Recognising the signs of hearing loss

If you work in the early years or a primary school, there is a high chance that a child in your care will have an undiagnosed hearing loss.

This is usually a temporary hearing loss caused by glue ear. Eight out of ten children will experience glue ear before the age of 10.

It could also be a permanent hearing loss. Over half of deaf children become deaf during childhood. This usually happens in the first three years of life.

Any hearing loss, even if it’s temporary or mild, can have a big impact, particularly in the early years when children are developing their speech and language skills.

Signs of hearing loss

These are common signs of hearing loss - a child:

• Does not respond when called
• Constantly says "what?" or asks for speech to be repeated
• Watches faces/lips intently
• Doesn’t always follow instructions straightaway
• Often misunderstands or ignores instructions
• Makes little or no contribution to group or activities or discussions
• Watches what others are doing before doing it themselves
• Complains about not being able to hear
• Tires easily
• Talks louder or softer than expected
• Becomes easily frustrated
• Seems startled when people come into their line of vision
• Appears inattentive or as though daydreaming 

Remember: a mild or slight hearing loss may be difficult to identify. Children may respond to questions easily when asked one-to-one and in a quiet environment whilst at the same time not respond to questions asked at a distance and to the whole class.

In addition, temporary hearing loss can fluctuate, meaning that children may display some of the signs above on some days but not others.

What to do if you suspect a hearing loss

Discuss any concerns that you may have with the family. Some families may already have concerns whilst to others it may be a complete shock. You should suggest that they ask their GP or health visitor for a referral to the local audiology clinic for a hearing test.

Your setting may have a policy or procedure in place for how such concerns should be shared with parents.

Undiagnosed hearing loss can cause or contribute to a child’s speech and language delay and difficulties learning and reading, and can cause difficulties communicating and socialising with others. There can be an overlap with the signs or symptoms of other language or developmental disorders in childhood.

It is therefore good practice to consider a referral for a hearing test if a child is being referred to other professionals, such as a speech and language therapist or educational psychologist. This should help to either diagnose the cause of the problem, or rule out additional difficulties.

Recording your observations can be helpful in identifying if there seem to be particular situations which the child finds challenging.

What can I do to help a child who may have a hearing loss?

There are lots of simple things that you can do to help a child with a hearing loss in your setting. For example:

• Ensure that communication is clear and effective.
  For example: make sure that you have the child’s attention before you start talking, speak clearly and at your normal level and pace and make sure that the child can see your face clearly.
  
  
• Reduce background noise as much as possible.
  For example, close the door if there is any noise outside.
  
  
• Seek advice from a specialist.
  A Teacher of the Deaf from the local authority specialist education service for deaf children may be able to provide you with more information and advice. You can also contact our helpline. 

Our website also has more information and advice on supporting children with a hearing loss. You may find the below particularly helpful:

• Video on supporting children with a mild hearing loss 
• Creating good listening conditions for learning: We've produced a series of resources to set out the simple steps that can be taken to improve the listening environment in nurseries, schools, and other education settings. 
  • Information on creating good listening conditions: For education settings
  • Tips on how schools can improve listening conditions
  • Managing listening conditions checklist
  • Preliminary noise survey
  • Pupil survey
  • Presentation for Teachers of the Deaf
  • Information for parents
  • Sound simulations of classroom with poor or good acoustic conditions 

You can also access online training on supporting children with a suspected hearing loss in the early years.