustic emissions are generated. This not only allowed calibration errors to be reduced, but also provided physicians with improved differential diagnosis possibilities, since with the new procedure, they can test the function of the inner ear without a doubt and, potential damage of the middle ear, thus, has less influence. Clinical studies should follow.

Scientific publication

Zebian, M.: Calibration of Distortion Product Otoacoustic Emission Probes. Dissertation, TU Braunschweig (2012)

Single Sided Hearing Loss Can Seriously Impact Lifestyle and Work…



I sleep through bed side alarm because I happen to be lying with my hearing ear to the pillow. I have Single Sided Deafness (hearing loss in one ear) …But I am able to  manage my life…But…


What are Symptoms of Single sided deafness?

  •  Inability to hear sound from affected side of the ea
  • Inability to locate the direction of where the sound is coming from.
  • Understanding speech in background noise, sounds all blur into one flat mono channel
  • May turn their head to hear with their “good ear.”

I can manage my life with one ear but is there some psychosocial impact?


It affects social, work and home interactions due to the reduced ability to localize sounds and to discriminate speech in background noise.

  • Irritability and fatigue due to more effort needed to listen
  • Frequent headaches, stress
  • Social isolation
  • Blamed for “not paying attention.”
  • Avoids group situations because the noise overwhelms them,
  • Can hear only half of the components of the music, e.g., bass or piano, but not both


How one sided hearing loss is diagnosed?

ENT evaluation and Hearing test (audiometry) can detect hearing loss in one ear. Further tests may be required to know the cause.

It can be conductive, sensor neural or mixed in nature.

Conductive hearing loss may be due to problem in the ear canal, such as earwax, ear drum injury or infections.

Senorineural hearing loss can be either congenital or present at or just after birth due to malformation of the inner ear or a dysfunction/absence of the auditory nerve. It can also be acquired later on in life as the result of various causes such as ototoxic drugs, immunological diseases and infections.

 What is the treatment for one sided hearing loss?

Medicines and surgery may help in conductive hearing loss. Hearing aid help for sensorineural hearing loss

For permanent total one sided hearing loss even normal hearing aid does not help and aim is to restore the sensation of hearing by sending a signal to the better hearing side. It can be achieved by following two options-

Surgical: (BAHA)

BAHA (bone anchored hearing aid), are surgically placed into the temporal bone of the unaidable ear. A sound processor transmits sound waves to the implanted fixture, which in turn causes sound to travel via bone conduction to the cochlea of the better ear.

Image courtesy:cochlear

Non-surgical: CROS Hearing aid 

Sound is picked up by a microphone worn on the unaidable ear and wirelessly transmitted to a hearing aid, which is worn on the better ear. The sound signal is typically transferred either by a wire connecting each device or wireless.

Image courtesy:Phonak

Unilateral Hearing Loss in Children:

Did you KNOW …?

SCHOOLCHILDREN with UNTREATED unilateral hearing loss are LIKELY TO FAIL one or more grades despite normal cognitive abilities?

Most of the time child with hearing loss in one ear is  MISSED till he grows sufficiently older to tell parents about his hearing problem. Child may be labelled as not paying attention in school

They can greatly benefit from fitting of hearing aid or sound field system (desk top or ear level FM system) to ensure the child can hear the teacher’s voice. Children with profound one sided hearing loss may benefit from CROS hearing aid designed to transfer sound from hear with hearing loss to the FM Technology.

Helping child with a unilateral hearing loss

Keep background noise to a minimum as much as possible.

Get child’s attention before speaking to them.

Position yourself so that you are on their side with good hearing.

Make the teacher aware that child has a unilateral hearing loss.

Ask for child to be seated as near to the teacher as possible

What is the Phonak CROS System?

The Phonak CROS/Bi CROS wireless system allows sounds to be transmitted from the dead ear to the normal /damaged ear. It is also the smallest solution on the market and is even available in a waterproof version, specially designed for active people.

Hearing Screening in Newborn

When Mishi (name changed) was born her parents were extra cautious for her hearing as her elder sister now 4 years old has cochlear implantation done.

