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- More than 12 percent of children between the ages of 6 and 19 already have hearing damage from loud noises
- Young people are frequently exposed to dangerously loud noises
- Simple steps like turning down the volume, using hearing protection, and avoiding loud environments can make a difference
Your child's hearing is crucial to their overall well-being and development, and understanding the mechanics of hearing can empower you to take actionable steps toward protecting this vital sense. Hearing loss is increasingly common among children, teens, and young adults. In fact, according to research from the Centers for Disease Control and Prevention (CDC), more than 1 in 8 children (12 percent) between the ages of 6 and 19 already have some level of hearing damage due to loud noises. This guide aims to provide you with practical tips and resources to safeguard your child's auditory health.
Understanding Sound and Our Ears
Sound is integral to our lives, but how do our ears process it? Understanding the mechanics of hearing and sound measurement can empower you to make informed decisions about your auditory environment to reduce the risk of hearing loss for you and your children.
How Our Ears Work
Four main components are at work when we hear sound:
- Outer Ear Sound waves enter the outer ear and travel through the ear canal.
- Middle Ear The sound waves hit the eardrum, causing it to vibrate. These vibrations are then transferred to three tiny bones called the malleus, incus, and stapes.
- Inner Ear The vibrations reach the cochlea, a snail-shaped structure filled with fluid. Inside the cochlea, hair cells ride the fluid wave, and their movement triggers electrical signals.
- Brain Processing The auditory nerve carries these electrical signals to the brain, interpreting them as sound.
Sound is measured in units called decibels (dB). Sounds at or below 70 dB are generally considered safe. Any sound at or above 85 dB poses a risk of damaging your hearing over time, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). For context, normal conversation is around 60 to 70 dB, while music through headphones at maximum volume can reach 94 to 110 dB, more than 100 times as intense as 85 dB.
Real-Life Sound Examples
- Quiet Breathing, library whispers (30 dB)
- Moderate Normal conversation, dishwasher running (60–70 dBA)
- Loud but safe Coffee grinder, traffic noise, loud restaurant (70–85 dB)
- Risky Tractor, power tools, leaf blower (85–90 dB)
- Unsafe Sporting event, nightclub, ambulance (110 dB)
*As opposed to dB, which measures sound intensity, dBA measures how sound relates to the threshold of the human ear.
Causes of Childhood Hearing Loss
Congenital (at birth) hearing loss is generally not preventable and is caused by factors like genetics and premature birth. Acquired hearing loss, on the other hand, has many potentially preventable causes, like exposure to loud noises (noise-induced hearing loss), chronic ear infections, and other illnesses or injuries.
Noise-Induced Hearing Loss
Noise-induced hearing loss (NIHL) is a hearing impairment caused by exposure to loud sounds. Unlike other forms of hearing loss, NIHL is unique in being entirely preventable. But once it occurs, the damage is permanent and irreversible. It’s important to note that NIHL can accumulate over time, especially with repeated exposure to loud noises. Understanding NIHL and its contributing factors can help parents take preventive measures to protect their children's hearing for a lifetime.
Factors Influencing NIHL
NIHL depends on three main factors:
- Level The louder the sound, the higher the risk.
- Distance The closer you are to the source of the sound, the more chance you have of hearing damage.
- Time The longer your exposure to the sound, the more significant the risk.
Common Sources of NIHL for Children
- Concerts and Sporting Events The loud music and crowd noise can reach dangerous levels.
- Loud Headphones Listening to music at maximum volume can produce sound levels up to 110 dBA.
- Toys With Loud Sounds Some toys can produce surprisingly high noise levels.
- Fireworks These can produce extremely loud and sudden sound levels.
- Lawnmowers and Power Tools Even brief exposure can be harmful.
Ear Infections Causing Hearing Loss
Chronic ear infections (otitis media) can be a significant factor in hearing loss among children. These infections often accumulate fluid in the middle ear, causing temporary hearing impairment. If left untreated, research published in 2022 shows the fluid can damage the eardrum and the small bones in the ear, leading to permanent hearing loss.
“It's important to get a speech pathologist involved early to address any speech concerns,” notes Rachel Magann Faivre, AuD, owner of Oklahoma City-based Ash Audiology. “And to take it one step further, untreated speech delays can affect academic success when the child enters school.”
