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Symptoms of Hearing loss / Ear problems in children

Depending upon the type and severity, any of the following symptoms may be seen in a child with hearing loss/ ear problems.

  • Developmental milestones of auditory and speech behaviors are absent / delayed.
  • Some speech sounds may not be pronounced correctly, particularly /sa/, /sha/, /fa/, etc.
  • Inconsistent response to sound.
  • Understands speech better when facing the speaker.
  • Not attentive in class.
  • Asks for repetitions.
  • Complains of pain / discharge / ringing sound in the ear.
  • Keeps the television on at a louder volume.
  • Uses inappropriate loudness of voice.

Symptoms of Hearing loss in Adults

Many symptoms are common to children and adults. In addition, an adult with hearing loss may have:

  • Difficulty understanding speech in group settings / noisy situations
  • Difficulty understanding telephonic speech
  • Difficulty understanding some speakers

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Hearing Loss in Children

Hearing loss can be present at birth(congenital) or acquired later. Hearing disorders can be due to problems in outer, middle or inner ear (peripheral system) or in the nerve pathway connecting the ear to the brain (Central Auditory System).

Some causes of hearing loss are

Outer Ear Middle Ear Inner Ear Central Auditory System

Excessive wax


Problems during pregnancy and childbirth


Foreign bodies


Genetic causes

Malformation etc.,

Eustachian tube malfunction etc.

Excessive Noise

Development of Auditory Behaviour

The following is the broad outline of the auditory behaviors exhibited by babies. The behaviors exhibited at the earlier stages continue at later stages also. If your child is over one year of age, look at the milestones of speech & language development.

0 - 3 Months
  • Startle to loud sounds
  • Cessation of activity in response to sounds
3- 6 Months
  • Turning to source of sound
  • Smile, blink, limb movement in response to sound
  • Crying child quietened at least momentarily by mother's voice even when mother is not seen
6 - 9 Months
  • Understands questions like "Where is light / fan / Amma?" and looks in the appropriate direction
  • Responds to sound of Television, or noise makers by smiling and looking in that direction
  • Responds appropriately to the "tone" of voice, i.e., anger/ soothing tone
9 -12 Months
  • Responds to music; responds by waving hands when asked (not demonstrated) to "wave bye bye"
  • Begins to understand speech more and more

Whenever you are in doubt about your child's hearing status contact an Audiologist at the earliest.

Things to bear in mind when you bring a child for testing

  • Children are difficult to test. So, be prepared to stay an entire day for testing
  • Bring along food / water
  • You may need to make the child sleep for testing
  • Sometimes sedation may be needed to make your child sleep, which requires a prescription from your child's pediatrician
  • If you have an older child, explain to him /her that hearing testing is absolutely painless and encourage him / her to co-operate
  • You may have to make repeated visits before a diagnosis can be made

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Hearing Loss in Adults

Many of the causes for hearing loss in adults are the same as those in children. The following are some of the other causes for hearing loss in adults:

  • Children are difficult to test. So, be prepared to stay an entire day for testing
  • Exposure to excessive noise
  • Ageing
  • Degenerative diseases
  • Infections
  • Medication induced hearing loss
  • Trauma (i.e., head injury)

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Audiology - Diagnostic Services

Features of the diagnostic facilities at the Institute

  • Qualified Audiologists
  • State of art facilities - including

    Technologically advanced Audiometers

    • Extended frequency range useful in early detection of noise / drug induced hearing loss
    • Special audiological tests – useful in differential diagnosis.
    • Free field testing and visual reinforcement Audiometry useful in testing infants and young children
    • Dichotic tests – useful in testing central auditory processing.

    Immitance Audiometry

    Useful in assessment of
    • Middle ear functioning
    • Eustachian tube functioning
    • Inner ear functioning
    • VII and VIII cranial nerve functioning
    • Brainstem pathology
    • Monitoring recovery in middle ear disorders and facial nerve palsy
    Additional Features of Immitance Audiometers at the Institute
    • Quick screen facility - screens infant's middle ear status in < 3 seconds. Multi frequency probe tone
    • Different parameters of acoustic admittance can be tested (conductance, susceptance) help in accurate diagnosis
    • Acoustic reflex measures - latency, amplitude, and decay of the reflex tested, is useful in differential diagnosis.

    Evoked Auditory Potential Measures

    Most evoked potential tests do not require active subject participation. These tests (i.e., BERA, MLR, LLR, ASSR) measure electrical activity at various levels in the auditory nervous system and are a very useful diagnostic tool in both children and adults.

    Useful in
    • Detection of hearing loss in neonates and infants
    • Diagnosis of Auditory disorders such as
      • Tumours at various levels of the auditory nervous system
      • Degenerative diseases of the auditory nervous system, ex: multiple sclerosis
    • Monitoring therapy progress in children with learning disability
    • Monitoring maturation of the auditory nervous system in children with cochlear implants
    • Medico legal cases

    OAEs - Oto Acoustic Emissions

    OAEs are extremely soft sounds generated by most normal inner ears. They can be recorded in the ear canal. OAEs can be evoked and recorded using different sounds.

