Hearing Loss

You may have hearing loss and not even be aware of it. People of all ages experience gradual hearing loss, often due to the natural aging process or long exposure to loud noise. Other causes of hearing loss include viruses or bacteria; heart conditions or stroke; head injuries; tumors; and certain medications. Treatment for hearing loss will depend on your diagnosis.

How does the hearing sense work?

Hearing is a complex and intricate process. The ear is made up of three sections: the outer ear, the middle ear, and the inner ear. These parts work together so you can hear and process sounds.

The outer ear, or pinna (the part you can see), picks up sound waves and directs them into the outer ear canal. These sound waves travel down the ear canal and hit the eardrum, which causes the eardrum to vibrate.

When the eardrum vibrates, it moves three tiny bones in your middle ear. The middle ear is a small air-filled space between the eardrum and the inner ear. These bones form a chain and are called the hammer (or malleus), anvil (or incus), and stirrup (or stapes). The movement of these bones transmits and amplifies the sound waves toward the inner ear.

The third bone in the chain, the stapes, interfaces with fluid which fills the hearing portion of the inner ear, the cochlea. The cochlea is lined with cells that have thousands of tiny hairs on their surfaces. As the fluid wave travels through the cochlea, it causes the tiny hairs to move. The hairs change the mechanical wave into nerve signals. The nerve signals are then transmitted to your brain, which interprets the sound.

Test your hearing

To get an idea of how well you hear, answer the following questions and then calculate your score. To calculate your score, give yourself 3 points for every “Almost always” answer, 2 points for every “Half the time” answer, 1 point for every “Occasionally” answer, and 0 for every “Never.” Please note: If hearing loss runs in your family, add an additional 3 points to your overall score.

The American Academy of Otolaryngology—Head and Neck Surgery recommends the following[LMW1] :

  • 0-5 points­—Your hearing is fine. No action is required.
  • 6-9 points—Suggest you see an ear, nose, and throat (ENT) specialist.
  • 10+ points—Strongly recommend you see an ear, nose, and throat (ENT) specialist.

I have a problem hearing over the telephone.
Almost always (3)
Half the time (2)
Occasionally (1)
Never (0)

I have trouble following the conversation when two or more people are talking at the same time.
Almost always (3)
Half the time (2)
Occasionally (1)
Never (0)

People complain that I turn the TV volume too high.
Almost always (3)
Half the time (2)
Occasionally (1)
Never (0)

I have to strain to understand conversations.
Almost always (3)
Half the time (2)
Occasionally (1)
Never (0)

I miss hearing some common sounds like the phone or doorbell ring.
Almost always (3)
Half the time (2)
Occasionally (1)
Never (0)

I have trouble hearing conversations in a noisy background, such as at a party.
Almost always (3)
Half the time (2)
Occasionally (1)
Never (0)

I get confused about where sounds come from.
Almost always (3)
Half the time (2)
Occasionally (1)
Never (0)

I misunderstand some words in a sentence and need to ask people to repeat themselves.
Almost always (3)
Half the time (2)
Occasionally (1)
Never (0)

I especially have trouble understanding the speech of women and children.
Almost always (3)
Half the time (2)
Occasionally (1)
Never (0)

I have worked in noisy environments (such as assembly lines, construction sites, or near jet engines).

Almost always (3)
Half the time (2)
Occasionally (1)
Never (0)

Many people I talk to seem to mumble, or don't speak clearly.
Almost always (3)
Half the time (2)
Occasionally (1)
Never (0)

People get annoyed because I misunderstand what they say.
Almost always (3)
Half the time (2)
Occasionally (1)
Never (0)

I misunderstand what others are saying and make inappropriate responses.
Almost always (3)
Half the time (2)
Occasionally (1)
Never (0)

I avoid social activities because I cannot hear well and fear I'll make improper replies.
Almost always (3)
Half the time (2)
Occasionally (1)
Never (0)

Ask a family member or friend to answer this question: Do you think this person has a hearing loss?
Almost always (3)
Half the time (2)
Occasionally (1)
Never (0)

What can I do to improve my hearing?

  • Eliminate or lower unnecessary noises around you.
  • Let friends and family know about your hearing loss and ask them to speak slowly and more clearly.
  • Ask people to face you when they are speaking to you, so you can watch their faces and see their expressions.
  • Use sound amplifying devices on phones.
  • Use personal listening systems to reduce background noise.

Tips to maintain hearing health

  • If you work in noisy places or commute to work in noisy traffic or construction, choose quiet leisure activities instead of noisy ones.
  • Develop the habit of wearing earplugs when you know you will be exposed to noise for a long time.
  • Earplugs can reduce the volume of sound reaching the ear to a safer level
  • Try not to use several noisy machines at the same time.
  • Try to keep television sets, stereos, and headsets low in volume.

