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Keep track of your child's listening skills using this chart.

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The LittlEars is a questionnaire that your audiologist may use with you to get a better sense of how you think your child responds to sounds in their environment. Here is a link to an online version:

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Are you concerned about your child's hearing? Take our Little Ears Auditory Questionnaire (LEAQ) to see if your child might have a hearing loss.

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Watch this informational video to learn more.

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You just found out your child has hearing loss. What's next? Visit this site to see read about next steps.

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Getting Started
If you are reading this you probably recently have found out your child is deaf or hard of hearing. The news may have come as a shock - maybe you never met a deaf person before. Or maybe it came as a relief - perhaps noticed your child wasn't responding to your voice but were not sure why. In any case, you are looking for answers and support. Here are some tips to consider as you gather information and make decisions for your child and family.

Language and communication. The ability to express and understand language and to be able to communicate is essential to our lives. It is what makes us human and allows us to learn and grow. Your child can develop language and communication and reach his/ her potential. Some families choose to use sign language with their child as well as speak, others choose spoken language only. Regardless of how you communicate, your child should have as much access to the language as possible. Pay attention to how s/he responds and whether s/he reaches her language milestones on time.

Speech and language. Language is a linguistic system of symbols that can be expressed several different ways, including through speech. Speech is not the same thing as language. Many deaf and hard of hearing children and adults have a complete language foundation although they may not have the ability to speak. The ability to speak has nothing to do with a person's intelligence. Further, the ability to speak does not interfere with the learning of sign language, and the ability to sign does not interfere with the learning of speech. Communicate with your child as richly as possible, to the best of your ability.

Early intervention. Ensure your child is enrolled in an early intervention program in your area. For most children, early intervention is necessary to develop age appropriate language skills. (See Early Intervention Services.)

Assistive technology. Most deaf and hard of hearing children benefit from hearing aids, so try to have your child fitted with hearing aids soon. Try to work with an audiologist with experience with young children to find the most appropriate hearing aid for your child. Some families also use additional assistive listening systems. Families also use visual alerting systems in the home, such as a flashing light connected to the doorbell, to give their child information about what is happening in their environment.

Learn from other parents. Meeting other parents of deaf or hard of hearing children will provide support and information that only another parent can provide. Ask your early intervention program to connect you with parent groups or individual parents within your community.

Learn from deaf and hard of hearing adults. Many deaf and hard of hearing individuals are happy to answer your questions about raising a child with hearing loss and give you practical suggestions for communication at home. Ask your early intervention program about a Deaf Mentor program, groups, and events in your area.

No decision needs to be forever. There will be many twists and turns throughout the life of your child and family. Be flexible enough to stay with approaches that work and to modify those that don't. Take your cues from your child. Observing your child's development will help guide you on this sometimes difficult, yet rewarding path.

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Getting Started If you are reading this you probably recently have found out your child is deaf or hard of hearing. The news may have come as a shock - maybe you never met a deaf person before. Or maybe it came as a relief - perhaps noticed your child wasn't responding to your voice but were not sure why.

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Would it be helpful to talk to someone who has been in your shoes as a parent of a child with hearing loss? Follow this link to learn more about being paired with a parent mentor.

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Illinois Sound Beginnings: Guide By Your Side (GBYS)

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Parent to parent support for families with children who have a hearing loss

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Across the top is pitch: on left is the low, or bass, pitches, which get higher in pitch as you move across to the right--kind of like a piano keyboard! From bottom to top is volume: from soft to loud. X's and O's are plotted on the chart, which shows how loud the audiologist had to make the sounds for the child to hear them.

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What is it like to have different degrees of hearing loss? Watch this simulation to get a better idea.

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Look at this document for information about ways to protect your child's hearing!

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Your audiologist may have told you about different communication options available for your child with hearing loss. You can read more about them here:

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Some hearing loss can be progressive, which means it worsens over time. Your audiologist can tell you whether they think it will get worse based on your child's specific hearing loss. In general, you should do everything you can to preserve the hearing that your child does have!

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There are fun ways to keep hearing aids on your child! These clips attach to a shirt collar to prevent loss of hearing aids even if they pull them out of their ears.

