How Noise-Induced Hearing Loss Can Impact Children

Approximately 5.2 million children aged 6 to 19 have suffered damage to their hearing from excessive noise exposure. Noise-induced hearing loss occurs when the inner ear is damaged from noises that are too loud, too close, or last too long. This can lead to ear pain or ringing, distorted or muffled hearing, and an inability to hear warning signals. Hearing loss in children has other implications and can cause communication disorders and learning difficulties,

While exposure to a single loud sound can cause damage, research suggests that significant noise-induced hearing loss usually develops after ten or more years of cumulative exposure. This damage cannot be reversed, but preventing it is easy if you know what to do.

Parents lead the way toward healthy hearing

As parents, we can teach our children healthy listening habits. This begins with appreciating hearing as a valuable sense that requires protection. Parents can model healthy behavior by turning down the volume when it becomes too loud, walking away from loud sounds, and using hearing protection when needed.

Hearing screenings are administered to newborns at birth. Repeat screenings should continue as children grow and are typically administered at school entry, at least once at ages 6, 8, and 10, at least once during middle school, and at least once during high school, according to the Centers for Disease Control (CDC). Screenings typically occur at school; parents can follow up with their child’s pediatrician if needed.

Parents should know what signs to look for when determining if their child might be impacted by noise-induced hearing loss. The American Speech-Language Hearing Association (ASHA) lists signs and symptoms of hearing loss in children as follows:

• Delayed speech and language development
• Difficulty producing speech sounds
• Difficulty following or understanding directions
• Frequent requests for repetition
• Use of increased volume on listening devices
• Difficulty expressing themselves in conversation and writing
• Inability to communicate effectively
• Exhaustion at the end of a school day
• Academic, behavioral, or social challenges at school

Prevention is key

To avoid noise-induced hearing loss, it's a good idea to:

• Reduce exposure to loud sounds
• Turn down the volume when listening to music
• Move away from the source of loud sounds when possible
• Wear hearing protection if unable to move away from loud sounds
• Seek a hearing assessment by a licensed audiologist if there is a concern about a potential hearing loss

To prevent exposure to dangerous sounds, it is important to determine when sound levels become unsafe. Sound levels are too loud if:

• You must raise your voice to be heard
• You can’t hear or understand someone 3 feet away
• Speech around you sounds muffled after you leave a noisy area
• You have pain or ringing in your ears after loud noise exposure

Safe volume levels

It’s often difficult to determine if sounds in our everyday environment are safe. Sound level meters can detect sound volume in decibels (dB) to distinguish safe levels of sound from dangerous levels. The good news is that there are apps that can turn your phone into a sound level meter, and they can be downloaded through the App Store for free—one option is Decibel X. Apple watches also have the noise exposure tracking option, which alerts you when sound levels become unsafe.

Noise over 70 dB over a prolonged period may start to damage your child’s hearing. Louder noise above 120 dB can cause immediate harm to their hearing. According to ASHA, sounds at 85 dB can lead to hearing loss if exposed to them for over 8 hours at a time. Sounds over 85 dB can damage hearing even faster.

Checking the volume of noise in every environment your children visit may not be possible, but Lisa Mariello-Baiada, Au.D. of Flourtown Audiology in Flourtown, Pennsylvania, says having hearing protection on hand is a simple way to ensure you can protect your children’s hearing when you are unsure if the levels are safe. “It is always a good idea to get kids used to wearing hearing protection in high-level noise situations,” Dr. Mariello-Baiada suggests.

How to help children safely use listening devices

When purchasing headphones or earbuds for your child, choosing ones with volume limiters is safest. The Children’s Hospital of Philadelphia (CHOP) confirms that most earphones get loud enough to damage hearing in only a few minutes at full volume.

For safe listening, CHOP suggests the 80/90 rule: A volume setting of 80% of the maximum volume can only be safely enjoyed for a maximum of 90 minutes. They also recommend the arm’s length rule: If you can’t hear someone speaking to you from an arm’s length away, your music is likely too loud.

Dr. Mariello-Baiada says the volume on listening devices should be kept at no more than 50 to 60 percent of the maximum volume. When devices are set to a safe volume, children should be able to hear their parents’ voices while the device is being used.

If traveling by plane where there is a great deal of noise, Dr. Mariello-Baiada suggests children use headphones with a noise-cancelling feature, as these can reduce background noise and eliminate the need to increase the volume. Her go-to recommendation is the Puro Sound Labs headphones, which come in wired and wireless options and offer volume limiting for ear protection.

Who to contact if you think your child may have hearing loss

Audiologists are healthcare professionals who help prevent, identify, diagnose, and treat hearing, balance, and other auditory disorders for people of all ages. They can administer a full hearing assessment and provide recommendations for rehabilitation as needed. All the care they provide is evidence-based.

Dr. Mariello-Baiada says the first step in an audiological evaluation is taking a comprehensive case history. The child’s eardrums will be assessed to determine if fluid in the middle ear or negative pressure is an issue. A hearing test is then administered to check the child’s ability to hear tones as well as speech sounds.

While every child’s needs differ, Dr. Mariello-Baiada says some treatment options may include preferential seating in the classroom, hearing aids, or an FM system to amplify sounds. She wants parents to know, “We may need to work with other professionals to ensure the child is successful and reaching their full potential.”

Speech-language pathologists (SLPs) are one type of professional who can help children with hearing issues. They work to prevent, assess, diagnose, and treat speech, language, social communication, cognitive-communication, and swallowing disorders in both adults and children. They also provide speech therapy for children with hearing loss when needed.

Preventing noise-induced hearing loss is possible

Hearing is a precious sense, and while loud noises can induce hearing loss quickly, it’s easy to prevent it if you’re prepared. Through volume limits on listening devices, avoidance of loud noise exposure, use of hearing protection, and education about maintaining healthy hearing, we can protect our children from noise-induced hearing loss. As parents, we have the ability to give our children the knowledge they need to maintain healthy hearing for a lifetime.

Experts

• Dr. Lisa Mariello-Baiada, Au.D. of Flourtown Audiology in Flourtown, Pennsylvania,