In the past few years, my six-year-old daughter has suffered from repeat ear infections. The last was so severe it caused a ruptured ear drum. After this unfortunate event, my husband and I noticed that she struggled to hear, often asking us to repeat ourselves or to turn up the volume on the television or iPad.
At first, we thought it might be temporary, a result of the ear drum being damaged. The problem, however, has persisted, even when she is at school. According to her pediatrician, it’s possible the infections have caused some hearing loss, although further testing is required. Sadly, her story is not unique.
Experts say chronic ear infections, which are common among children, can lead to hearing impairment or permanent hearing loss. Additionally, many children are born with hearing impairment. Together, about two to three of every 1,000 children in the United States are born with a detectable hearing loss in one or both ears, and almost 15 percent of school-age children (ages six to 19) have some degree of hearing loss.
Yet sometimes we are unaware that our children are having any difficulties. Now, according to new research, one of the earliest warning signs of hearing impairment might be when a child struggles to read or write.
In a study of 196 youngsters ages eight to 10, including 36 with dyslexia and 29 with a history of repeated ear infections, researchers at Coventry University found that 25 percent of participants who had reading difficulties showed mild or moderate hearing impairment of which their parents and teachers were unaware. Children who have a hard time hearing will find it much more difficult than children who have normal hearing to learn vocabulary, grammar, word order, idiomatic expressions, and other aspects of verbal communication.
Study participants completed a series of tests to establish their reading and writing skills, and how they used the structures of words based on their sounds and meanings in both speech and literacy. After 18 months, they were tested again and a hearing screening was also carried out. Children with dyslexia had difficulties with literacy activities involving the ability to manipulate speech sounds (known as phonology) and the knowledge of grammatical word structure (called morphology), while those with a history of chronic ear infections mainly had problems with the phonology tasks.
“This is an important study, which should alert families to talk with their doctors about screening their children for hearing difficulties,” says Susan Neuman, professor of childhood education and literacy development at the Steinhardt School of Culture, Education, and Human Development at New York University.
As many teachers know, she adds, attentional difficulties in classrooms may be caused by hearing problems; furthermore, children cannot attend to some of the subtle differences in the sounds of our language which makes decoding instruction very difficult for them.
“Auditory struggles can have a significant impact on a student’s ability to read,” says Tina Liberatore, president of Gemm Learning, a provider of online learning software that treats the source of reading and learning difficulties including auditory processing challenges. “Reading isn’t just visual. Reading is a listening skill. If a student is not able to comfortably map the sounds of language to reading, learning to read will be an uphill battle.”
Liberatore says estimates of auditory processing disorder, a condition that makes it hard for kids to recognize subtle differences between sounds in words, range between two to seven percent of the general population. However, when testing struggling readers, she says, the percentages are much higher.
Students with auditory processing disorder experience difficulties when using auditory information to learn and communicate. They may have difficulty hearing important information when background noise is present. They may ask to have information repeated or misinterpret what has been communicated. They may have trouble following and recalling verbal instructions and may also appear easily distracted in the classroom and elsewhere.
Students with auditory struggles often display difficulty with phonological skills. Upon “learning to read,” they many have trouble comprehending written material. They may struggle with receptive and expressive language. Due to these challenges, many will also experience mental fatigue by the end of the school day, says Liberatore.
Report author Helen Breadmore said, "Current hearing screening procedures are not picking up these children, and we would advise that children have their hearing tested in more detail and more often.”
Liberatore says the signs can be subtle and sometimes mimic attention and/or behavior issues. Auditory processing disorder will likely not be identified in a typical hearing exam. Parents with concerns should ask for an auditory processing evaluation with an audiologist.
The Centers for Disease Control and Prevention (CDC) says that there is no single treatment or intervention for childhood hearing loss. However, it says that some options may include working with a support group or medical professional, or buying a hearing aid.