Hearing : Uncovering Hearing Problems Helps Kids Learn

Michaela Gibson Morris, Northeast Mississippi Daily Journal, Tupelo

It's hard to learn reading, 'riting and 'rithmatic, when you can't hear the teacher. That's why school nurses and audiologists routinely screen preschool and elementary students for hearing trouble each fall.

Not paying attention and bad behavior can be rooted in poor hearing.

"It often goes unnoticed because it mimics other things," said Milam Elementary school nurse Kristi Sloan.

When kids can't hear, they're likely to do anything but tell you they can't hear.

"We have to do some sleuth work," said Dr. Ryan Simmons, a Tupelo ear, nose and throat specialist.

Sometimes, they can compensate well.

"As long as a child is hearing pretty well out of the other ear, they may not complain," Simmons said.

But those strategies may not work in the classroom.

"They may do well one on one, but they're not able to screen out background noises," Simmons said. "They can't focus on only what they want to listen to."

But they usually won't say they can't hear, and some may avoid drawing any attention to the issue.

"We had one student always sit in the back of the class, because he didn't want to be called on because he couldn't hear," Sloan said.

Parents can watch and listen for red flags that may indicate hearing loss, said Vicki Gaillard, an audiologist with Regional Rehabilitation Center, which offers free services including hearing evaluations and speech therapy.

"They may be watching your mouth when you're talking," Gaillard said.

The TV or radio may be turned up, but the child asks for it to be louder. There may be extra helpings of 'whats?' and 'huhs?' in response to questions and directions from parents.

"If they're getting in trouble for not paying attention, you may need to have their hearing tested," Gaillard said.

Screening

Most children with nerve hearing loss are diagnosed as newborns in Mississippi, Simmons said. Although there are a handful of children with progressive nerve hearing loss found through school screenings, nearly all children who are flagged have conductive hearing loss issues, which are typically caused by fluid behind the ear drum and foreign objects lodged in the ear. Once the source of the problem is treated, hearing returns to normal, no hearing aids needed.

"The majority of children (identified in school screenings) have conductive hearing loss," Simmons said.

During a hearing screening, usually conducted by a school nurse, speech pathologist or audiologist, the children are checked at different frequencies and volumes. Typically, kids are screened in preschool, kindergarten through third grade, and again in fifth grade. Sloan, who is assigned to Milam through the North Mississippi Medical Center school nurse program, also conducts screenings for sixth-graders.

When children are flagged in a hearing screening, they are tested again in two weeks. If they don't pass, they are referred to further evaluation with an audiologist. Parents and kids shouldn't be nervous about the evaluation, Gaillard said.

"It's easy, and it actually can be fun," Gaillard said, noting that there's no pain and no shots involved.

Many kids are cleared by the evaluation, which are conducted under more quieter conditions with fewer distractions than school screenings.

Conductive hearing loss

Conductive hearing loss occurs because the sound waves can't get through to the inner ear because they have road blocks in the outer or middle ear. The fix is generally straightforward --remove the blockage and treat the infection, and hearing returns to normal.

In the outer ear, it can result from wax build-up, a foreign body or an outer ear infection, Simmons said. Rocks, crayons and small toys are common suspects among the toddler set.

Middle ear issues, particularly fluid behind the ear --which is called effusion --are a common source of conductive hearing loss for younger and older kids. The fluid can build up slowly over time and is usually related to nose and sinus issues. The Eustachian tubes run between the middle ear and the sinuses as a way for the body to equalize air pressure in the sinus cavities.

The fluid can remain after an ear infection has cleared. For most people, the fluid is a relatively short-lived annoyance.

"In 90 percent of people, the fluid will clear in three months," Simmons said. Most people will be clear within a month.

Most kids have ear infection issues as babies and toddlers because their Eustachian tubes are so short, and they grow out of the problem. But some people have ongoing issues with fluid behind their ears, and it affects their ability to hear and learn.

"Some people just don't have very good ventilation," Simmons said.

If fluid behind the ear is the culprit, usually ear, nose and throat specialists start by making sure any infection is cleared up and use medications like antihistamines and nasal sprays to help treat any underlying allergy and sinus issues.

"If there's no resolution of the fluid, then we'll talk about tubes to drain and ventilate," Simmons said.

The tiny tubes, which are placed in the ear drum, are a very simple procedure, Simmons said. Children usually required gas anesthesia, and the procedure is usually done at an ambulatory surgery center. Adults usually have ear tubes placed in the ear, nose and throat specialists office.

michaela.morris@journalinc.com

©2012 the Northeast Mississippi Daily Journal (Tupelo, Miss.)

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