They visited audiologist for hearing evaluation. Their worst fears was confirmed, Mishi now 6 months has severe to profound hearing loss and is fitted with hearing aids. But there is hope, as she is young she will most probably lead normal life like her elder sister which was intervened early and appropriately.

On the other hand khushi is 3 and ½ years old, pediatrician immediately referred her to audiologist for delayed speech, thanks to increasing awareness in Navi Mumbai. But even after confirmation of hearing loss, they are not willing for intervention as her father thinks she will start talking with time.


Importance of assessing hearing in a new-born child:

Two out of every 100 children under 6 years of age have permanent moderate deafness and 1-4 out of every 1,000 newborns have significant hearing loss.

Birth to 3 years are critical for speech and language development and if child does not hear the sound, he can not speak, even a mild or one sided hearing loss can affect speech language skills, academic & intellectual skills, and it affects individual for the rest of his life.

“American Academy of Pediatrics recommends new born hearing screening and periodic hearing testing for first three years of life. Joint Committee on Infant Hearing (JCIH, 1994) recommends that all infants with hearing loss should be identified by 3 months of age, and should be fitted with hearing aids or cochlear implant and receive services to help them learn to listen and speak by 6 months of age.


Importance of OAE hearing screening:

Newborns, infants and children below 5 years are difficult to diagnose by routine tests. Traditional subjective methods of behavioral observation to ringing bells and hand clapping are not fully reliable as child may respond to some sound because of residual hearing or they may take cues from visual prompts, at the same time child with normal hearing may not respond.

Prior to Objective tests such as OAE, infants with hearing loss typically remained unidentified until 2 ½ years of age. – far too late for optimal language development.

Advances in technology make it possible to assess the hearing of infants even while they are asleep.


Method for hearing screening Otoacoustic Emission (OAE):  

A small probe is placed in the child’s ear canal. This probe delivers a low-volume sound stimulus into the ear, which travels from middle ear to inner ear. If hearing is good this sound will bounce back as echo generated by outer hair cells of cochlea (called OAE)  and is measured with a microphone.

In approximately 30 seconds, the result is displayed on the screening unit as a “pass” or “refer.”

It is very important to remember that fail OAE  does not mean child have haring loss it just indicates that further  tests are required for full hearing evaluation. (BERA and ASSR test).


Newborn hearing screening in India:

 In developed countries like US it is mandatory to check hearing of each and every newborn within 48 hours of birth. But currently there are no mandatory rules or regulations for Newborn Hearing Screening in India and hence the identification of hearing loss is mostly at later ages.



OAE screening is proved to be reliable method of screening. If hearing screening is made mandatory for the newborns at the time of birth or within the first month of life many more cases of hearing & speech impairment could be avoided.

Hearing impairment must be corrected before the child reaches six months of age. Late intervention of the hearing loss will yield very poor results as the plasticity of the brain reduces drastically as the child grows older. Undetected hearing loss is big obstacle to educational achievement and socialization.

Mother’s instinct should never be ignored and probable hearing loss in the child should be subjected to audio logical assessment.  It should not be ignored withIt shall improve in the next few years” or ‘child did not hear because he was busy playing or watching television’.

For more information about OAE screening visit hearing screening protocol at Audicco

or mail at

At Risk Children for Late Onset Hearing Loss

The Joint Committee on Infant Hearing 2000 position statement suggests that the following indicators place an infant at risk for progressive or delayed-onset sensorineural and/or conductive hearing loss.


  • Parental or caregiver concern regarding hearing, speech, language, and or developmental Delay
  • Family history of permanent hearing loss in childhood
  • Infections after birth such as bacterial meningitis
  • Head trauma
  • Repeated or persistent bouts of ear infections lasting at least 3 months
  • Infections during pregnancy such as cytomegalovirus, herpes, rubella, syphilis, and toxoplasmosis
  • Syndromes associated with progressive hearing loss
  • Neonatal indicators such as persistent pulmonary hypertension
  • Unusual appearance of baby’s head, face or ears