Is Hearing Loss Common in People With Cerebral Palsy?
Hearing loss is somewhat common in people with cerebral palsy. The American Academy of Neurology states that about 12% of individuals with cerebral palsy have hearing loss. However, some estimates suggest that the rate of cerebral palsy and hearing loss could be as high as 25%.
Hearing loss is most common in children with dyskinetic or hypotonic forms of cerebral palsy and less common in spastic and ataxic cerebral palsy.
In addition to hearing loss, children with cerebral palsy often experience other issues, such as visual impairment, speech problems, and intellectual
Risk Factors for Cerebral Palsy Hearing Loss
Certain risk factors can make some children with cerebral palsy even more likely to have hearing problems.
Risk factors for hearing loss in children with cerebral palsy include:
- Genetic abnormalities
- Head or skull injury
- Infections during pregnancy
- Low birth weight
- Premature birth
If you suspect your child with cerebral palsy has hearing loss, you should have them tested for hearing loss as early as possible.
Types of Hearing Loss in Children With Cerebral Palsy
There are three main types of hearing loss that children with cerebral palsy may experience.
Conductive Hearing Loss
Conductive hearing loss happens when sound can’t pass properly from the outer or middle ear to the inner ear.
This type of hearing loss can be partial or complete. It can occur in one ear or both ears at the same time.
Sensorineural Hearing Loss
On the other hand, sensorineural hearing loss is caused by damage to the inner ear or auditory nerve and usually occurs gradually over time.
This type of hearing loss results when tiny hairs on the cochlea in the inner ear, called stereocilia, become damaged after prolonged exposure to sounds above 85 decibels (about as loud as using a hair dryer or a blender close by). It can occur in one ear or both ears, depending on the cause.
Mixed Hearing Loss
When someone has a combination of both conductive hearing loss and sensorineural hearing loss, it is called mixed hearing loss.
How Speech and Hearing Are Linked in Cerebral Palsy Patients
Hearing and speech are closely linked. When someone has hearing problems, it can distort the sounds they hear, which in turn can affect their speech.
Some ways hearing loss affects communication and speech include:
- Children with hearing loss often repeat themselves out of fear of being misunderstood.
- Individuals may talk louder than normal, as they can no longer detect the volume of their own voice.
- Speech is less crisp as the child can no longer detect the accuracy of their own speech.
Speech issues related to hearing loss are likely to worsen if the hearing loss is left untreated or undiagnosed.
With prompt intervention and working with a speech-language pathologist, many children with cerebral palsy can improve their speech caused by hearing loss.
Hearing Loss vs. Cognitive Impairment
The younger a child is, the harder it is to recognize signs of hearing impairment. Additionally, hearing loss is often mistaken for cognitive impairment in children with cerebral palsy.
For this reason, getting a child with cerebral palsy tested for hearing loss as early as possible or as early as the first signs or symptoms appear is important.
Hearing loss and cognitive impairment treatments are drastically different, so a child’s condition must be diagnosed appropriately.
Types of cognitive impairment associated with cerebral palsy include:
- Learning disabilities
- Memory issues
- Problems with concentration and focus
Signs of Hearing Loss in Your Child With Cerebral Palsy
The signs of hearing loss in a child with cerebral palsy vary based on their age and the type of hearing loss they experience.
Further, infants with cerebral palsy may not show signs of hearing loss until they are older, as many of the signs are discovered through a child’s speech.
Here are some signs that your child with cerebral palsy might have hearing loss:
- Delayed speech
- Frustration when trying to communicate
- Not being startled by loud or sudden noises
- Repeating themselves
- Speaking at a louder volume for no apparent reason
- Unclear speech
- Unresponsiveness or inattentiveness
If your child is old enough, they may be able to communicate or complain to you directly about the symptoms they are experiencing, such as pain or blockages.
When Can You Test for Hearing Loss in Children With Cerebral Palsy?
While it is important to test children as early as possible to diagnose and begin treatment, it can be difficult to test younger children since they cannot participate or communicate as well for tests.
Although a child can be tested for hearing loss within a day or two of birth, an accurate diagnosis might only be possible when they are older.
For this reason, doctors usually recommend that babies with cerebral palsy be tested for hearing loss both as a newborn and infant, then again as a toddler by 30 months of age.
Testing for Hearing Impairment in Children With Cerebral Palsy
Some types of testing for hearing impairment can be used for all ages, while others are meant for newborns, babies, or toddlers.
In some instances, multiple testing types are required to confirm a diagnosis.
Tests for hearing impairment in children with cerebral palsy include:
- Auditory brainstem response (ABR): Measures the brain’s response in sleeping newborns to clicking sounds played via earphones.
- Behavioral audiometry: Tests infants with suspected hearing loss by playing sounds and observing their responses.
- Evoked otoacoustic emissions (EOAE): Sends sounds through an ear plug in sleeping newborns, recording the ear’s otoacoustic responses.
- Play audiometry: For toddlers, it uses structured play to observe reactions to various sounds via headphones.