Why It Happens
The structure of young children's eustachian tubes makes them more susceptible to ear infections. Before the age of two, these tubes are shorter and more horizontal than those in adults, making it easier for fluid to become trapped and infections to develop.
Parents can take these precautions against lingering or recurring ear infections:
- Early Diagnosis Consult a healthcare provider for proper diagnosis and treatment at the first sign of symptoms of infection, like ear pain or difficulty hearing. Chronic ear infections that go untreated can spread to the mastoid bone (called mastoiditis). This can be treated with antibiotics, but if not caught soon enough, surgery is required to clear out the infection, resulting in permanent, conductive hearing loss.
- Follow Treatment Plans Adherence to prescribed medication treatments and regular follow-up appointments are essential to eradicate infections fully.
- Preventive Measures Discuss preventive strategies, such as vaccines and hygiene practices, with your healthcare provider to minimize the risk of recurrent infections.
In Arriba, Colorado, Laurel M., has a son who had chronic ear infections as a small child. He was eventually treated with tubes, but he had at least 10 ear infections before that happened. The chronic infections led to mild to moderate hearing loss in one ear, which was finally diagnosed in kindergarten because teachers were noticing delays, especially in speech. “I think his ear infection just never fully cleared up, and we were fighting it for years,” Laurel says. “By the time we finally got it under control, it had already caused permanent damage.”
Other Causes of Childhood Hearing Loss
Other common diseases or injuries can also lead to hearing loss:
- Prenatal Infections Certain diseases and infections during pregnancy, such as cytomegalovirus, rubella, and toxoplasmosis, can lead to congenital hearing loss.
- Childhood Illnesses Acquired hearing loss can occur due to infectious diseases in childhood, like meningitis, measles, varicella (chicken pox), and even influenza (the flu).
- Untreated Swimmer's Ear Swimmer's ear, an infection of the outer ear canal, can lead to temporary hearing loss if left untreated. The condition can become chronic and result in more severe and permanent hearing issues.
- Central Auditory Processing Disorder (CAPD) CAPD is a type of hearing loss that occurs even though the outer, middle, and inner ear all work well. Instead, the condition results from an issue with the auditory nerve and how it sends messages to the brain. With CAPD, a person can hear sounds at normal volumes, but they can’t interpret or understand them properly.
- Ototoxic Substances According to the American Academy of Audiology, some medications and chemicals are toxic to the ears and may cause permanent damage with extended exposure. Common ototoxic medications are certain IV antibiotics, aspirin, and many chemotherapy drugs. Environmental exposures to mercury, lead, and carbon monoxide are also ototoxic.
- Injury Physical injuries to the ear, such as a perforated eardrum, can also cause hearing loss. This type of injury often occurs due to trauma, leading to conductive hearing loss, which may be treatable with medicine or surgery.
The following precautions will protect against hearing-damaging diseases and injuries:
- Consult a Healthcare Provider If you notice symptoms like delayed speech or unresponsiveness to sound, consult an audiologist or ENT for diagnosis and treatment.
- Regular Check-Ups Keep up with regular pediatric appointments to monitor your child's hearing and overall health.
- Be Informed Educate yourself about the various causes of hearing loss and take preventive measures.
Protecting Your Child’s Hearing
Protecting your child's hearing is crucial and achievable without much interference in their daily life. Here's a list of actionable tips from the NIDCD to help avoid damage to your child’s ears:
- Turn Down the Volume Lower the volume on devices, like TVs, music players, and especially headphones. High volume levels can lead to noise-induced hearing loss over time, and now more smartphones have volume parameters parents can set to keep their children from damaging their ears.
- Maintain a Safe Distance Avoid sitting or standing directly in front of speakers at events and concerts. The closer you are to the source of loud noise, the greater the risk.
- Use Earplugs While Swimming Wearing earplugs can help prevent swimmer's ear.
- Be Mindful of Your Environment If you have to raise your voice to speak to someone just a few feet away, the noise level is probably too high and could damage your hearing.
- Get Hearing Tests Regular hearing tests can help monitor any changes in your child's hearing and catch issues early.
- Use Personal Hearing Protection When you can't avoid loud noises, use personal hearing protection, like earplugs or earmuffs.
