Sound Advice: Audiology

HEARING LOSS AND DOWN SYNDROME 

Hearing loss is common in children who have Down Syndrome and can affect the development of their communication skills. The physical ear structure of children who have Down syndrome may predispose them to hearing difficulties.  

Types of hearing loss 
The majority of hearing loss associated with Down  Syndrome is conductive in nature. This type of hearing loss happens in children with Down Syndrome because they often have narrow ear canals, which may lead to occlusion of the ear canal with ear wax. Additionally, these children are more prone to middle ear issues such as build-up of fluid, infections, and eardrum perforations. 

Conductive hearing loss can be transient as is the case with otitis media; however, recurrent or chronic otitis  media can damage the middle ear and eardrum leading to a permanent conductive hearing loss. While a transient conductive hearing loss is rarely treated with hearing aids, amplification may be recommended for a more permanent loss. 

Sensorineural hearing loss occurs less often in children with Down Syndrome than conductive hearing loss but it can occur. It may be pre-sent at birth or develop later in childhood. Therefore, it is important for children to receive routine hearing tests even if they passed the hearing screening as a newborn.

When should my child’s hearing be tested?
Every infant should receive a newborn hearing screen. This is typically completed before the child is discharged from the newborn nursery. Infants who do not pass the screening are referred for diagnostic testing to further evaluate hearing sensitivity. 

After passing the initial hearing test, infants who have Down Syndrome should have their hearing tested again between 9-12 months of age.
  
If there are no concerns, the child’s hearing should be tested every 6 months until normal hearing is confirmed in both ears. 

If concerns exist, the child should be referred to an Ear, Nose, and Throat (ENT) specialist. 

Once normal hearing is confirmed in both ears, children should continue to receive an audiogram every year to monitor for any changes. If hearing loss has not been ruled out for a child you know who has Down Syndrome, consult their doctor for a  referral to an audiologist for a hearing evaluation.  

As a parent or caregiver of a child who has Down  Syndrome, it is important to be aware of the possibilities of hearing loss. A high prevalence of hearing loss does not mean that your child has/will have one. However, adequate monitoring will assist in early identification and appropriate treatment, if necessary. 

Adapted from: https://www.massgeneral.org/children/down-syndrome/hearing-loss