Child Hearing Loss & Screening

A Child’s Hearing Loss

As the parent of a child with newly diagnosed hearing loss, you will have many questions and concerns regarding the nature of this problem, its effects on your child’s future, treatment options, and resources. This brief guide will give you necessary initial information and provide guidance about the availability of resources and the respective roles of different care providers.

It is always difficult for parents to receive bad news about any aspect of their child’s health. Reacting with anger, grief, and even guilt are not unusual when finding out that your child is hearing-impaired. These feelings are best managed by discussing them with a family member, close friend, clergy, or mental health professional. At times, the feeling may also result in a degree of denial. Feel free to seek a second opinion, but it is unadvisable to delay further recommended diagnostic evaluations for your child. The best treatment for hearing loss of any degree is appropriate early intervention. Significant delays may result in irreversible harm to your child’s hearing, speech, language, and eventual educational development.

You will come into contact with many healthcare and rehabilitation specialists during the long-term management of your child’s hearing loss. Some of them will be involved early in the journey and again at intervals. Others may step in later on. The following are professionals you will encounter and the role each of them will play in managing your child’s hearing loss.

The Audiologist

The audiologist is likely to be the first professional you encounter and possibly the one who gives you the initial news regarding your child’s hearing loss. The audiologist will carry out behavioral or objective testing (such as auditory brainstem responses) or a combination of these approaches to determine the degree and type of hearing loss. The audiologist will also eventually recommend appropriate amplification, following a medical consultation. The audiologist will also provide your child with well-fitting ear molds along with the hearing aids, as he or she grows. The audiologist may also be the professional who provides you with information and referral to an early intervention program. Over time, the audiologist will provide periodic follow-ups to chart your child’s progress and to monitor his or her hearing loss.

Otologist, Otolaryngologist, or Pediatric Otolaryngologist (ENT Physician)

Upon diagnosis of hearing loss, your child will be referred to an ear, nose, and throat specialist (otolaryngologist) or one who specializes in childhood ear and hearing problems. This physician’s initial role is to determine the specific nature of the underlying problem that may be at least partially causing the hearing loss. Additionally, the physician will also determine if the problem is medically or surgically treatable and, if so, provide the necessary medical or surgical treatment. Such treatments could include something relatively simple, like the placement of eardrum ventilation tubes or more complex surgical procedures. The ENT specialist may also refer your child for additional diagnostic procedures, such as imaging studies (X-rays, CT-scans, MRI scans), to further define the type and source of hearing loss. The doctor also provides clearance for hearing aid fitting, after determining that no other intervention is indicated. If it is determined that your child needs a cochlear implant, the otolaryngologist, along with the audiologist, will carry out further tests and examinations and will perform the implant surgery.

Primary Care Physician: Pediatrician or Family Practitioner

Your child’s primary care physician may be either a pediatrician or a family practice doctor. If your child is not diagnosed with a hearing loss in the newborn period but develops hearing loss later in life, it is the responsibility of this doctor to make appropriate referrals to an ear, nose and throat specialist and an audiologist to rule out or diagnose hearing loss. Your child’s primary care doctor may also participate in the treatment of ear infections or refer them to an otolaryngologist for treatment. The primary care physician or the otolaryngologist may also provide a referral to a doctor who specializes in medical genetics to find out if your child’s hearing loss may be hereditary. That may help you determine if a similar hearing loss could occur in your other children.

Early Intervention Specialist

This professional is typically someone with an education background. He or she can help you find resources in your community; define family members’ roles in early intervention and management of the hearing loss; and can help you with questions regarding future educational placement. This specialist will also help you with your observations and concerns about your child and give you information and support regarding your child’s educational needs in the future.

Speech/ Language Pathologist (SLP)

This professional will evaluate the impact of your child’s hearing loss on speech/language development, and monitor his/her progress, noting if progress with that speech/language is falling behind. If this happens, the SLP may refer back to the audiologist or otolaryngologist to determine if any changes have occurred in your child’s hearing. The SLP will also help your child to learn proper speech production, including correct articulation of speech sounds. If you choose oral communication for your child, in addition to the speech language pathologist, your child may also be treated by an auditory-verbal therapist, who can help your child acquire the full range of speech sounds and guide the family to additional medical or audiological treatments. The auditory-verbal therapist will also help the child’s family become familiar with appropriate speech/language, auditory, and cognitive developmental milestones you may expect for a child with hearing loss.

Finally, many other people can provide additional assistance for your hard-of-hearing child. Parents of older hard-of-hearing children, and hard-of-hearing adults, can share their experiences with you and may have suggestions for educational and recreational resources in the community.

Child Hearing Screening

Why Is Early Childhood Hearing Screening Important for Your Child?

Approximately two to four of every 1,000 children in the United States are born deaf or hard-of-hearing, making hearing loss the most common birth disorder. Many studies have shown that early diagnosis of hearing loss is crucial to the development of speech, language, cognitive, and psychosocial abilities. Treatment is most successful if hearing loss is identified early, preferably within the first few months of life. Still, one in every four children born with serious hearing loss does not receive a diagnosis until 14 months old.

