Unilateral deafness

Unilateral deafness means a hearing loss in one ear. Here we provide information on issues around unilateral deafness and how it can affect your child.

Child with hearing aid plays with parents at home.

What is unilateral deafness?

We use the term ‘deafness’ to refer to all types of hearing loss.

Unilateral deafness means that your child has a hearing loss in one ear – it’s sometimes called unilateral hearing loss, one-sided hearing loss or single-sided deafness (SSD). The deafness can range from mild to profound in the affected ear.

Most children with unilateral deafness have a sensori-neural deafness which is caused by a fault in the inner ear. You may be offered medical tests to find the reason for your child’s hearing loss; however, it is not always possible to identify the cause. Our information on the causes of deafness gives more detail about some of the most common causes of hearing loss in children.


How will unilateral deafness affect my child?

When someone can hear well with both ears their brain is able to filter out unwanted background noise and concentrate on just what they want to listen to. This is much harder for a child with unilateral deafness and in some situations they may have difficulty:

  • hearing sounds or speech in the ear with a normal level of hearing coming from the side with the deafness because the head naturally blocks some sound from that side, making it harder to hear (this is called the 'shadow effect')
  • identifying the source of sound, the direction a sound is coming from or judging the distance the sound is coming from
  • understanding speech when there is background noise. 

This can affect a child with unilateral deafness in different ways:

Incidental learning and speech and language development

Incidental learning is learning that takes place in everyday settings like when you are at home or out and about and is not taught at school. Children learn language through play and by hearing things going on around them. This helps them build vocabulary, and gives them grammar and general knowledge.

Because children with unilateral deafness may not always hear what’s going on around them, and can miss out on quiet conversations, especially when there is background noise, they may need to be taught skills directly that other children get from incidental learning or overhearing. 

Unilateral deafness may also impact on any co-existing conditions or additional needs such as:

  • children with learning difficulties
  • children with speech or language disorders
  • children with attention deficit disorder
  • children who use English as a second language.

While many children with unilateral deafness have normal speech and language development in the early years this is not true for all. Good communication is extremely important in making sure that unilateral deafness doesn't affect your child’s development.

Our resource Helping your Deaf Child to Develop Communication and Language (0–2) is full of practical ideas about how to promote communication and language development.

You may also find our information on speech and language therapy helpful if you think it could benefit your child.

Tiredness and concentration fatigue 

Children with unilateral deafness may have to spend more energy concentrating on listening and as a result may experience tiredness and frustration that affects their behaviour. This is very common in children with all levels of hearing loss and it’s important to manage this so that it doesn't affect your child’s development or learning. Our webpage Tiredness in deaf children provides guidance on how you can help your child with tiredness and concentration fatigue.

Child riding bike.

Road safety

Unilateral deafness makes it difficult for a child to tell which direction traffic is coming from, so it's important to teach your child to take extra care when crossing the road. When out cycling, rear view mirrors on your child’s bicycle can help them to see a car when it’s behind them. Our factsheet on cycling is full of tips on how you can help your child to ride their bike safely.


What do my child's hearing tests mean?

Your child's hearing tests will help you understand the level of deafness your child has by showing how loud, and at what frequency, a sound must be before they can hear it.

You can find information on how to understand your child's hearing tests by downloading our resource Understanding Your Child’s Hearing Tests

“Professionals say that typically, children with unilateral deafness are fine...but they’re not taking the time to assess the individual child" — Emma, mum to Maisie (4) who has unilateral deafness.

Mum Emma felt that professionals weren’t taking her daughter’s hearing loss seriously. Read our family story about her struggle to get the right support.


How can I make listening and communicating easier?

Small adjustments to your environment and how you communicate can make listening much easier for your child. For instance, try to position yourself so that when you are talking to your child, you are positioned closest to your child’s ear with better hearing.

Our Deaf awareness section contains other tips for communicating with children who have a hearing loss and advice on how to create better listening environments.

Will hearing aids help?

There is no clear agreement on the benefits of providing hearing aids to all children with unilateral deafness. Some children with unilateral deafness find a hearing aid helpful but this is not the case for every child. Your child should be carefully assessed on what their individual needs are.

Children with a unilateral hearing loss may benefit from a type of hearing aid known as a CROS aid (contraletral routing of signal). It works by transferring sound from the deaf ear to the side of the hearing ear.

Our resource Hearing aids – Information for families explains in more detail what types of hearing aids are available, how they work and if they might be suitable for your child.


Will my child need extra support at nursery or school?

It’s important that your child gets the support they need in all early years settings including playgroups, childcare and nurseries, and at school. 

To help with this we have produced a series of Personal Passports which are documents you can fill in and give to anyone working with or caring for your child which describe how they can support your child in the best way possible.

You can further help by passing on our resource Supporting the Achievement of Hearing Impaired Children in Early Years Settings to staff working with or caring for your child.

For more information about education for children with a hearing loss visit our Education section.

Child in classroom, and teacher with radio aid.

In the classroom

Many children with unilateral deafness will manage well at school and it will not affect their schoolwork. However, if the listening environment in the classroom isn't as good as it can be, or there is poor deaf awareness, children with unilateral deafness may become distracted more easily and find concentrating difficult.

There are some small adjustments that your child and your teacher can make to help with this like:

  • sitting with their good ear directed toward the teacher and their ear with the hearing loss facing away from the class (such as near a wall)


  • the teacher checking that your child has understood instructions especially when they are changing topic or task.

Your child’s teacher should know about their hearing loss so that their progress can be monitored closely. If you are worried about your child's school work speak to their teacher, special educational needs coordinator (SENCO) or special education needs advisor (Scotland).

Technology can help

There is technology available that can help improve listening conditions for your child at school like a soundfield system which uses speakers fitted in the classroom. Classroom soundfield systems are increasingly popular and may already be fitted at your child’s school.

Your child could also benefit from using a radio aid, which consists of a radio transmitter worn by the teacher and a receiver worn by your child. Radio aids can be worn with or without a hearing aid and help to make the teacher's voice clearer wherever they are in the classroom. They can also be useful outside of school and at home. It may be worth getting in touch with your local authority to find out if they can fund a radio aid for your child.

For more information about soundfield systems and radio aids download our resource How radio aids can help.


Where can I get other support?

  • You can contact our freephone Helpline if you have questions about your child’s hearing.
  • Our family events are a great way to meet other parents, share experiences and get advice from professionals.
  • Parent Place is our online forum where you can connect with other parents.
  • Our local groups run social activities which are another great way to meet other parents.