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Are cochlear implants an option for my child?
How well do they help children hear and what do patients say about sound quality?
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Hearing Loss
What is hearing loss?
Hearing loss is a common condition that reduces a child’s ability to detect sound in one or both ears and can range from slight to profound. Even slight hearing loss can affect speech, language, learning, communication, and overall development.
What is pediatric hearing loss?
Pediatric hearing loss refers to hearing difficulties that occur in infancy, childhood, or adolescence and may change over time. Some childhood hearing losses may be temporary and related to treatable conditions, while others are permanent and require long-term management. Because hearing status plays a critical role in early development for most children, identifying hearing loss early helps guide timely care and support.
About four in every 1,000 children are born with hearing loss. By age 12, approximately 20 percent of children have some degree of hearing loss. Hearing loss may be present at birth or develop later in childhood due to factors such as illness, head trauma, exposure to loud noises, or certain medical treatments.
What are the different types of pediatric hearing loss?
Hearing loss in children is classified based on where sound transmission is disrupted:
- Conductive hearing loss occurs when sound is blocked in the outer or middle ear. This type of hearing loss is common in young children and is often temporary.
- Sensorineural hearing loss involves damage to the inner ear or auditory nerve. It is usually permanent and may be present at birth or develop later in childhood.
- Mixed hearing loss is a combination of conductive and sensorineural hearing loss.
- Auditory neuropathy spectrum disorder (ANSD) affects how sound signals travel from the inner ear to the brain. Children with ANSD may detect sound but have difficulty processing or understanding it clearly.
Symptoms & Causes
What are the signs of hearing loss in children?
Signs of hearing loss in children can vary depending on age and stage of development. In some cases, signs may be subtle and easy to miss, especially in very young children.
Infants and newborns with hearing loss may:
- Not startle or respond to loud sounds
- Not recognize caregivers’ voices by around 3 months of age
- Not turn toward sounds by about 6 months of age
- Not begin imitating sounds or simple vocalizations by 12 months
Toddlers and older children experiencing hearing loss may:
- Have delayed speech or language development
- Speak unclearly or have difficulty being understood
- Increase the volume on televisions, tablets, or music
- Have trouble following conversations, especially in noisy settings
- Show learning difficulties or problems with attention
These behaviors may be signs of hearing loss and should prompt further evaluation by a health care provider.
What causes hearing loss in children?
Some children are born with hearing loss, while others develop hearing loss later in childhood. Causes present at birth may differ from those that develop over time, and in some cases, more than one factor may contribute.
Common causes of hearing loss in children include:
- Genetic and inherited conditions, which are a leading cause of hearing loss present at birth
- Ear infections or fluid buildup in the middle ear
- Head trauma or sports-related injuries
- Certain illnesses or medical treatments that affect the ears or auditory system
- Exposure to loud noises over time
- Idiopathic causes, where the exact cause of hearing loss is unknown
Diagnosis & Treatments
How is hearing loss diagnosed in children?
Hearing tests for children typically begin at birth with newborn hearing screening and continue at regular intervals throughout childhood. If signs of hearing loss are observed in newborns, infants, or older children, more detailed audiologic testing is recommended to evaluate hearing and guide next steps.
What interventions are available for children with hearing loss?
Intervention recommendations depend on the type, degree, and underlying cause of hearing loss. Making sure every child has early and consistent access to language is just as important because it supports learning, relationships, and emotional development.
Some causes of hearing loss may require medication or surgical intervention, while others benefit from long-term management and supportive care. Establishing care with qualified professionals helps families understand the full range of opportunities available.
Support for children with hearing loss may include:
Language and communication support
- Early exposure to a fully accessible language, such as American sign language (ASL)
- Speech and language therapy to support spoken and/or signed communication development
- Visual communication strategies and classroom accommodations
Hearing technology and medical care
- Hearing aids to help amplify sounds
- Bone-anchored hearing devices (BAHs) for children with conductive hearing loss who meet candidacy criteria
- Cochlear implants for children with severe or profound hearing loss who meet candidacy criteria
- Medication or surgical treatment for conditions affecting the outer and/or middle ear
- Gene therapy for hearing loss, an investigational approach being studied in clinical trials for certain genetic forms of hearing loss
Many d/Deaf and hard of hearing children benefit from a combination of visual language, communication strategies, and hearing technologies. Together, these supports promote cognitive, social, and language development and help ensure children have every opportunity to thrive.
Mark's winning pass with cochlear implants
Mark made a splash as a starting quarterback on his school's varsity team as a freshman. He also happens to wear cochlear implants.
How we care for children with hearing loss at Boston Children’s Hospital
Boston Children’s Hospital provides comprehensive, multidisciplinary care for children with hearing loss. Our teams comprise specialists in audiology, otolaryngology, genetics and genomics, speech-language pathology, neuropsychology, social work, and beyond who work closely with families to understand each child’s unique needs. Together, we develop individualized care plans that may include diagnostic evaluation, treatment, early intervention, and long-term developmental monitoring, with a focus on supporting communication, learning, and overall development at every stage.
