Hearing loss and speech development in children

The sense of hearing develops in the womb. The first sounds, e.g. mother's heartbeat or her voice, can be perceived by a toddler from about the fifth month of gestation. The sounds that are heard by the child during this period are a great opportunity for the first exercises to differentiate them. Thanks to this, the toddler is born with developed hearing and usually reacts lively to various sound stimuli. 

Hearing is of fundamental importance for the proper development of speech, because it is through listening combined with observing the immediate environment, the toddler learns to speak. The child understands speech before using it. However, if the baby does not react to the sounds of the environment, both soft ones, such as mom's voice or loud ones, such as clapping hands, it may be a sign that he cannot hear them properly. What behavior might indicate your baby has a hearing loss? Does the speech of a child with a hearing loss differ from that of fully healthy peers? We answer these and other questions in the article below.

What are the causes of hearing disorders?

Hearing disorders can have various causes. They are associated with the malfunctioning of the structures of the hearing organ, i.e. the outer ear, middle ear and inner ear.

The outer ear

It is the auricle and the external auditory canal.

Middle ear

It consists of the eardrum, the tympanic cavity, the air spaces of the mastoid process (including the mammary cavity) and the Eustachian tube.

Eustachian tube

It is an element connecting the tympanic cavity with the nasopharynx. It plays an important role because it enables the pressure in the tympanic cavity to equalize with the atmospheric pressure, facilitates the drainage of secretions produced by the mucosa of the middle ear to the nasopharynx and prevents discharge from the nasopharynx into the middle ear.

Differences between the structure of the ear in a child and an adult are important in the pathology of these structures typical for developmental age. The length of a child's Eustachian tube is shorter than that of an adult. The cartilage portion is relatively longer and wider than that of adults and is also more horizontal. This is conducive to the emergence of frequent middle ear infections - especially in young children. With age, the oropharyngeal orifice of the Eustachian tube changes its position, making infections less frequent and eventually disappearing altogether.

Hearing loss in a child: types

It can be congenital, but it can also appear as a consequence of past infections. It stands out three types of hearing loss:

• conductive;
• receiving;
• mixed.

Hearing loss conductive in a child

It applies to the outer and middle ear. It occurs as a result of disturbances in the activity of the auditory canal that arose in the process of e.g. inflammatory infections, injuries or developmental defects.

With fluid remaining in the tympanic cavity, the child cannot hear soft sounds, especially those with low frequencies. Because a toddler learns speech by imitation - if he hears a given sound incorrectly - he will also reproduce it incorrectly or not at all.

Hearing loss receiving in a child 

The second type of hearing loss is sensorineural hearing loss. It occurs in the case of disorders within the inner ear and is associated with damage to the auditory cells of the cochlea and impairment of the auditory nerve.

Hearing loss mixed in a child

With the simultaneous damage to the structures of the middle and inner ear, the so-called mixed hearing loss.

In the case of suspected conductive and sensorineural hearing loss, or its mixed form, it is crucial to carry out the diagnosis as early as possible and initiate appropriate treatment.

The behavior of a child with hearing loss

The behavior of a child with hearing loss is not unambiguous, therefore the diagnosis of hearing impairment, especially in an infant, may be difficult for parents. There are some symptoms manifested in the toddler's behavior and reactions, which may indicate that he has a problem with reception, and thus with understanding the sounds of the environment, including speech sounds.

The correct responses to a sound stimulus in an infant are:

• Moro reflex (sudden opening of the hands, especially when there is a sudden noise); cessation of sucking;
• pointing the head towards the sound source (e.g. turning the head towards the rattle);
• awakening from sleep;
• cry.

If such reactions do not occur, it is necessary to consult a pediatrician or ENT specialist who will refer you to a specialist hearing test.

Characteristics of the behavior of a child with hearing loss: what to pay attention to?

Later in life, a child's hearing loss can lead to behavioral disturbances. Thus, the behavior of an older child with hearing loss is somewhat simpler. When a child does not hear exactly what their parent or guardian is saying, reacts e.g anger or even aggression. As a result, it may be perceived by the environment as hyperactive and restless. In kindergarten or at school no response to command to educators, caused by hearing loss, may be perceived as a sign of disobedience or distraction.

Children with hearing problems usually alone they speak loudlyand can therefore be perceived as flashy and loud. It is also good to pay attention to whether our child often asks to repeat what we say to him or listens too loudly to cartoons on the TV. Such behaviors are signals that should encourage parents to check whether the child can hear properly.

Speech of a child with hearing loss

In older children, hearing loss can cause difficulties in building longer statements, which will hinder communication and establishing relationships with peers. Linguistic errors and articulation disorders (e.g. omitting sounds, distortions in their pronunciation) occurring in children with hearing impairment are difficult to correct due to difficulties with their correct reception and require special speech therapy.

Hearing is a key sense in the proper development of speech at every stage. Therefore, if you notice any disturbing behavior of the child or difficulties in speech, it is necessary to consult a specialist doctor.

Hearing loss in a child: basic hearing tests in children

Currently, thanks to the latest medical equipment, it is possible to diagnose a child and detect damage from the first days of life as well as at every stage of development. Moreover, in the last few years, every newborn baby has been subjected to mandatory hearing tests. Thanks to this, it is much easier to detect any irregularities and immediately start appropriate therapeutic measures.

Źródła:

Gryczyńska D., Jaroch T .: "Objective examination of the hearing organ" in "Children's Otolaryngology" Gryczyńska D. (ed.) Alfa Medica, Bielsko-Biała 2007, 58-61;
Kornas-Biela D .: "Prenatal conditions of speech development" in: "Speech therapy from conception" B. Rocławski (ed.), Glottispol, Gdańsk 1998