Why is it important to detect hearing loss as early as possible?
How common is hearing loss in children?
Types of paediatric hearing loss
Possible causes of congenital hearing loss
Possible causes of acquired hearing loss
What is conductive hearing loss?
What is sensorineural hearing loss?
I've been told my child has ‘glue ear", what is it?
Are babies screened for hearing loss at birth?
How does the CUMH screening work?
What hearing tests are available for infants in the community?
How is my school child's hearing tested?
How can I tell if my infant has a hearing problem?
How will I know if my preschool and older child has a hearing difficulty?
I am concerned about my child's hearing, what can I do?
My child has recently been diagnosed with a hearing loss, what next?
Will my child need regular check-ups now?
What is the Visiting Teacher Service for Children with Hearing Loss?
How often will the Visiting Teacher see my child?
What does the Visiting teach do?
How long can our child avail of this service?

Why is it important to detect hearing loss as early as possible?

Children learn to communicate by imitating the sounds they hear. If they have a hearing loss that is undetected and untreated, they can miss much of the speech and language around them. This results in delayed speech/language development, social problems and academic difficulties.

How common is hearing loss in children?

It's quite common. About four in every 1,000 children at school entry level in Ireland have unilateral (in one ear) and bilateral (in both ears) mild to profound hearing loss. That means between 3,000 to 4,500 preschool and school age children in Ireland will have a permanent hearing impairment, with potential consequences for communication, literacy, social and emotional development, and later employability.

Types of paediatric hearing loss

There are two primary categories of hearing loss in children: congenital (present at birth) and acquired (occurring after birth). These hearing losses may be sensorineural, conductive or mixed.

Possible causes of congenital hearing loss

Infections during pregnancy (German measles, toxoplasmosis and cytomegolavirus)
Ototoxic medication used during pregnancy
Birth complications (serious infection present at birth, such as toxoplasmosis, herpes, rubella or cytomegolavirus; birth weight less than 3 lbs; unusual appearance of baby's head, face or ears; baby required blood transfusion; or drugs used for respiratory life-sustaining measures on premature infant)
Disorder of the brain or nervous system
Genetic syndromes, such as Ushers, Down's and Waardenburg's syndromes
Family history of hearing loss

Possible causes of acquired hearing loss

Untreated middle-ear infections
Other infections, such as meningitis, mumps, measles or whooping cough
Perforation of the eardrum
Excessive noise, such as fireworks or loud music
Disease, such as otosclerosis or Ménière's disease
Serious injury to the head
Ototoxic medication

What is conductive hearing loss?

Frequently, hearing loss in young children is conductive. This is often temporary, and caused by earwax or middle ear infections. Many children with temporary hearing loss can have their hearing restored through medical treatment or minor surgery.

What is sensorineural hearing loss?

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

I've been told my child has ‘glue ear", what is it?

Glue ear is a condition where the middle ear fills with glue-like fluid instead of air. This causes dulled hearing. It usually affects children and is also known as
chronic otitis media with effusion (OME); secretory otitis media, or middle-ear effusion.
In most cases it clears without any treatment. Temporary childhood hearing impairment due to ‘glue ear' is widespread, with an 80% prevalence at some point between birth and seven years of age; 3% of young adults have a hearing loss due to childhood glue ear.
If glue ear is persistent (longer than three months), your doctor may recommend surgery. This may involve the insertion of grommets (ventilation tubes).

Are babies screened for hearing loss at birth?

Prior to 2011, newborn hearing screening was pioneered in three areas through the efforts of local hospital clinicians (Galway, Sligo/Letterkenny, Kerry). However, the first phase of a National Newborn Hearing Screening Programme was launched in Cork University Maternity Hospital (CUMH) in April 2011. This screening service is gradually being expanded across HSE South and throughout the country.

How does the CUMH screening work?

Parents of all babies born at CUMH will be offered a hearing screening test for their baby prior to being discharged from hospital. The test is available free-of-charge for all babies. Any baby who does not have a clear response in one or both ears from the test will be seen for a full audiological (hearing) assessment at an Audiology Clinic in Cork University Hospital (CUH) shortly after discharge.

What hearing tests are available for infants in the community?

For babies, there is the ‘Infant Distraction Test (IDT) screen' (a behavioural test of hearing, based upon the child's ability to turn to a sound) usually performed by public health nurses on babies at around eight months of age.
In some areas where a baby fails the distraction test screen a further test is undertaken by the community health doctor in a second tier clinic and if the baby fails the second test he/she is referred for further assessment.

How is my school child's hearing tested?

At school entry, there is a hearing screening test based upon the pure tone audiometry ‘sweep' test performed by public health nurses. During this test, the child will listen to a range of beeps and whistles (called pure tones) and indicate when they can hear them, by pressing a button. The loudness of each tone is reduced until your child can just hear the tone. The softest sounds your child can hear (his/her hearing thresholds) are then marked on a graph called an audiogram. This test is useful for highlighting if a hearing problem exists. The public health nurse will refer your child for further investigation if necessary.

