Family Doctor Health Advisor
Children: Babies under one
Sleeping problems in babies | Excessive crying | Fever in babies | Vomiting in babies | Diarrhoea in babies | Feeding problems | Slow weight gain | Skin problems in babies
Children: All ages
Feeling generally unwell | Tiredness | Sleeping problems in children | Growth problems | Excessive weight gain | Fever in children | Rash with fever | Skin problems in children | Hair, scalp, and nail problems | Itching | Lumps and swellings | Dizziness, fainting, and seizures | Headache | Confusion and/or drowsiness | Clumsiness | Speech difficulties | Behaviour problems | School difficulties | Eye problems | Disturbed or impaired vision | Painful or irritated ear | Hearing problems | Runny or blocked nose | Sore throat | Coughing | Breathing problems | Mouth problems | Teeth problems | Eating problems | Vomiting in children | Abdominal pain | Diarrhoea in children | Constipation | Abnormal-looking faeces | Urinary problems | Toilet-training problems | Genital problems in boys | Genital problems in girls | Painful arm or leg | Joint and back problems | Foot problems | Limping
Children: Adolescents
Adolescent weight problems | Adolescent behaviour problems | Problems with puberty in boys | Problems with puberty in girls | Adolescent skin problems
Hearing problems
Hearing problems are often not noticed in a child. If your child always needs to have the television or radio on louder than you think necessary or there is a sudden deterioration in your child's school performance, a hearing problem may be the cause. Hearing problems in babies are often detected at routine developmental checks by your nurse or doctor, but you may be the first to notice that your baby is not responding to sounds or learning to speak as quickly as you think he or she should. This should always be brought to your doctor's attention.
Hearing loss and loud music
Using a personal stereo safely
Your child should not turn the volume too loud on a personal stereo. Other people should not be able to hear the music.
Many older children and adolescents enjoy listening to loud music at concerts or through headphones. However, they need to be made aware of the potential danger to hearing that this can present.
There is a temporary reduction in hearing after short exposure to loud noises, but this usually lasts for only a few hours. However, repeated exposure over a long period progressively damages the hair cells in the inner ear that transmit sounds to the brain.
If your child is using headphones, he or she may be tempted to turn up the volume - for example, to exclude external noise. Hearing can be damaged even if the volume is not causing pain, so the fact that your child insists that the volume is not uncomfortably high is not a reliable way of judging that the level is safe. A useful guide is that if others in the room can hear the music when your child is wearing headphones, it is likely that the volume is too high.
Hearing tests in childhood
The McCormick test
The doctor prevents the child from lip-reading by covering his or her mouth and then asks the child to identify various toys.
Tests to assess hearing are performed throughout childhood as part of routine developmental screening; the type of test depends on the age of the child. Newborn babies can be assessed using tests such as otoacoustic emission, in which a sound is played into the ear and an ear piece measures the resulting echo from the inner ear. Speech discrimination tests can be used to detect hearing loss in young children who have a simple vocabulary. For example, in the McCormick toy discrimination test, the child is shown various toys and is asked to identify pairs of toys that have similar sounding names, such as tree and key. Tympanometry is a test that is also used for adults. It measures movement of the eardrum in response to sound and is useful in detecting a build-up of fluid in the middle ear. By age 4, most children are able to cooperate with a simple form of audiometry, which measures how loud sounds of various frequencies need to be for the child to hear them.
Treating glue ear
Location
Grommet in place
The grommet inserted into the eardrum provides a channel between the middle and outer ear, allowing air to circulate normally in the ear, which improves hearing.
In the disorder glue ear (chronic secretory otitis media), fluid builds up in the middle ear, resulting in reduced hearing. The condition may be treated surgically by inserting a tiny plastic tube, called a grommet, through the eardrum. The grommet allows air into the middle ear and fluid to drain away. The grommet is left in place and usually falls out after 6-12 months. The eardrum then heals. Although grommets relieve hearing problems caused by fluid build-up, they do not prevent future ear infections. The operation to insert a grommet is usually performed under general anaesthesia as day surgery and rarely needs to be repeated.
Family Doctor Health Advisor is for information purposes only, and is designed as a general reference and catalyst to seeking further information.
The RACGP is not engaged in providing medical or other advice or services, and is not responsible for the results of any actions taken by any person on the basis of any information in this publication, or for any error in, or omission from, this publication.
Publication Date: 31 March 2009
Authorised By: RACGP