    • Tool for assessing cochlear health
    • Tool for hearing screening in neonates / infants
    • Quick and non invasive test
    • Can monitor hearing status in persons
      • Undergoing treatment with ototoxic drugs ex: Cisplatin, Gentamycin
      • Exposed to loud noise
    • Helps in differential diagnosis
  • Sound treated rooms conforming to international standards
  • Regularly calibrated instruments
  • Use of a battery of tests

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Aural Rehabilitation

  • Amplification
    • Process of selection

      • Wide choice of Hearing aids to suit all needs and budgets.
      • Scientific methods of selection.
      • Computer programs available, which can interface with the programmable hearing aids to meet individual amplification needs.
      • Measurement of hearing aid output in the ear canal
        • Prevents over amplification in children
        • Helps in hearing aid prescription in difficult to test population
      • Effects of earmould on hearing aid performance considered.
      • Graphic representation of the actual hearing aid performance.
      • Increased client satisfaction.
    • Types of hearing Aids

      Different degrees and types of hearing loss require fitting with different hearing aids

      Conventional Hearing aids:

      Progressively decreasing in size are:

      • Pocket models (body level hearing aids)
      • B T E - Behind the ear
      • I T E - In the ear
      • I T C - In the canal
      • C I C - Completely in the canal

      Better sound perception is achievable with ear level hearing aids than body level hearing aids.

      Programmable Hearing Aids:

      • Analog and digital types available in all the above models except body level hearing aid.
      • Different programs can be stored in memory for listening under different conditions, such as quiet and noisy.

      Digital Aids: Digital aids with "smart features" can be programmed by computer software to c adjust their performance depending on the environment.

      Advantages of Digital hearing aids are:

      • Extremely sharp sound quality
      • Can be re-programmed even if individual hearing loss increases (upto a certain limit)

      For more details see FAQS on hearing Aids

      Process of getting adjusted:

      Listening through a hearing aid is a different sensory experience and one needs to get used to it. Professional help is required in getting used to amplification. The process of getting adjusted is longer and more difficult with children.

      Hearing aid repair workshop:

      • All types and makes of Hearing aids serviced and repaired
      • Servicing and repairing done by a qualified person

      Ear moulds - custom moulds, soft moulds:

      • Regular moulds (for body level hearing aids), skeletal moulds (BTE's)
      • Impressions for I T C and C I C also taken
      • U.V Moulds
      • Ear mould modification
  • Assistive listening devices

    An Assistive Listening Device is not a hearing aid but a device designed to improve the ability of a person with HI to communicate and to function more fully. Assistive listening devices are of two types:

    • Devices that transmit the amplified sound more directly from its source to the listener
      • FM systems
      • Infra red systems
      • Loop induction system
      • Telephone amplifiers
    • Devices that transform sound into a visual or tactile signal.
      • Alarm clocks which use vibration or light as their signal
      • Telephone ring indicators
      • Door bells with visual indicators
  • Cochlear Implant (CI) Program
    • This program, headed by Ms. Madhuri Gore, was launched in 1996, and has been running successfully for the past 11 years at ISH. The Institute is fully equipped to assess and rehabilitate clients with cochlear implants.
    • There are broadly two steps in the execution of the CI program. (1) Pre-surgical assessment for candidacy (2) Post-surgical rehabilitation, which includes customizing (mapping) the device and providing auditory verbal therapy (AVT).
  • Auditory Verbal Therapy

    Aims at providing listening training and verbal communication skills for persons with hearing impairment. This therapy is used mostly with young children, who have been fitted with appropriate hearing aids. This systematic therapy needs to be carried out for a long time to achieve good listening and speaking skills. Home training and parental involvement are essential for success of this therapy.

  • Speech Reading

    Speech reading (or lip-reading, as it is commonly known) refers to understanding of speech through the visual modality. To enable speech comprehension, a person has to not only observe the movement of lips and tongue but also recognize gestural cues, facial expressions, body postures and environmental cues.

    Speech reading cannot be used as a substitute for auditory information. Majority of speech sounds are not visible and persons with hearing impairment may miss out on some information through the auditory modality also. However, with realistic expectations and speech reading instructions, persons with HI can derive significant benefits this technique.

    We provide speech reading instructions to persons with HI who get very little benefit from amplification.

  • Sign Language
    • Basic sign language course is aimed at bridging the communication gap between the deaf and the hearing

    Who can learn Sign language?

    • Any one who is interested
    • Age/ Qualification - No bar

    Signers' World:

    Signers' World is an association deaf and hearing persons interested in popularizing Sign language. It started with a handful of deaf persons who came to the Institute once a week to interact with students learning Sign language. Their numbers grew steadily and Signers' World was started in 2000. The members of Signers' world have taken several measures to create awareness about Sign language. These include articles in newspapers and magazines, and interacting with students.

    For more information, Sign Language Courses

  • Education of hearing impaired children
  • Mothers' training program

    The objective of this program is to train the mothers of young children with hearing impairment in learning to communicate with their children. The program primarily focuses on enabling mothers to carry out incident oriented lesson to develop cognitive skills including attention, memory and reasoning abilities, language, speech and literacy skills. Mothers are trained to handle children with different degrees of hearing loss.

    Mothers provide training to their children in their mother tongue. Mothers who successfully complete three years training along with their children are awarded a certificate from the Institute.

    Ms. Rathna Shetty, D.Ed S.E (HI)
    Coordinator - Mother's Training Center

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