- Avoid Inserting Objects Into Ears Never stick anything in your ear, not even for cleaning. This can lead to infections or even perforate the eardrum.
- Consult a Doctor Promptly If you notice any signs of ear or hearing damage, consult a healthcare provider immediately for diagnosis and treatment.
Note: These tips not only apply to your child but are important for the whole family.
When safeguarding your child's hearing, several types of ear protection are available. Here's a rundown of options to consider:
Ear Plugs and Custom-Fit Ear Plugs
Ear plugs are small devices made to fit directly into the ear canal. They come in various forms, such as formable foam and pre-molded plastic, rubber, or silicone. Custom-fit ear plugs are molded specifically to your child's ears, offering a more comfortable and effective fit. These are particularly useful for children who need frequent ear protection.
Swimming Ear Plugs/Ear Molds
For children who swim regularly, specialized swimming ear plugs or ear molds can be used to prevent swimmer's ear. The design of these plugs keeps water out of the ear canal, reducing the risk of infection.
Noise Reduction Headphones/Earmuffs
Noise reduction headphones and earmuffs are often worn by kids at concerts or loud events. Constructed as padded plastic cups connected by a headband, they are easy to use and fit most children's sizes. They reduce noise by completely covering both ears and are generally more comfortable for extended wear than ear plugs.
Zoë M. Schmitz, AuD, a pediatric audiologist at Rocky Mountain Pediatric ENT Associates, offers advice on hearing health for children. “The best thing a parent can do to protect their child’s hearing is invest in hearing protection. Sporting events, concerns, and even fireworks shows can reach upwards of 115 decibels, which can immediately damage hearing and cause long-term effects. You can purchase hearing protection at many convenience stores or by visiting your local pediatric audiologist to obtain custom hearing protection. Another way to protect your child’s hearing is by monitoring the time spent and the volume of electronic devices. Most devices offer volume limiting capabilities, which allow parents or users to set the maximum volume on their phone or tablet. This can reduce excessive noise exposure and create a safer listening environment when listening to music or phone calls, streaming movies, and during gaming.”
- Noise Reduction Rating (NRR) Check the NRR of the ear protection to gauge how much noise they can block out. The higher the NRR, the more noise they can reduce. According to the CDC, you generally want to choose protection with an NRR of at least 30, especially for very loud environments.
- Comfort and Fit Choose a type of hearing protector your child finds comfortable and easy to use, so they are more likely to wear it consistently.
Bringing Kids to Loud Places
You don’t have to skip out on family outings to protect your child’s hearing. Taking your children to concerts or loud events like monster truck rallies can be a fun experience, but it's crucial to protect their hearing. Here are some tips to ensure a safe auditory environment for your kids:
- Prepare Them in Advance Talk to them about what to expect and let them know it will be loud and why it's essential to protect their ears.
- Choose the Right Gear Opt for earplugs or noise-reducing earmuffs suitable for children and get them accustomed to wearing them before the event.
- Pick a Safe Spot Choose a spot away from the speakers — the closer you are to the noise source, the higher the risk of hearing damage.
- Monitor noise levels If you have to shout to communicate with someone a few feet away, the noise level is too high and could be damaging your hearing.
Testing Children’s Hearing
If you're concerned about your child's hearing, it's essential to consult your healthcare provider for advice. Newborn hearing screens are now standard, and regular hearing tests are usually recommended at ages 4, 5, 6, 8, and 10 years, as well as during the preteen and teen years. But if you notice symptoms, like delayed speech or unresponsiveness to sound, it's crucial to speak to your child's doctor immediately. According to an American Journal of Audiology study, early intervention is key to reducing language developmental delays.
What Is a Hearing Test Like?
An audiologist will conduct a hearing test specific to your child's age, stage of development, and overall health. The test is not painful and often involves wearing headphones to listen to calibrated speech and pure tones. For infants and babies under 18 months, an audiologist will look at brainwave responses (this is called an ABR, or auditory brainstem response test) that a child listens to while sleeping. Since infants can't tell you if they're hearing something, this objective test lets everyone know exactly what volume levels the brain is hearing and receiving. Other signals an audiologist will look for in babies and toddlers are behavioral responses, like eye movements or head turns. Older kids may move a game piece or raise their hand in response to a sound.
