The Effects of Unilateral Hearing Loss in Children

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Based on a research, it has been estimated that Unilateral Hearing Loss (UHL) are more likely to occur in 0.83/1,000 newborn children (Prieve& Stevens, 2000). Children with UHL face a unique set of challenges as they grow older (Bess & Tharpe, 1984; Culbertson & Gilbert, 1986; Giolas & Wark, 2014). According to American Speech-Language-Hearing Association, UHL defines as having normal hearing in one ear but there is hearing loss in the other ear where it may be a range from mild to moderate and it may affect both children and adults. In most cases, the effect of UHL has not been studied deeply. Thus, in this essay we will talk more in detail about the adverse repercussions of UHL in children.

Firstly, children with UHL experience difficulties in sound localization, as they do not have binaural hearing ability. Binaural hearing ability is required for development of auditory processing and perception (Rohlfs et al., 2017). Localization of sound source in space is harder without binaural hearing (Lieu, 2004). The lack of head shadow effect in children with UHL results in poor directional hearing. This is due to the lack of inter-aural level difference (ILD) which is the head and pinna attenuates sound at far ear while boosts sound at near ear. In this case, the lack of ILD affects the head shadow and cocktail party effects to come into play to allow sound localization and spatial hearing. UHL leads to sound localizing error according to the severity of UHL in children. Thus, UHL affects the ability to localize the sound in children with UHL.

Ordinarily, there are high possibilities for a child that passed newborn hearing screening to have late-onset UHL undetected over the years. This may affect the development of language and speech of the child as they grow. Children with UHL are proven to have speech and language delay, where they demonstrated poor cognitive and oral language scores, especially among children with severe to profound sensorineural hearing loss, when compared to normal hearing children (Anne, Lieu, & Cohen, 2017). UHL is also closely associated with significant negative scores on standardized speech language test (Lieu, Tye-Murray, Karzon, & Piccirillo, 2010). This could be due to children with UHL activate attention networks less strongly compared to normal hearing children, thus causing memory, learning and attention deficits (Vila & Lieu, 2015). They may also face problems in sound localization and speech discrimination in noise, which is the utmost importance of binaural hearing (Yoshinaga-Itano, Johnson, Carpenter, & Brown, 2008). Children with UHL may have difficulties in allocating and focusing on the teacher’s voice, and it is hard for them to discriminate between phonemes thus it is onerous for them to acquire speech correctly. Speech and language delay will also lead to academic failures.

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UHL in school-age children mayaffect their academic performances in school. Many studies have reported on school-age children with UHL seem to have increased rates of grade failures, need for additional educational assistance, and perceived behavioural issues in the classroom (Kuppler, Lewis, & Evans, 2013; Lieu, 2013). Their parents also noticed some difficulties in their children when learning at school, especially when the class is very noisy (Lieu, 2004). This is because the noise will mask the teacher’s voice and this may lead to difficulty in speech discrimination, thus they may be unable to obtain all the information given by the teacher. Hence, this will affect their understanding in class. Besides, children with severe UHL (60 dB HL) had a significantly lower IQ score (Kuppler et al., 2013). They may not be able to perform well in academic learning. To cut short, children with UHL have poorer academic performances compared to normal hearing students.

In addition, UHL does not only affect the children’s academic performances, it also increases the risk of developing social skills difficulties. Children with unilateral mild hearing loss (UMHL) had lower social skills than the typical hearing (TH) children (Laugen, Jacobsen, Rieffe, & Wichstrom, 2017). This is because during a conversation they might not be able to hear clearly if others speak softly. Things will be even worse when they have a noisy background. The results suggest that despite a limited effect on vocabulary development, early intervention is likely to promote social skills development in children with UMHL (Laugen et al., 2017).

In conclusion, UHL has affected the quality of the children’s life in the aspects of sound localization, speech and language delay, academic performances and social skills.Therefore, with some early interventions and many efforts from parents and teachers, the quality of life can be improved. It is also an important step to ensure that hearing screening is being done throughout childhood, especially on children with high-risk factors.

Bibliography

  1. Anne, S., Lieu, J. E. C., & Cohen, M. S. (2017). Speech and Language Consequences of Unilateral Hearing Loss: A Systematic Review. Otolaryngology - Head and Neck Surgery (United States). https://doi.org/10.1177/0194599817726326
  2. Kuppler, K., Lewis, M., & Evans, A. K. (2013). A review of unilateral hearing loss and academic performance: Is it time to reassess traditional dogmata? International Journal of Pediatric Otorhinolaryngology. https://doi.org/10.1016/j.ijporl.2013.01.014
  3. Laugen, N. J., Jacobsen, K. H., Rieffe, C., & Wichstrøm, L. (2017). Social skills in preschool children with unilateral and mild bilateral hearing loss. Deafness and Education International. https://doi.org/10.1080/14643154.2017.1344366
  4. Lieu, J. E. C. (2004). Speech-Language and Educational Consequences of Unilateral Hearing Loss in Children. In Archives of Otolaryngology - Head and Neck Surgery. https://doi.org/10.1001/archotol.130.5.524
  5. Lieu, J. E. C. (2013). Unilateral hearing loss in children: Speech-language and school performance. B-ENT.
  6. Lieu, J. E. C., Tye-Murray, N., Karzon, R. K., & Piccirillo, J. F. (2010). Unilateral Hearing Loss Is Associated With Worse Speech-Language Scores in Children. PEDIATRICS. https://doi.org/10.1542/peds.2009-2448
  7. Prieve, B. A., & Stevens, F. (2000). The New York State universal newborn hearing screening demonstration project: Introduction and overview. Ear and Hearing. https://doi.org/10.1097/00003446-200004000-00003
  8. Vila, P. M., & Lieu, J. E. C. (2015). Asymmetric and unilateral hearing loss in children. Cell and Tissue Research. https://doi.org/10.1007/s00441-015-2208-6
  9. Yoshinaga-Itano, C., Johnson, C. D. C., Carpenter, K., & Brown, A. S. (2008). Outcomes of children with mild bilateral hearing loss and unilateral hearing loss. Seminars in Hearing. https://doi.org/10.1055/s-2008-1075826
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