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Girl Mouse - Hearing Aid Cord or Cochlear Implant Cord

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Our security cords are perfect for infants, toddlers, people with disabilities, the elderly or anyone that is active and looking for added security from losing their hearing device. We have a large selection of cord colors and felties to customize your cord to suit your personality. Our security

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Individuals With Disabilities Education Act

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Individuals With Disabilities Education Act

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IDEA is a law that helps to ensure that children with disabilities receive free and appropriate public education. Read more about IDEA here to learn about the services it provides at different stages in your child's education:

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Individuals with Disabilities Education Act

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The Individuals with Disabilities Education Act (IDEA) is a law that makes available a free appropriate public education to eligible children with disabilities throughout the nation and ensures special education and related services to those children.

The IDEA governs how states and public agencies provide early intervention, special education, and related services to more than 8 million (as of school year 2022-23) eligible infants, toddlers, children, and youth with disabilities.

Infants and toddlers, birth through age 2, with disabilities and their families receive early intervention services under IDEA Part C. Children and youth ages 3 through 21 receive special education and related services under IDEA Part B.

Additionally, the IDEA authorizes:

Formula grants to states to support special education and related services and early intervention services.

Discretionary grants to state educational agencies, institutions of higher education, and other nonprofit organizations to support research, demonstrations, technical assistance and dissemination, technology development, personnel preparation and development, and parent-training and -information centers.

Congress reauthorized the IDEA in 2004 and most recently amended the IDEA through Public Law 114-95, the Every Student Succeeds Act, in December 2015.

In the law, Congress states:

Disability is a natural part of the human experience and in no way diminishes the right of individuals to participate in or contribute to society. Improving educational results for children with disabilities is an essential element of our national policy of ensuring equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with disabilities.

Other Laws for Children with Disabilities

The U.S. Department of Education's Office for Civil Rights (OCR) provides additional resources of interest for individuals with disabilities and their families.

OCR does not enforce the IDEA; however, OCR does enforce the Rehabilitation Act of 1973, Section 504 and Americans with Disabilities Act of 1990, Title II rights of IDEA-eligible students with disabilities.

To learn more, visit the OCR's Frequently Asked Questions About Section 504 and the Education of Children with Disabilities.

Visit OCR's website for additional resources.

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About IDEA - Individuals with Disabilities Education Act

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The IDEA is a law that makes available a free appropriate public education to eligible children with disabilities throughout the nation and ensures special education and related services to those children.

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Before calling your audiologist, check these few things!

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Tips for Inserting Your Child's Hearing Aid

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Tips for Inserting Your Child's Hearing Aid

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It can be difficult to know whether the earmold is inserted correctly into your child's ear. Here are some tips for correct insertion to avoid whistling!

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For optimal performance, the hearing aid must be in the correct position. Learn more about inserting a hearing instrument into your child's ear.

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FM systems such as the Phonak "Roger" allow the teacher's voice to be streamed directly to your child's hearing aids. This pamphlet provides information about the different Roger configuration options, including Phonak hearing aids as well as options to adapt to hearing aids from other manufacturers.

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Wondering why your child needs an FM system? This helps to explain how an FM/Roger system can help your child in school.

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Here are the top 5 parent-approved options for keeping hearing aids where they should be:

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If your child has Phonak hearing aids, you can make custom stickers to personalize the look.

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Shop all custom Phonak skins online at Skinit and create a design that best suits your style.

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Do you wonder what you can do as a parent to better communicate with your child with hearing loss? This video has some good tips.

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Hearing Loss in Children: Strategies for Better Communication | Boston Children's Hospital

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This is a fun, interactive diary to fill out with your child that can help to document their hearing journey.

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Here are some activities to do with your child to help enhance their auditory skills.

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You can make a free account with the Advanced Bionics "Listening Room" site to play online interactive auditory training games with your child!

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Welcome to
The Listening Room!

Here you will find a host of free, fun activities and resources to support the development of speech, language, and listening skills in people of all ages with a hearing loss.

The Listening Room features three sections with content created specifically for their respective age groups: Infants & Toddlers, Kids, and Teens & Adults.

Log in to get started or register now to create your free account.

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Here you will find a host of free, fun activities and resources to support the development of speech, language, and listening skills in people of all ages with a hearing loss. The Listening Room features three sections with content created specifically for their respective age groups: Infants & Toddlers, Kids, and Teens & Adults.