When Should a Child’s Hearing Be Tested?

The first opportunity to test a child’s hearing is in the hospital shortly after birth. If your child’s hearing is not screened before leaving the hospital, it is recommended that screening be done within the first month of life. If test results indicate a possible hearing loss, get a further evaluation as soon as possible, preferably within the first three to six months of life.

Is Early Hearing Screening Mandatory?

In recent years, health organizations across the country, including the American Academy of Otolaryngology – Head and Neck Surgery, have worked to highlight the importance of screening all newborns for hearing loss. These efforts are working. Recently, many states have passed Early Hearing Detection and Intervention legislation. A few other states regularly screen the hearing of most newborns, but have no legislation that requires screening. So, check with your local authority or hospital for screening regulations.

How Is Screening Done?

Two tests are used to screen infants and newborns for hearing loss. They are otoacoustic emissions (OAE), and auditory brain stem response (ABR). Otoacoustic emissions involves placing a sponge earphone in the ear canal to measure whether the ear can respond properly to sound. In normal-hearing children, a measurable “echo” should be produced when sound is emitted through the earphone. If no echo is measured, it could indicate a hearing loss.

Auditory brain stem response is a more complex test. Earphones are placed on the ears and electrodes are placed on the head and ears. Sound is emitted through the earphones while the electrodes measure how your child’s brain responds to the sound.

If either test indicates a potential hearing loss, your physician may suggest a follow-up evaluation by an otolaryngologist.

Signs of Hearing Loss in Children

Hearing loss can also occur later in childhood. In these cases, parents, grandparents, and other caregivers are often the first to notice that something may be wrong with a young child’s hearing. Even if your child’s hearing was tested as a newborn, you should continue to watch for signs of hearing loss, including:

  • Not reacting in any way to unexpected, loud noises.
  • Not being awakened by loud noises.
  • Not turning his/her head in the direction of your voice.
  • Not being able to follow or understand directions.
  • Poor language development.
  • Speaking loudly or not using age-appropriate language skills.

If your child exhibits any of these signs, report them to your doctor.

What Happens If My Child Has a Hearing Loss?

Hearing loss in children can be temporary or permanent. It is important to have hearing loss evaluated by a physician who can rule out medical problems that may be causing the hearing loss, such as otitis media (ear infection), excessive earwax, congenital malformations, or a genetic hearing loss.

If it is determined that your child’s hearing loss is permanent, hearing aids may be recommended to amplify the sound reaching your child’s ear. Ear surgery may be able to restore or significantly improve hearing in some instances. For those with certain types of very severe hearing loss who do not benefit sufficiently from hearing aids, a cochlear implant may be considered. Unlike a hearing aid, the implant bypasses damaged parts of the auditory system and directly stimulates the hearing nerve, allowing the child to hear louder and clearer sound.

Research indicates that if a child’s hearing loss is remedied by age six months, it will prevent subsequent language delays. You will need to decide whether your deaf child will communicate primarily with oral speech and/or sign language, and seek early intervention to prevent language delays. Other communication strategies such as auditory verbal therapy, lip reading, and cued speech may also be used in conjunction with a hearing aid or cochlear implant, or independently.

Infant Hearing Loss

If your newborn child

  • does not startle, move, cry, or react in any way to unexpected loud noises,
  • does not awaken to loud noises,
  • does not turn his/her head in the direction of your voice,
  • does not freely imitate sound, or
  • has failed a newborn hearing screening test,

then he or she may have some degree of hearing loss.

More than three million American children have a hearing loss, and an estimated 1.3 million of them are under three years of age. Parents and grandparents are usually the first to discover hearing loss in a baby, because they spend the most time with them. If at any time you suspect your baby has a hearing loss, discuss it with your doctor. He or she may recommend evaluation by an otolaryngologist—head and neck surgeon (ear, nose and throat specialist) and additional hearing tests.

Hearing loss can be temporary, caused by ear wax, middle ear fluid, or infections. Many children with temporary hearing loss can have their hearing restored through medical treatment or minor surgery.

However, some children have sensorineural hearing loss (sometimes called nerve deafness), which is permanent. Most of these children have some usable hearing, and children as young as three months old can be fitted with hearing aids.

Early diagnosis is crucial in the management of pediatric hearing loss. When diagnosis is delayed, there can be significant impact on speech and language development. Early fitting of hearing or other prosthetic aids, and an early start on special education programs can help maximize a child's existing hearing. This means your child will get a head start on speech and language development.

Schedule An Appointment

Visit Denver Hearing Specialists website for more details

Schedule an Appointment

CalendarSet an Appointment
Schedule an appointment with our doctors at our state-of-the-art facility in Denver, Colorado. 

Convenient Location

VISIT US AT OUR OFFICES
Located at Skyridge Medical Center Just West Off of Ridgegate Parkway.

Patient Forms

Click here to download
patient forms

Please Fill out  patient forms and bring them to your appointment