- Pure tone audiometry: Children 3 or 4 and older listen and respond to various sounds and pitches through earphones.
- Tympanometry: Measures pressure changes in the middle ear and is useful for detecting potential middle ear problems causing hearing loss. This test is best for children over 3 or 4 as stillness is required.
Effects of Hearing Loss on Children With Cerebral Palsy
The effects of hearing loss on children with cerebral palsy can range from mild to severe.
Here are some ways cerebral palsy and hearing loss can impact a child:
- Barriers to activities and play
- Communication issues
- Delays in speech and language
- Learning delays in school
- Low-self esteem
- Social problems, like difficulty making friends
The older a child gets, the more drastic the potential effects of their hearing loss may become. So, diagnosing and addressing hearing loss as early as possible is important.
Treatment for Children With Cerebral Palsy and Hearing Loss
Children with cerebral palsy have a few different treatment options available, depending on the type of hearing loss they have.
Working With an Audiologist
Audiologists are experts who can diagnose, treat, and manage hearing loss conditions in patients of all ages, including children with cerebral palsy.
After performing audiological (hearing and sound) and otologic (ear) assessments of your child, an audiologist can help identify the best treatment options and refer them to specialists when necessary.
Working With a Speech-Language Pathologist
Speech-language pathologists, more commonly called speech therapists, work with people of all ages to diagnose and treat speech and communication problems.
They can also work with families to help the child improve their communication and confidence when speaking.
Treatment for Ear Infections and Fluid Buildup
If your child’s hearing issues are related to ear infections or fluid buildup, their health care provider will likely start with a round of antibiotics to clear up the infection.
Physicians may also recommend over-the-counter pain relievers such as ibuprofen or acetaminophen to help treat ear infections, depending on the severity.
Depending on the cause of a child’s cerebral palsy-related hearing loss, surgery on the ear or ears may restore some of their hearing.
For instance, if a child’s hearing loss is related to fluid buildup from frequent ear infections, their physician may be able to surgically implant special tubes to help keep fluid drained.
Cochlear implants are a type of surgically implanted device that can help reduce hearing loss in people with moderate to severe hearing loss.
They are intended for people with sensorineural hearing loss and are usually used in combination with therapy to help with any related speech issues.
Hearing aids are similar to cochlear implants in amplifying sounds and reducing hearing loss. However, they differ in that they are removable at any time.
This type of hearing loss treatment is also intended primarily for people with sensorineural hearing loss.
What to Do If Your Child With Cerebral Palsy Shows Signs of Hearing Loss
If your child with cerebral palsy is showing signs of hearing loss, remember that early intervention is important.
Here are some steps you may want to take if you suspect hearing loss in your child.
1. Alert Your Pediatrician or Cerebral Palsy Specialist
You can first alert your child’s pediatrician or cerebral palsy specialist, who can examine your child and make further recommendations and referrals.
It is important to let them know as soon as you notice symptoms because taking steps early on can help your child’s long-term hearing.
2. Seek Diagnostic Testing
A child’s hearing can be tested in a few different ways, depending on their age and the types of hearing loss symptoms they are experiencing.
For your child’s hearing loss to be properly treated, an accurate diagnosis is essential.
3. Find Appropriate Treatment
How your child’s hearing loss is treated will depend on the severity.
Children with more severe hearing loss may benefit more from ear surgery or cochlear implants. Children with milder cases may see improvement simply from working with an audiologist or speech therapist.
4. Explore Cerebral Palsy and Hearing Loss Resources
Discovering your child has cerebral palsy and hearing loss can feel overwhelming, but there are resources available.
Resources for Children With Cerebral Palsy and Hearing Loss
Several resources are available for children with cerebral palsy and hearing loss and their parents, families, and caregivers.
Resources for children with cerebral palsy and hearing loss include:
- American Society for Deaf Children: An online platform offering classes and support to empower deaf and hard-of-hearing children and their families with American Sign Language skills.
- Cerebral Palsy Guide: Offers no-cost educational content, financial aid, and support resources for families impacted by cerebral palsy and related birth injuries.
- Cerebral Palsy Resource by Cerebral Palsy Foundation: A hub for advocacy and awareness, educational resources, videos and podcasts, and information about research and clinical trials.
- Supporting Success For Children with Hearing Loss: This organization provides resources to children, parents, teachers, and professionals to help better support children living with hearing loss.
- United Cerebral Palsy: An inclusive resource offering housing, transportation, education, job opportunities, health care, and assistive technology solutions, including hearing aids, for families impacted by cerebral palsy.
Support for Children With Cerebral Palsy and Hearing Loss
Raising a child with cerebral palsy can feel demanding. The challenges intensify when your child also experiences hearing loss. Understand that you are not alone.
Families can gain valuable support by accessing educational resources and joining support groups. It’s also beneficial to seek specialized therapies.
If you have concerns or questions about your child’s situation, consider reaching out to a cerebral palsy lawyer who can provide guidance on your family’s specific circumstances.
Connecting with professionals skilled in cerebral palsy and hearing loss ensures your child gets the comprehensive care they deserve, tailored to their needs.