Mild hearing loss is a misnomer. I do not know what word to substitute but mild hearing losses are not a mild problem. The data is clear. Children with mild hearing loss are at risk for academic, speech-language, and social-emotional difficulties. Newborn hearing screening does not always pick up mild hearing loss so babies with mild hearing loss may not get identified until they demonstrate delays.

 

Why is newborn hearing screening missing mild hearing loss?

Current standard newborn hearing screening techniques are good at identifying moderate or greater hearing loss. So when the baby passes hearing screening the family is told the baby has normal hearing. Since the parents and pediatricians have been told that the baby has normal hearing, if concerns develop, it may not occur to parents or the pediatrician that hearing loss may be a factor.

 

What exactly is mild hearing loss?

The definition of mild hearing loss varies depending on the researcher so results indicating the effects of mild hearing loss vary. Some audiologists define mild hearing loss as hearing thresholds of 15-30 dB, others use 20-40 dB. Statistics vary from 1-3% of the newborn population to 54/1000 in the school population. What ever criteria is used results in a significant number of affected children. The topic cannot be ignored.

 

What are the effects of a mild hearing loss?

Mild hearing loss is an invisible acoustic filter. The speech signal is not sufficiently loud and clear. Children with mild hearing loss will have less access to speech. A child with a 30 dB hearing loss will miss 25-40% of what happens in the classroom. A child with a 35-40 dB hearing loss will miss about 50% of what happens in the classroom. Bess et al, (1998) reported that 37% of children with minimal hearing loss (mild or unilateral) failed a grade by third grade.

 

A child with mild hearing loss will hear speech that is spoken close to the child, but when the child is 10 feet from the person talking, it will be difficult to hear. This is not an insignificant problem. More than 80% of what children learn they learn by overhearing things not specifically directed to them (incidental learning). If a child has, even a mild hearing loss, he will miss a lot of what is said, resulting in delayed language. Likely the delay will not be recognized for several years by which time we are talking about having to try and correct deficits rather then preventing delays.

 

Children with a mild hearing loss can be expected to have more problems hearing in noise then their typically hearing peers. Since the world is a noisy place it is not possible to avoid noise. If speech perception decreases in noise we expect a child to have language learning, and academic delays.

 

Middle ear disease?

Children with mild hearing loss can have a more significant problem from middle ear disease than children with normal hearing. Middle ear disease can decrease hearing by as much as 15-30 dB. If you have normal hearing, having a drop of 20 dB may not be a problem but if you have a hearing loss of 30 dB, an additional 20 dB drop can be devastating. Parents and physicians need to be vigilant and move quickly if a child has a mild hearing loss.

 

Do children with mild hearing loss need hearing aids?

Audiologists do not agree on the answer to this question. I am in the group that believes we need to do whatever we can do to assure that children hear everything around them. I will do extensive testing to see how a child is hearing, including speech perception as soon as a child can do that task. If a child is having trouble hearing soft speech that is a concern, and for me, that usually means hearing aids will be beneficial. For school, children with mild or unilateral hearing losses need FM systems to reduce the negative effects of distance and background noise.

 

Counseling about mild hearing loss.

The worse thing we can say to a family is “it’s only mild.” It is not a mild problem. The data is very clear that children with mild hearing losses struggle. Does this mean they will never succeed? No, of course not. But it does mean that they will have to work harder. So let’s do what we can to make things as easy as we can. Let’s use technology and provide necessary therapy and school assistance. Our goal is to have all kids with any degree of hearing loss be able to do whatever they want to do.

 

 

5 Responses to A Mild Hearing Loss is Not a Mild Problem

  1. Lauren says:

    Important article! We only wish all authors, where it fits, or mostly fits! would also mention the necessity for real time quality captioning on media (not only TV), and for live events including classroom learning too. It reduces the struggle, helps children learn to read, and fills in the gaps in ways no hearing aids, loops, implants, or other devices can do. It may seem “off” to say use captioning for children learning to speak, and learning to learn, but it’s vital. Yes, you do mention “technology” yet since so many are unaware of what captioning is, we hope more and more authors will mention it specifically. For adults who discover real time captioning (called CART), it’s a life-saver, without exaggeration. Cheers, LS/CCAC

  2. Krysty says:

    Jane – this is a great post about the importance of addressing mild hearing loss and the impact that it can have on learning. Spoken language is such an important of classroom learning, even in early elementary classrooms and a mild hearing loss can cause a child to miss up to 25% of classroom instruction. It’s important to have access to consistent, appropriate therapies and amplification options. I am going to throw in a quote here by Carrol Flexer, “Hearing is not optional, it’s not something that is nice to have. Every child needs to have consistent access to clear speech and acoustic detail in order to succeed.” I am glad that you take it seriously as an audiologist.

  3. Beth Jabate says:

    My uncle who had a mild hearing loss and that is between 71 and 90 dB. But he hear well in one and one conversation, but when we talk in quiet he can’t follow. Even in a noisy atmosphere he is unable to get the conversation. Right now he is under treatment in Hearing solutions Canada. So mild hearing loss is not a simple one and never ignore it. Get the help from any hearing aid clinic before it get worse.

  4. Ravi sanikop says:

    Mild hearing loss is an invisible problem.these children can access common day today environmental sounds very well.parents perception of child’s hearing is that do adequate level. Even if all concerned professionals have counselled the parents , they find it hard to accept the diagnosis. Consequently hearing aid usage and compliance is very bad. Assessments by teacher of the deaf at school us Ming speech audio entry can highlight the problems, Teacher of the Deaf(TOD) role is very important. Speech in noise testing with audiologist would be better at the assessing the functioning of the child, you need parents on your side,spend time with them!

  5. Chevone says:

    Thank you for this! I absolutely love reading your articles. I’ve written a blog about my personal experience when my son was diagnosed with “mild” bilateral hearing loss http://chevslife.wordpress.com/2014/09/24/hearing-loss-diagnoses-the-first-6-months/.

    I agree with you when you say that the worst thing that one can do is to tell a parent that it is “only mild”, or treat the parent as if the child’s challenges are insignificant when just looking at the audiogram. I’ve experienced first hand with my son that a mild hearing loss is in fact, not a mild problem…