Can You Test Hearing at Home?
While at-home testing can indicate whether or not your child is experiencing hearing loss, it’s not a substitute for a professional evaluation.
Why Might a Doctor Recommend a Hearing Test?
A doctor will recommend a hearing test if there are signs a child is having difficulty hearing or if a parent or teacher is concerned. Common signs of hearing loss in children are:
- Not reacting to loud noises
- Not responding to their name
- Turning up the volume on electronics
- Speech delays
Following Your Intuition
If you’re concerned about your child’s hearing ability, listen to your gut and be proactive. Parents know their children best and are usually the first to notice when something is wrong. That’s why it's important to advocate for them and press for answers if you sense there is a problem.
A Mother’s Hearing Loss Journey
Lauren Berrones, of Miami, Florida, has a three-year-old son, Dean, with severe to profound bilateral hearing loss. Dean passed his newborn hearing screen just like his older brother, so the family had no reason to be concerned early on. He also attended every well-child check and was babbling, laughing, and even using a few words. When Dean was just past his first birthday, Berrones began to notice that he wasn’t hearing her. He wasn’t turning when she called his name, and he also didn’t seem to notice loud noises, like the sound of the blender running. Berrones made an appointment with their pediatrician to have his hearing checked and was quickly told nothing was wrong — the doctor even called her a "worried well mama."
Berrones knew in her heart that something was wrong, so she pursued an audiologist consultation herself. At 14 months old, Dean underwent several evaluations and extensive testing and was eventually diagnosed with severe to profound sensorineural hearing loss. Fortunately, they found he was a candidate for cochlear implants because his auditory nerves were functioning. Dean was fitted with cochlear implants at 18 months of age. He adapted to them right away and began quickly catching up to his peers developmentally.
Because Berrones was proactive and assertive, Dean is now thriving and developing normally. He attends preschool and is able to fully communicate with his friends and teachers. "I have no idea what caused his hearing loss, but I suspect it was some childhood illness,” she says. Had Berrones not pushed for further evaluations and testing, she says, "He would not have been able to develop speech, and sign language would have been his only option."
The Bottom Line
Protecting your child's hearing is crucial to their overall health, development, and well-being.
The first steps are to understand the mechanics of hearing and recognize the causes of hearing loss.
Then, it’s important to take direct action to protect your child’s hearing with precautions like equipping them with the right ear protection, whether custom-fit earplugs or noise-reducing earmuffs. If you plan to attend loud events, prepare your child in advance and choose a safe spot away from the speakers. Regular hearing tests are essential, especially if you notice signs of hearing issues. These tests are non-invasive and can be a fun experience for your child.
Finally, always push for an additional evaluation or testing if you are told your child’s hearing is fine, but you feel something is wrong. Taking these proactive measures will significantly reduce the risk of hearing loss for your child and help ensure their continued healthy development.
Editorial Sources and Fact-Checking
- Listen Up! Protect Your Child's Hearing. CDC. April 13, 2018.
- Data and Statistics About Hearing Loss in Children. CDC. Aug. 24, 2023.
- How Do We Hear? NIDCD. May 2015.
- Too Loud. Too Long. NIDCD.
- Noise-Induced Hearing Loss. NICDC. June 2019.
- Alsabea A, Jamal A, Tarakmeh M. Effect of Ear Infections on Hearing Ability: A Narrative Review on the Complications of Otitis Media. Cureous Journal of Medical Science. July 28, 2022.
- Risk Factors for Late Onset Hearing Loss: In Utero Infection. Washington State Department of Health.
- Causes of Hearing Loss in Children. ASHA.
- Swimmer's Ear (External Otitis). Nemours KidsHealth. April 2023.
- Ototoxicity. American Academy of Audiology.
- Ear Injuries. Nemours KidsHealth. February 2020.
- Custom Hearing Protection and Swim Molds. OSU Department of Speech and Hearing Science.
- Three Tips for Choosing the Right Hearing Protector. CDC NIOSH Science Blog
- Hearing Tests. Nemours KidsHealth.
- Ching T. Is Early Intervention Effective in Improving Spoken Language Outcomes of Children With Congenital Hearing Loss? American Journal of Audiology. September 2015.
- Hearing Loss in Children. ASHA.