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You may have heard about cochlear implants and are curious if you child is a candidate. This site gives an overview of the requirements for cochlear implantation, and whether it may or may not be appropriate for your child. Your audiologist will help to guide you through this process if he or she is a candidate!

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Your audiologist or hearing professional will help you to determine if your child is a candidate for a cochlear implant.

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How to Help Your Child Understand Their Hearing Loss

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How to Help Your Child Understand Their Hearing Loss

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This website provides interactive and informational videos to help explain hearing loss. These videos can help to facilitate a discussion about self-advocacy with your child.

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It is important that you do all you can to provide your child with the best language models and exposure to language as possible. Click this link to learn more about language development and how to incorporate learning into daily activities.

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Language and Learning - My Baby's Hearing

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Important information about early intervention, communication development and opportunities for nurturing language development.

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It may seem tedious to take regular trips back to the audiologist, but it is necessary to follow the recommendations for hearing aid check-ups! At these appointments, the audiologist cleans and inspects the hearing aids and is able to measure how they are working in the child's ears. They may also do hearing  tests with and without the hearing aids, in order to measure how they are helping. This testing can also help us to determine if the hearing loss is progressive, or getting worse, which can be more common in children.

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While often times there is no way to determine the exact cause of the hearing loss, there are some common causes and risk factors as discussed on this website created by the American Speech Language and Hearing Association (ASHA). Genetic testing can sometimes help to identify an inherited type of hearing loss if it is present.

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Otitis Media
What is otitis media?
Otitis media is an inflammation in the middle ear (the area behind the eardrum) that is usually associated with the buildup of fluid. The fluid may or may not be infected.

Symptoms, severity, frequency, and length of the condition vary. At one extreme is a single short period of thin, clear, noninfected fluid without any pain or fever but with a slight decrease in hearing ability. At the other extreme are repeated bouts with infection, thick "glue-like" fluid and possible complications such as permanent hearing loss.

Fluctuating conductive hearing loss nearly always occurs with all types of otitis media. In fact it is the most common cause of hearing loss in young children.
How common is otitis media?
Otitis media is the most frequently diagnosed disease in infants and young children (1). Seventy-five percent of children experience at least one episode of otitis media by their third birthday. Almost one-half of these children will have three or more ear infections during their first 3 years of life (2). Health costs for otitis media in the United States have been reported to be $3 billion to $5 billion per year (3).
Why is otitis media so common in children?
The eustachian tube, a passage between the middle ear and the back of the throat, is smaller and more nearly horizontal in children than in adults. Therefore, it can be more easily blocked by conditions such as large adenoids and infections. Until the eustachian tube changes in size and angle as the child grows, children are more susceptible to otitis media.
How can otitis media cause a hearing loss?
Three tiny bones in the middle ear carry sound vibrations from the eardrum to the inner ear. When fluid is present, the vibrations are not transmitted efficiently and sound energy is lost. The result may be mild or even moderate hearing loss. Therefore, speech sounds are muffled or inaudible.

Generally, this type of hearing loss is conductive and is temporary. However when otitis media occurs over and over again, damage to the eardrum, the bones of the ear, or even the hearing nerve can occur and cause a permanent, sensorineural hearing loss.
Can hearing loss due to otitis media cause speech and language problems?
Children learn speech and language from listening to other people talk. The first few years of life are especially critical for this development.

If a hearing loss exists, a child does not get the full benefit of language learning experiences.

Otitis media without infection presents a special problem because symptoms of pain and fever are usually not present. Therefore, weeks and even months can go by before parents suspect a problem. During this time, the child may miss out on some of the information that can influence speech and language development.
How can I tell if my child might have otitis media?
Even if there is no pain or fever, there are other signs you can look for that may indicate chronic or recurring fluid in the ear:

Inattentiveness

Wanting the television or radio louder than usual

Misunderstanding directions

Listlessness

Unexplained irritability

Pulling or scratching at the ears

What should I do if I think that otitis media is causing a hearing, speech, or language problem?
A physician should handle the medical treatment. Ear infections require immediate attention, most likely from a pediatrician or otolaryngologist (ear doctor). If your child has frequently recurring infections and/or chronic fluid in the middle ear, two additional specialists should be consulted: an audiologist and a speech-language pathologist.

An audiologist's evaluation will assess the severity of any hearing loss, even in a very young or uncooperative child, and will indicate if a middle ear disorder is present.

