Toddler hearing concerns

“More loud, Mommy.”

Nicola Aquino turned up the TV volume once again, but not without a niggling concern: Twenty-month-old Anthony had been asking for “more loud” almost every time the tube was on lately. Plus, she’d been hearing a lot of “Huh?” and “What?” as he’d ask his little friends to repeat themselves.

When Aquino took Anthony for a checkup, the doctor pointed out that the toddler had been treated for six ear infections in five months. Since repeated ear infections are a common cause of hearing loss, she recommended Anthony see an audiologist.

Audiologist Josée Lagacé, who works with the Canadian Association of Speech-Language Pathologists and Audiologists in Ottawa, agrees that repeated ear infections are the most common cause of hearing loss in toddlers. Usually this is temporary, but in some cases there may be damage to the eardrum, the bones of the ear or even the nerves in the ear — all possible causes of permanent hearing loss.

When should you be worried about your child’s hearing? Sometimes it’s hard to know. Many toddlers sleep right through the wailing of a smoke alarm or the telephone ringing just inches from their ears, and seem to blithely ignore everything you say, yet their hearing is just fine. Other children have seemingly minor problems with their speech that turn out to be signs of hearing loss.

Parents are generally good at judging how well their toddlers hear. Lagacé says, “Trust your instincts. If you think something is wrong, get it checked out. A hearing evaluation is painless; children have nothing to lose but everything to gain.”

These signs may indicate hearing difficulties:
• Your toddler does not look up or turn towards you when you call her name.
• She doesn’t seem to understand you unless she can see your face.
• She repeatedly asks to have the TV or radio louder.
• She frequently asks for you to repeat what you say.
• She has difficulty listening to stories.
• She says and understands fewer words than expected for her age.

The more serious the hearing loss, the more obvious the signs, Lagacé says. With mild hearing loss, the signs may be subtle and more easily missed, yet the effects on your child’s learning can be significant.
How do audiologists test rambunctious (and not always co-operative) toddlers? Aquino was impressed with how the audiologist treated her son. Anthony was able to sit on his mother’s lap and simply turned to look at toys when the audiologist used them to make noises. Lagacé confirms that audiologists generally use tests that seem more like a game with young children.

Relieved that the process had been so painless, Aquino was also pleased to be told that Anthony’s hearing was normal.

When Aquino’s second son, Patrick, turned 18 months, he also began to show signs of possible hearing concerns. “He would only say the endings of words,” Nicola recalls. “So truck came out “uck” and cat sounded like “at.” I realized he might not be catching the softer beginnings of words.”

This time, the trip to the doctor determined that Patrick really was having trouble hearing due to a buildup of wax in his ears. Having the doctor clean the wax out went fairly smoothly: “He wasn’t happy about how it felt,” Aquino reports, “but there was no kicking and screaming.” Since then, his speech has gradually improved.

Lagacé urges all parents concerned about their toddlers’ hearing to get it checked out. “These first few years are so critical for development,” she says. “If it turns out to be normal, then at least you’ve ruled out that possibility and can consider other causes.”

All Ears
• Parents can find an audiologist in private practice through the Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA) website, caslpa.ca. A doctor’s referral is not required.
• Many communities have free programs (covered by provincial health insurance or other government programs) to test the hearing of toddlers and preschool children; check with your doctor or local public health unit for more information.
•While a paediatrician can certainly check a toddler’s hearing, the testing would not generally be as thorough as what an audiologist can do.

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