How can I tell if my infant has a hearing problem?

Parents are often the first people to sense that their infant has a hearing problem. It is important to recognise the signs of hearing loss in infants and toddlers as early as possible. The most critical period for speech and language development is from birth to four years of age.

Observe your child's development from infancy on. The following are age-appropriate behaviours for infants and toddlers. If you suspect a problem, do not delay in getting your child's hearing tested. It's never too early to ask.

Does your baby:

Birth to 4 months:
Awaken or stir at loud sounds?
Startle at loud noises?
Calm at the sound of a familiar voice?
Respond to your voice (smiles or coos)?

4 to 9 months:
Turn eyes toward source of familiar sounds?
Smile when spoken to?
Notice rattles and other sound-making toys?
Cry differently for different needs?
Make babbling sounds?
Seem to understand simple word/hand motions such as "bye-bye" with a wave?

9 to 15 months:
Babble a lot of different sounds?
Respond to his/her name?
Respond to changes in your tone of voice?
Say "ma-ma" or "da-da"?
Understand simple requests?
Repeat some sounds you make?
Use his/her voice to attract attention?

15-24 months:
Point to familiar objects when they are named?
Listen to stories, songs and rhymes?
Follow simple commands?
Use several different words?
Point to body parts when asked?
Name common objects?
Put two or more words together?

How will I know if my preschool and older child has a hearing difficulty?

It is important to observe your child for any signs of potential hearing loss.
Does your child:
Turn up the volume of the TV excessively loud?
Respond inappropriately to questions?
Not reply when you call him/her?
Watch others to imitate what they are doing?
Have articulation problems or speech/language delays?
Have problems academically?
Complain of earaches, ear pain or head noises?
Have difficulty understanding what people are saying?
Seem to speak differently from other children his or her age?

While these signs don't necessarily mean that your child has a hearing problem, they could be indicators of one. If you answered "yes" to any of the above questions, or if you suspect your child may have difficulty hearing, arrange an appointment with your GP who will investigate further and refer you to an audiologist (hearing expert) or ENT (Ear Nose and Throat) consultant, if necessary.

I am concerned about my child's hearing, what can I do?

Contact your general practitioner (family doctor) or public health nurse who will be able to arrange for your baby/child to have a hearing assessment.

My child has recently been diagnosed with a hearing loss, what next?

If the hearing loss is temporary, your audiologist or ENT surgeon will advise you on the best course of action, which may involve antibiotics or minor surgery.
If your child has been diagnosed with permanent hearing loss, it is sometimes difficult to take in everything the specialist is saying to you. After the diagnosis you will be given an appointment for the fitting of hearing aids. The second appointment is a good time to ask any questions you may have as you would have had time to think about the situation.

It may be helpful to write down questions as you think of them, and take them with you to this appointment. You can also make contact with a support service for deaf or hard of hearing people, who can answer any queries you may have; notify you of welfare benefits; provide peer support, confidential counselling; social events for the family; and information sessions.

Will my child need regular check-ups now?

If your child has been diagnosed with some degree of permanent hearing loss, he or she should now be seen by the ENT (ear, nose and throat) Department on a regular basis to maintain his or her hearing aid and for regular hearing tests. Furthermore, when your child is identified with a hearing loss, the audiologist should make a referral to your local Education Department to arrange for a visiting teacher for children with hearing loss to visit you in your home. Their role is to support you, your child and the rest of the family.

What is the Visiting Teacher Service for children with hearing loss?

The Visiting Teacher Service is provided by the Department of Education & Science from the time of referral through to third level education. Each Visiting Teacher is responsible for a particular region and is allocated a caseload of pupils. The Visiting Teacher supports the children, parents/guardians, teachers and other professionals involved with the child.
The service is available at pre-school, primary, post primary and third level. Referral can be made through the audiology services and other professionals.


How often will the Visiting Teacher see my child?

The nature and frequency of visits will depend on a range of factors, including the age of the child, severity of hearing loss, educational placement and individual learning needs.

What does the Visiting Teacher do?

The Visiting Teacher calls to your home and supports the family, provides information about hearing loss and advises on the management of amplification devices (hearing aids, cochlear implants, FM systems, etc.) and the satisfactory development of communication skills. These include spoken language skills and/or sign language.
Home visits take place by mutual agreement. In addition, the Visiting Teacher discusses with parents the range of educational options available and makes recommendations regarding appropriate placement.

How long can our child avail of this service?

The involvement of the Visiting Teacher continues throughout the education of a child with a hearing loss. At present, the majority of children with a hearing loss are enrolled in the mainstream school system. At this level, the Visiting Teacher continues to visit the children at home and at school, providing advice and guidance on the education of the child.