It is not uncommon for your child’s pediatrician, speech therapist or other health care provider to recommend an Audiology evaluation for your child if there are concerns about your child’s language development. Newborn Hearing screens were implemented in order to identify significant hearing losses at birth and have been known to identify a large percentage of children with congenital (occurring from birth) hearing problems. It is not uncommon, however, to pass the newborn hearing screen, only then to be later diagnosed with hearing problems that can negatively impact a child’s development of speech and language skills. If a child cannot hear what is being said around him, then he will have great difficulty learning how to talk and/ or following directions. Cause for hearing problems in children up through preschool age includes having a history of ear infections, episodes of middle ear fluid (with or without an ear infection present) and/or “glue ear”.
An ear infection can be easily identified by your child’s pediatrician as by this point the eardrum has become red and swollen making it highly visible to a pediatrician while doing a routine ear exam. The build-up of middle ear fluid however, can occur without an ear infection present and it is not easily identifiable by a pediatrician. Most children do not have any signs or symptoms of having middle ear fluid as it is not often associated with pain or discomfort. To identify middle ear fluid, an Audiologist would perform a Tympanogram to identify middle ear function. If there is fluid present, the eardrum will not be able to move properly. A child with fluid in his ears is often said to be hearing as if “underwater”. The speech sounds are muffled decreasing your child’s ability to hear speech sounds correctly. “Glue ear” is a term used to refer to excessive ear wax that is impacting the ear canal. Many pediatricians are able to clean out the earwax within an office visit, however, it is important to note that repeatedly having to remove impacted earwax can cause scarring in the ear canal.
A referral to an Ear Nose and Throat Specialist (ENT) would be recommended if your child suffers from frequent ear infections and or middle ear fluid. The ENT will assess whether the placement of Pressure-equalization (PE) tubes would be beneficial in order to reduce and/or completely eliminate the number of ear infections that occur.
A hearing assessment for a child should be completed by a Certified Pediatric Audiologist as techniques used on adults are very different than those used with children. The Audiologist will assess middle ear function by use of a Tympanogram and test hearing in a sound field/booth. If your child is known to be highly sensitive to objects in or around his ears, share this with the Audiologist at the begin of the evaluation.
Ear infections and the presence of middle ear fluid do not ALWAYS lead to problems developing speech and language, however, if your child has had a history of ear infections and is behind in language development, it is worthwhile to ask his/her pediatrician about a referral for a hearing assessment in order to rule this out as the cause of the language delay. At the very least, your child’s hearing ability and language development should be continuously monitored.