What is hearing impairment?

Hearing impairment is when your child’s ears can’t do all the things they should be able to do. For example, your child might have muffled hearing, or she might not be able to hear sounds coming from some directions, or she might have trouble hearing certain frequencies or sounds.

Types of hearing loss

There are two main types of hearing impairment – conductive and sensorineural.

Conductive hearing impairment is when sounds from outside your child’s ear have trouble getting to or going through the different parts inside the ear. Conductive hearing impairment is usually caused by middle ear infections, and is usually temporary.

In sensorineural hearing impairment, the nerves that are in charge of receiving sound and sorting out what it means don’t work properly. Sensorineural hearing impairment can be mild, moderate, severe or profound.

Sensorineural hearing impairment usually lasts for life and can worsen over time.

Some children have only conductive hearing impairment. Others have sensorineural hearing impairment as well. This is called a mixed hearing loss.

Diagnosing hearing impairment: universal newborn hearing screening

In Australia, universal newborn hearing screening is an essential part of diagnosing hearing impairment in children.

All Australian states and territories have a universal newborn hearing screening program that aims to:

  • screen the hearing of all babies by one month of age
  • refer any babies with possible hearing impairment for diagnostic testing with an audiologist by three months of age
  • start early intervention for those babies with hearing loss by six months of age.

What is hearing screening?
During screening, special equipment plays specific sounds into your baby’s ears and records the responses from your baby. The screening technology might be different in different parts of Australia.

In most places, your baby will be screened in hospital, before you take your baby home. Each state has its own way of following up on babies who don’t have a hearing screen in hospital.

Each state also has its own way of referring babies to audiology and supporting parents and families.

Hearing screening isn’t compulsory. You have to give your permission for your baby to be screened, which means signing a consent form.

If the screening test doesn’t pick up any hearing problems at birth, or your child didn’t have his hearing screened as a newborn, but you’re concerned about your child’s hearing, speech or language development, ask your doctor to refer you to an audiologist to get your child’s hearing tested.

Early diagnosis of hearing impairment means your child can get early intervention and support. This can make a big difference to her language development. If your child has undiagnosed hearing impairment in early childhood, she could miss out on essential learning and development opportunities.

The Australasian Newborn Hearing Screening Committee website has links to each state and territory newborn hearing screening program, as well as other important newborn hearing screening links.

Signs of hearing loss

All typically developing babies and young children have the same developmental milestones. Babies develop at different rates, but should reach the milestones in the same order.

If your baby has a hearing impairment, he won’t hear people speaking, which means he might not respond to your voice and other noises in the way you’d expect. As he gets older, you might notice that his speech and language aren’t developing like other children’s.

As a guide, here’s what you’d expect in a typically developing baby. If your child isn’t doing these things, it might be a good idea to talk to your GP or child and family health nurse.

  • At 0-4 months, your baby should startle at a loud noise, turn her head or move her eyes to locate the source of the sound. If she’s upset, she should calm down when she hears your voice.
  • At 4-8 months, your baby should notice sounds around him, smile when spoken to, babble and understand simple words like ‘bye-bye’.
  • At 8-14 months, your baby should respond to her name, say simple words like ‘mama’ and ‘dada’, copy simple sounds and use her voice to get attention from people nearby.
  • At 14-24 months, your child will start to develop vocabulary, understand and follow simple instructions, and put two words together.

Even if everything seems OK but you still feel worried, you should see your doctor or nurse. After all, you know your baby best.

Some children who have a hearing impairment have another disability too. There are early intervention services specifically for infants and preschool children with hearing impairment and other disabilities. These children and their families will need support from a team of professionals, not only those who specialise in hearing loss.

Building communication and language skills

If your child has a hearing impairment, he might use spoken language, sign language or a combination of sign and spoken language to talk. These are called communication modes.

Even with the best technology, learning to communicate with spoken language for children with severe or profound loss is really hard work, takes many years and doesn’t always succeed. The most important thing for your child’s development, and for your relationship with your child, is being able to communicate. Delaying this while waiting for your child to become a good hearer and speaker is a risk.

Some children find it hard to learn spoken language, so manual signing or sign language will be the best choice for these children. But this doesn’t mean that only children who find it hard to learn spoken language should learn to sign.

In fact, many families choose to teach their child to both speak and sign, regardless of whether the child can use spoken language. If this is your family’s choice, you and the rest of your family need to learn sign language too. This is because the best way to support language development is lots of parent-child interaction, which can happen only when you speak the same language.

You can ask the health professionals who are caring for you and your child for more information and support to learn sign language.

Listening devices to help your child

If your child has a mild to moderate hearing impairment, there are special devices that can help her hear spoken language. And when she can hear spoken language, your child can start learning to use language herself.

The right type of device for your child will depend on what type of hearing impairment he has and how severe it is. These devices, called amplification devices or assistive listening devices, include:

The more severe your child’s hearing impairment, the less benefit she’ll get from hearing aids. Children with more severe hearing loss might benefit from cochlear implants.

Your child might use one device, or a combination of devices listed above. Using a combination gives your child more opportunities to hear sounds because each device does a slightly different job. Your child might also use these devices in combination with spoken language and sign language.

Most children with hearing impairment use assistive listening devices on both ears.

Early intervention services for children with hearing impairment

The earlier you find out your child has a hearing impairment, the earlier he can begin therapy and have language to communicate with. It also means you and your family can get advice and support as soon as possible, giving your child the best start in life.

It can be hard to know what to do when you first find out your child has a hearing impairment. Through early intervention services, you can work with health professionals who’ll help you learn how to spend time with your child in ways that support her development.

The team of professionals who might be involved in supporting you and your child includes audiologists, speech pathologists and special education teachers.

Learning as much as possible from your speech pathologist and audiologist will help. Don’t be afraid to ask lots of questions. Forming a relationship with these professionals means that they can continue to work with you and your child as he grows and becomes more independent.

If you need more information about hearing impairment, good places to start are:

Children learn the most from the people who care for them and with whom they spend most of their time. When you learn some tips for playing, connecting and communicating with your child throughout the day in ways that encourage her hearing and development, it can help her a lot.

Services and financial support for children with hearing impairment

Many services and supports can help your child achieve his potential. But finding your way through the disability services system can be tricky. Our Disability Services Overview can help.

If you live in a National Disability Insurance Scheme (NDIS) trial area and your child has a confirmed diagnosis of hearing impairment, your child can get support under the NDIS. The NDIS helps you get services and support in your community, and gives you funding for things like early intervention therapies or one-off items like hearing aids.

If you don’t live in one of the NDIS trial areas, your child can get funding under the Better Start for Children with Disability initiative. If your child is eligible for the NDIS, she’ll be moved over when it becomes available in your area. Read our NDIS and Better Start FAQs for more information.

Looking after yourself

Although it’s easy to get caught up in looking after your child, it’s important to look after your own wellbeing too. If you’re physically and mentally well, you’ll be better able to care for your child.