A speech-language pathologist measures your child's specific speech and language skills and can recommend and/or provide remedial programs when they are needed.
Will my physician refer my child for these special evaluations?
As a parent, you are the best person to look for signs that suggest poor hearing. The American Academy of Pediatrics recognizes this when it states, "Any child whose parent expresses concern about whether the child hears should be considered for referral for behavioral audiometry without delay".

Parents should not be afraid to let their instincts guide them in requesting or independently arranging for further evaluation whenever they are concerned about their children' s health or development.

Congenital Causes

The term congenital hearing loss implies that the hearing loss is present at birth. It can include hereditary hearing loss or hearing loss due to other factors present either in utero (prenatal) or at the time of birth.

Genetic factors are thought to cause more than 50% of all incidents of congenital hearing loss in children (4). Genetic hearing loss may be autosomal dominant, autosomal recessive, or X-linked (related to the sex chromosome).

In autosomal dominant hearing loss , one parent who carries the dominant gene for hearing loss and typically has a hearing loss passes it on to the child. In this case there is at least a 50% probability that the child will also have a hearing loss. The probability is higher if both parents have the dominant gene (and typically both have a hearing loss) or if both grandparents on one side of the family have hearing loss due to genetic causes. Because at least one parent usually has a hearing loss, there is prior expectation that the child may have a hearing loss.

In autosomal recessive hearing loss , both parents who typically have normal hearing, carry a recessive gene. In this case the probability of the child having a hearing loss is 25%. Because both parents usually have normal hearing, and because no other family members have hearing loss, there is no prior expectation that the child may have a hearing loss.

In X-linked hearing loss, the mother carries the recessive trait for hearing loss on the sex chromosome and passes it on to males, but not to females.

There are some genetic syndromes,in which, hearing loss is one of the known characteristics. Some examples are Down syndrome (abnormality on a gene), Usher syndrome (autosomal recessive), Treacher Collins syndrome (autosomal dominant), Crouzon syndrome (autosomal dominant), and Alport syndrome (X-linked).

Other causes of congenital hearing loss that are not hereditary in nature include prenatal infections, illnesses, toxins consumed by the mother during pregnancy or other conditions occurring at the time of birth or shortly thereafter. These conditions typically cause sensorineural hearing loss ranging from mild to profound in degree. Examples include:

Intrauterine infections including rubella (German measles), cytomegalovirus, and herpes simplex virus

Complications associated with the Rh factor in the blood

Prematurity

Maternal diabetes

Toxemia during pregnancy

Lack of oxygen (anoxia)

Acquired Causes

Acquired hearing loss is a hearing loss which appears after birth, at any time in one's life, perhaps as a result of a disease, a condition, or an injury. The following are examples of conditions that can cause acquired hearing loss in children are:

Ear infections (otitis media) (link to specific section above)

Ototoxic (damaging to the auditory system) drugs

Meningitis

Measles

Encephalitis

Chicken pox

Influenza

Mumps

Head injury

Noise exposure

Finding Help
How can I find an audiologist or speech-language pathologist?
Search ASHA ProFind or contact the American Speech-Language-Hearing Association's Action Center, 2200 Research Boulevard #425, Rockville, Maryland 20850. Phone: 800-638-8255 or 301-296-5700.
Where can I find a pediatric audiology facility?
Search EHDI-PALS, a website with a national pediatric audiology facilities directory and great educational resources for families.

References

1. Dhooge, I.J. (2003). Risk factors for the development of otitis media. Current Allergy and Asthma Reports, 3: 321-325.

2. National Institute on Deafness and Other Communication Disorders. (2002). Otitis media (ear infection) (NIH Publication No. 974216). Bethesda, MD: Author.

3. Alsarraf, R., Jung, C.J., Perkins, J., Crowley, C. & Gates, G.A. (1998). Otitis media health status evaluation: A pilot study for the investigation of cost-effective outcomes of recurrent acute otitis media treatment. Annals of Otology, Rhinology and Laryngology, 107: 120-128.

4. Canalis, R.F., & Lambert, P.R. (2000). The ear: Comprehensive otology. Philadelphia: Lippincott Williams & Wilkins.

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Reasons for hearing loss in children are discussed including otitis media, congenital causes, and acquired causes.