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Children With Down Syndrome, A Hearing Loss Need To Know

Children with Down Syndrome have many health and development difficulties. Not least among them can be hearing loss. I read an interesting study in the Hearing Journal recently by Emily Nightengale AuD (1). The study results showed a high prevalence of hearing loss in children with Down Syndrome. 36% of the cohort studied showed some sort of hearing loss, whether, conductive, conductive and transient, sensorineural or mixed. In essence, the conclusion of this study was that it was important to educate parents and physicians to the possibilities in order that there could be early referrals.  In this article, I would like to help make the concerns and difficulties clear.

Physical Ear Structure Causes Problems

The physical ear structure of children with Down syndrome may predispose them to hearing difficulties. They are more prone to conductive hearing problems (problems with the middle ear and outer ear) over and above simple ear wax issues (which may be a regular issue) including middle ear issues such as middle ear effusion (build-up of fluid in the middle ear), acute otitis media (mid-ear infections), and eardrum perforations (2). 

ear anatomy courtesy of Phonak

In fact, it has been reported that up to 93% of children with Down syndrome suffer otitis media (3) and between 43 to 83% percent are fitted with grommets (4). Unfortunately, it appears that grommets may not be as successful a treatment as is the norm for children with Down Syndrome (5). 

It also seems that sensorineural hearing loss (a problem with the inner ear) can be a problem, again in the case of sensorineural hearing loss occurring, it appears physical structures may be the underlying problem. Computed tomography scans have been undertaken in cases of sensorineural hearing loss and they revealed structural abnormalities in the inner ear, such as narrow internal auditory canals and semicircular canal malformations (6). 

Conductive Hearing Loss

Conductive hearing loss can be transient as is the case with otitis media, however, recurrent or chronic otitis media can damage the middle ear and eardrum leading to a permanent conductive hearing loss. While a transient conductive hearing loss is rarely treated with hearing aids, a more permanent conductive loss is.

Sensorineural Hearing Loss

A sensorineural hearing loss is a permanent hearing loss that can only be treated with hearing aids.  

Developmental Difficulties

Unidentified or untreated hearing loss in children will delay their development and communication skills. It can also have an effect on their psychosocial skills. In most cases, the hearing loss can be treated with medical intervention (grommets) or hearing aids and ancillary equipment. In this way, at least one obstacle to development and communication can be removed.

The Advice

As the parent, the carer, or the physician of a child with Down Syndrome it is important to be aware of the possibilities. Just because there is a high prevalence of hearing loss does not mean that your child will suffer from one. However, forewarned is forearmed. Awareness will lead to early identification and hopefully treatment

  1. Hearing Loss in Children with Down Syndrome, Nightengale, Emily AuD, The Hearing Journal: February 2018 - Volume 71 - Issue 2 - p 10,12 doi: 10.1097/ Hearing Loss and Down Syndrome
  2. Otol Neurotol. 2015;36[2]:348; Eur Arch Otorhinolaryngol. 2014;271[5]:863; Otolaryngol Clin North Am. 2012;45[3]:599
  3. Scott Med J. 2011;56[2]:98
  4. Int J Pediatr Otorhinolaryngol. 2001;61[3]:199 Int J Pediatr Otorhinolaryngol. 1999;49[2]:143 
  5.; Eur Arch Otorhinolaryngol. 2014; Otolaryngol Clin North Am. 2012; Am J Med Genet C Semin Med Genet. 2006;142C[3]:131
  6. (Laryngoscope. 2006;116[12]:2113; Pediatr Radiol. 2012;42[12]:1449

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Geoffrey Cooling

Geoffrey Cooling

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Geoffrey (Geoff, anything else makes him nervous) Cooling has been involved with the hearing aid industry for over ten years. He has worked in private practice dispensing hearing aids and as a manufacturer's rep. He has written two books and they are both available on Amazon. He loves technology, passing on knowledge and is legendary for many other things, primarily the amount he curses, his dry and mischievous sense of humour and his complete intolerance of people who are full of themselves. Please feel free to connect with him

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