2. Does the child seem to be hearing well?
* Have you noticed that the infant startles with loud noise? Did the infant babble around 6 months? Does he or she talk; at what age did talking start? Was the speech intelligible?
* Ever had the child’s hearing tested? If there was a hearing loss, did it follow any diseases in the child, or in the mother during pregnancy?
(Note: It is important to catch any problem early, because a child with hearing loss is at risk for delayed speech and social development and learning deficit.)
Rationale: Children at risk for hearing deficit include those exposed to maternal rubella, syphilis, cytomegalovirus, or toxoplasmosis, or to maternal ototoxic drugs in utero; premature infants; low-birth-weight infants; trauma or hypoxia at birth; and infants with congenital liver or kidney disease.
In children, the incidence of meningitis, measles, mums, otitis media, and any illness with persistent high fever may increase risk of hearing deficit.
3. Does the child tend to put objects in the ears? Is the older child or adolescent active in contact sports?
Rationale These children are at increased risk for trauma.
NOTE TO EXAMINER – during history, note these clues from normal conversation,, which indicate possible hearing loss.
1. Person lip reading or watching your face and lips closely rather than your eyes.
2. Frowning or straining forward to hear
3. Posturing of head to catch sounds with better ear
4. Misunderstands your questions, or frequently asks you to repeat
5. Acts irritable or shows startle reflex when you raise your voice (recruitment)
6. Person’s speech sounds garbled, possibly vowel sounds, distorted.
7. Inappropriately loud voice.
8. Flat, monotonous tone of voice.