When hearing loss is discovered in early infancy, steps can be taken to minimize the pervasive effect of sensory deprivation. If undetected, a child's hearing loss may be misdiagnosed in later life as a learning disability. Parents often do not suspect a hearing loss until their child fails to form words at 12 to 18 months of age. An infant with partial hearing loss may still respond to some sounds, leading the parent to assume that hearing is normal. In addition, hearing-impaired infants may learn to respond to visual cues in their environment, thereby masking the condition.
Numerous factors increase a child's risk of hearing loss.
However, certain findings, on physical examination, should increase the index of suspicion for hearing impairment. These findings include heterochromia of the irises, malformation of the auricle, dimpling or skin tags around the auricle, cleft palate or lip, narrow ear canals, and microcephaly. If family history or physical examination indicates the possibility of hearing impairment, the child should be referred for complete audiometric testing. Impedance In-office sedation should be available and is sometimes necessary to ensure the child's cooperation. Once hearing loss is detected, intervention is possible regardless of the child's age.