Hearing loss is broken down into the following 3 different categories.
"Conductive hearing loss occurs when sound is not conducted efficiently through the outer ear
canal to the eardrum and the tiny bones of the middle ear. Examples of causes of conductive
hearing loss include ear infections, excessive earwax, and fluid in the middle ear. Conductive
hearing loss usually involves a reduction in sound level or the ability to hear faint sounds. This
type of hearing loss can often be corrected medically or surgically.
Sensorineural hearing loss (SNHL) occurs when there is damage to the inner ear (cochlea), or
to the nerve pathways from the inner ear to the brain. SNHL reduces the ability to hear faint
sounds. Even when speech is loud enough to hear, it may still be unclear or sound muffled.
Mixed hearing loss occurs when there is a conductive hearing loss combined with a sensorineural
hearing loss (SNHL). In other words, there may be damage in the outer or middle ear and in
the inner ear (cochlea) or auditory nerve. When this occurs, the hearing loss is referred to as a
mixed hearing loss.
Effects of Hearing Loss on Development
It is well recognized that hearing is critical to speech and language development,
communication, and learning. Children with listening difficulties due to hearing loss or auditory
processing problems continue to be an under-identified and underserved population.
The earlier hearing loss occurs in a child's life, the more serious the effects on the child's
development. Similarly, the earlier the problem is identified and intervention begun, the less
serious the ultimate impact.
- Vocabulary develops more slowly in children who have hearing loss.
- Children with hearing loss learn concrete words like cat, jump, five, and red more easily
than abstract words like before, after, equal to, and jealous. They also have difficulty
with function words like the, an, are, and a.
- The gap between the vocabulary of children with normal hearing and those with hearing
loss widens with age. Children with hearing loss do not catch up without intervention.
- Children with hearing loss have difficulty understanding words with multiple meanings.
For example, the word bank can mean the edge of a stream or a place where we put
- Children with hearing loss comprehend and produce shorter and simpler sentences than
children with normal hearing.
- Children with hearing loss often have difficulty understanding and writing complex
sentences, such as those with relative clauses ("The teacher whom I have for math was
sick today.") or passive voice ("The ball was thrown by Mary.")
- Children with hearing loss often cannot hear word endings such as -s or -ed. This leads to
misunderstandings and misuse of verb tense, pluralization, nonagreement of subject and
verb, and possessives.
- Children with hearing loss often cannot hear quiet speech sounds such
as "s," "sh," "f," "t," and "k" and therefore do not include them in their speech. Thus,
speech may be difficult to understand.
- Children with hearing loss may not hear their own voices when they speak. They may
speak too loudly or not loud enough. They may have a speaking pitch that is too high.
They may sound like they are mumbling because of poor stress, poor inflection, or poor
rate of speaking.
- Children with hearing loss have difficulty with all areas of academic achievement,
especially reading and mathematical concepts.
- Children with mild to moderate hearing losses, on average, achieve one to four grade
levels lower than their peers with normal hearing, unless appropriate management occurs.
- Children with severe to profound hearing loss usually achieve skills no higher than the
third- or fourth-grade level, unless appropriate educational intervention occurs early.
- The gap in academic achievement between children with normal hearing and those with
hearing loss usually widens as they progress through school.
- The level of achievement is related to parental involvement and the quantity, quality, and
timing of the support services children receive.
- Children with severe to profound hearing losses often report feeling isolated, without
friends, and unhappy in school, particularly when their socialization with other children
with hearing loss is limited.
- These social problems appear to be more frequent in children with a mild or moderate
hearing loss than in those with a severe to profound loss.
What You Can Do
Recent research indicates that children identified with a hearing loss who begin services early
may be able to develop language (spoken and/or signed) on a par with their hearing peers. If
a hearing loss is detected in your child, early family-centered intervention is recommended
to promote language (speech and/or signed depending on family choices) and cognitive
development. An audiologist, as part of an interdisciplinary team of professionals, will evaluate
your child and suggest the most appropriate audiologic intervention program."