Hearing Loss in Children:

Hearing loss is a problem that affects many aspects of a child's life, impacting their ability in communication skills, language learning, and social skills. Children start hearing from the very first day of their lives and learn to speak, picking up sounds around them over time. However, in some cases, a child may be born unable to hear or may lose their hearing during childhood due to an incident.
The earlier treatment for children with hearing loss begins, the better their chances of reaching their full potential. Newborns should be screened within the first month of life, and if hearing loss is detected, early intervention should start by six months to facilitate speech and language development. Children learn language before they start speaking, so it is crucial not to wait too long if you suspect your child is not responding to sound.

Hearing loss occurs when parts of the ear do not function properly, including the outer, middle, and inner ear, as well as the auditory nerve and any neural component responsible for hearing function. Hearing happens in the following steps, and any disruption in these steps will affect hearing:

1- Sound waves enter the outer ear and travel through the eardrum to the middle ear.
2- Sound waves vibrate the eardrum, sending vibrations to three small bones (ossicles) that transmit the vibrations to the inner ear where the cochlea is located.
3- The vibrating bones generate small waves in the fluid within the cochlea, lined with sensory cells that have hair-like structures. When hair cells move with fluid waves, they generate electrical signals.
4-  These signals travel through the auditory nerve (associated with the vestibular nerve responsible for balance) to the brain for interpretation into sounds and perception.

There are several types of deafness:

Conductive deafness: occurs when sound vibrations are not transmitted to the inner ear. This may be due to a physical obstruction (such as a child inserting something into their ear while playing) or accumulated earwax.
Sensorineural deafness: results from damage to the cochlea, auditory nerve, or any neural component contributing to hearing sensation. This type of hearing loss can range from mild (difficulty hearing certain sounds) to severe (inability to hear any sound). It is usually permanent but can improve with hearing aids or other devices.
- Mixed deafness: a combination of sensorineural and conductive hearing loss
* One type of deafness in children is known as auditory neuropathy spectrum disorder, where there is a problem in transmitting electrical signals to the brain for interpretation. This type of hearing disorder may occur if a child has health issues before or during birth or as a newborn. This condition may be present when the mother has an extremely premature birth or when the child experiences jaundice or low birth weight

Signs and Symptoms of Hearing Loss in Children:

The signs and symptoms of hearing loss can vary from one child to another, but if you suspect it, it is important to consult the nearest pediatrician for your child's hearing examination

Some signs that may indicate your child is experiencing hearing loss include:

1- Lack of response to loud noises and sounds.
2- Not turning towards the source of sound by six months of age.
3- Turning their head only when they see you, not when they hear your voice (this could be a hearing problem or simply the child ignoring at times).
4-  Not saying "mama" or "dada" by the age of one.
5-  Frequently raising the volume of the TV or music, indicating partial hearing loss.
6- Inability to follow instructions because they do not hear most of the speech.
7-  Delay in speech development and acquiring social communication skills.
8-  Repeating words or asking for repetition often.
9- Unclear speech and inability to play with children of the same age.

Hearing Examination and Diagnosis in Children:

Usually, the doctor diagnoses hearing loss based on a hearing test.
Hearing tests depend on your child's age and their ability to follow instructions.
For newborns and infants: a simple and short test done within minutes, painless for the child as they are usually asleep, including
Auditory Brainstem Response (ABR) tests check the inner ear, auditory nerve, and brain parts involved in hearing. During an ABR test
- Electrode pads are placed on the scalp by the provider, connected to a computer
- Small soft earphones are placed inside the ears
- The earphones play sounds.
- The electrodes measure how the brain responds to the sounds, with results displayed on the computer

Hearing Examination and Diagnosis in Children:

The Otoacoustic Emissions (OAE) test checks for damage to the hair cells in the cochlea. During an OAE test:
*- A small device is placed in the ear. It can make sounds and measure the sound.
*- The sound from the device makes the fluid in the cochlea ripple, moving the hair cells. When the hair moves, it creates vibrations that have their own sound called OAEs.
*- The device measures the OAEs to determine the quality of hair cell function. If the test shows little or no OAEs, your child may have sensorineural hearing loss

There are other tests performed when the child is older and able to cooperate with the doctor, such as:

- Putting on headphones and playing music, with the child making a signal each time they hear a tone.
- Speech discrimination testing: where words are said to the child in different tones and intensities (some of these words may be said in noise) to determine the child's ability to distinguish them.
- There are also several other tests that the doctor performs to determine whether your child has sensorineural or conductive hearing loss, as treatment differs depending on the condition.

Treatment for Hearing Loss in Children:

Treatment varies from child to child; there is no one-size-fits-all approach. For conductive hearing loss, the child often regains their hearing through procedures that may involve removing wax, draining fluids, or performing surgery to repair problems with the eardrum or ear bones. However, for sensorineural (nerve) hearing loss, the child may permanently lose their hearing. There are several modern communication techniques that can help improve the child's condition, such as hearing aids or surgery to implant a device called a cochlear implant.

Cochlear implants can help children with severe hearing loss when hearing aids are not sufficient. This surgically implanted device bypasses parts of the ear that do not function properly and directly stimulates the auditory nerve. Through training and therapy, children who have received a cochlear implant can learn to hear and speak well.
Hearing aids are the primary treatment for a type of hearing loss called sensorineural hearing loss. Hearing aids improve hearing by making sounds louder. Wearing hearing aids before they reach 6 months of age improves speech and language development. When hearing loss is present in both ears, children usually wear two hearing aids.
There are other therapeutic options if the child fails to have access to sound. Consulting pediatricians and audiologists for training the child in communication skills, including learning sign language or lip reading, or other methods of communication.
Education to help your child learn communication skills.
Assistive devices, such as using phones and alerting your child to alarms, doorbells, and other sounds.
Psychosocial support groups for the child, ensuring a normal and balanced life for them like their peers.