Hearing problems can cause speech problems and a language delay. If your baby or toddler is showing signs of a language delay due to hearing problems, don’t wait. Here are some things you can do right away.
Your doctor should look in your child’s ear with an otoscope. This might reveal problems with your child’s middle ear.
You should also request a full hearing test by an audiologist. Some children are born with a hearing loss. The middle ear will look normal, so it is impossible for a doctor to rule out a hearing loss just by looking in the ear. A full hearing test for a baby or toddler is done in a sound-proof booth and usually takes place at a hospital or health unit.
Upper respiratory infections, ear infections and allergies can cause temporary hearing loss. You may not notice the change in your child’s hearing because it won’t be a complete loss, only a partial loss.
Children who are congested can often hear voices and intonation (low frequency range), but they can’t hear the quiet consonants like SH, F, S, TH (high frequency range).
Temporary hearing problems like this can cause speech problems and a language delay because the input to the brain is inconsistent. Try to get help quickly if your child has ear infections or allergies.
The eustachian tubes connect to the middle ear, where the tiny ear bones are located. When your baby is healthy, the eustachian tubes allow fresh air to reach the middle ears.
Adults have eustachian tubes that run up and down. Young children have eustachian tubes that are more horizontal. They don’t have gravity helping to keep bacteria and viruses away from the middle ear. This is why babies often develop middle ear problems when they have colds and coughs.
When an infection develops in the middle ear, it is painful! The ear drum will be red and will bulge outward. The treatment is usually antibiotics.
The ear drum will not be able to move much in response to sound, especially very tiny sounds like SH, F, S, TH. There will be infected fluid in the middle ear.
You have probably experienced the sensation of plugged ears with a cold or at high altitudes. It is always a relief to be able to “pop” your ears by plugging your nose and blowing. You are forcing your eustachian tubes to open. This balances the air pressure so that your ears are at the same air pressure as your environment. Have you noticed that you can hear better after you clear your ears?
If your child is congested, the eustachian tubes become blocked. The middle ear cavity is now a sealed chamber which operates like a vacuum. The fluid in the surrounding tissues is sucked into the middle ear and becomes trapped there.
If the fluid stays there a long time, it thickens. Your child’s ear drum and middle ear bones can barely move. Effusion is also referred to as “glue ear” because the fluid in the middle ear is so thick.
With middle ear effusion, the problem may go on for a long time because there is no pain. It is common in children with allergies. Unfortunately, this means that a temporary hearing loss can also go undetected.
If your child has had multiple ear infections, or is chronically congested, the recommended treatment may be myringotomy tubes. This allows the fluid to drain and brings fresh air to the middle ear, taking over the role of the eustachian tube.
Ask for a referral to an ear-nose-throat specialist. Even if it is too early for tubes, get a referral and have a specialist monitor your child for at least 6 months. In Canada, it is common for young children to be fine in the summer and then suffer all winter. Make sure the specialist sees your child during the bad times.
Tubes do not address the cause of the problem, which is the blocked eustachian tube. Some children are subjected to multiple myringotomy tube surgeries during early childhood because of this.
Ask for a referral to a pediatric allergist. Why is your child chronically congested? Why is your child’s immune system weak? You may need to change your child’s diet, change to a different daycare, help your child get a better sleep, move to a different location, get rid of pets and improve your housekeeping.
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