Unilateral Conductive Hearing Loss

There are many types of hearing loss. One way that the types are divided is by which part of the ear is not working. A conductive hearing loss occurs when the middle ear (canal, eardrum, stapes, malleus, incus) is not functioning properly. The sound cannot travel through to the cochlea. Oftentimes, this is temporary and caused by fluid in the ear. Sometimes it is permanent due to abnormal structure in the ear.

The other type of hearing loss is a sensorineural hearing loss. The most common cause of this is a non-functioning cochlea. The cochlea is the part of the ear that converts the sound into electrical energy and sends it on through to the brain.

A friend of mine recently gave birth to a beautiful baby boy. He did not pass his newborn hearing screening and has been recently diagnosed with a severe unilateral (one-sided) conductive hearing loss. She called me to find out what she can do for him. Being a speech-language pathologist herself, she understands the need for auditory input to facilitate proper language development. She began to second-guess herself when the audiologist told her that children with hearing loss in one ear do very well and often don't need amplification.

This post is meant to put a start to breaking down that myth.

Children with hearing loss in one ear will obviously do better than children with hearing loss in both ears. But they will also obviously do worse than children with normal hearing. It is common sense.

Still, there are professionals out there who are uneducated in this matter. There are many who still believe that if a child has hearing in one ear then they can learn language normally and function well in the classroom. This is generally not true.

Children with unilateral hearing loss are at ten times more risk for academic failure than are children with normal hearing in both ears (Bess, Dodd-Murphy, & Parker, 1998; Tharpe, 2006). Also, they have demonstrated greater difficulty identifying speech in noise, localizing sound sources, and other important classroom skills. They have more difficulty discerning speech, even when it is spoken into the good ear (Cole, Flexer, Children with Hearing Loss, 2007).

This article is just one example of many studies that have recently been done showing these negative effects. As parents and professionals who are armed with this knowledge, we need to be advocates for these children by raising awareness and spreading research such as this.

Now. If your child has a unilateral hearing loss, you don't have to "wait and see" as my friend's audiologist told her, to see if it causes problems. "Waiting and seeing" often produces children with delays who spend much of their lives trying to catch up. Here are some options for you:

1) Talk with a good audiologist who will help you determine the cause and severity of your child's loss. Then you can determine what options are best.

3) Because many of these options are not as successful as in older children, just know which ear is your child's better ear and speak into that ear when possible. Speak closely to your child as much as possible. Little to no research has been done on the benefits of fitting newborn infants with unilateral hearing loss with amplification.

2) Make sure that your child's teacher uses an FM system.

3) Place your child at the front of the classroom.

4) You can also look into candidacy for a BAHA (bone-anchored hearing aid). This type of hearing aid bypasses the middle ear and sends the signal directly to the cochlea. It is recommended for children 5 and older.

5) The CROS system is an option for older children as well.

Some people might tell you that they had negative experiences with the BAHA and other methods of amplification for unilateral conductive losses. It is my opinion that you should be informed of all the possible risks and options so that you can make an informed decision.

Good luck!