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Unilateral deafness

Photo: Unilateral deafness only affects one ear

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

Children with unilateral deafness may have a sensorineural deafness which is caused by a fault in the inner ear (cochlea) or conductive deafness, which is often caused by microtia and/or atresia. The deafness may be permanent or temporary.

You may be offered medical tests to find the reason for your child’s hearing loss; however, it isn’t 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.

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.

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 only on what they want to listen to. This is much harder for a child with unilateral deafness which means there are some situations where they will find it more difficult to hear well. These include:

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

This can affect a child with unilateral deafness in a number of different ways.

Incidental learning and speech and language development

Incidental learning is learning that takes place in everyday settings, 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 overhear what people are saying or hear what’s going on around them, they may appear ‘out of it’, as though they don’t know what’s happening or appear unconnected to their environment.

Small adjustments to your environment and how you communicate can make listening much easier for your child. For example:

  • position yourself closest to your child’s ear with better hearing
  • have good eye contact
  • speak clearly, naturally and at a normal pace
  • when in a group, speak one at a time.

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

Our resource Helping your Deaf Child to Develop Communication and Language: For parents with a 0–2 year old 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.

Tiredness

Children with unilateral deafness may be using more energy concentrating on listening, particularly in noisy environments, and as a result may experience problems in concentrating, tiredness and frustration that affects their behaviour. They may prefer to play alone and experience more difficulties than other children in reading and learning.

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 bike can help them to see a car when it’s behind them. Our page on cycling is full of tips on how you can help your child to ride their bike safely.

Will hearing aids or implants help?

The importance of providing hearing aids or hearing implants to children with deafness in both ears as early as possible is widely recognised because this type of deafness will have a significant effect on a child’s ability to learn speech and language skills if left unsupported.

However, there is currently no clear agreement on the benefits of providing hearing aids or implants to all children with unilateral deafness. Some children with unilateral deafness require additional support with their speech and language development, while others appear to manage very well without additional support. Your child should be assessed on an individual basis depending on their particular needs.

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, as well as 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 could also share our Supporting Achievement resources with staff working with or caring for your child.

In the classroom

Many children with unilateral deafness will manage well at school and it won’t affect their schoolwork. However, due to the extra effort listening can take, 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)

and

  • 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’re 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.

For more information about soundfield systems and radio aids download our resource How radio aids can help — A guide for families.

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