What to Expect the Toddler Years (168 page)

A tendency to turn the volume of the TV and tape player up too high or to stand very close to them, as if to hear them better (though a toddler with normal hearing may occasionally do this out of curiosity).

Complaints about ringing or pain in ears.

Children who are at high risk for hearing problems should have a formal hearing screening early on, even if they do not display any of these signs. Children are considered to be at risk if:

They have been diagnosed as having a medical problem, such as Franconi syndrome, which is associated with hearing deficit.

There is a family history of inherited or unexplained childhood hearing loss (among siblings, parents, cousins, and so on).

They were exposed in utero to a viral infection known to affect hearing (such as cytomegalovirus [CMV] or rubella), particularly during the first trimester.

They weighed in under 1,500 grams (or 3 pounds, 4 ounces) at birth.

They were born with ear or facial abnormalities (craniofacial anomalies).

They had a low APGAR score (under 4) at birth, or experienced serious problems as newborns—such as asphyxia (oxygen deprivation), seizures, or intracranial bleeding, or if they received prolonged ventilation.

They were given potentially ototoxic (ear damaging) medications (such as Gentamicin) or contracted an illness (such as bacterial meningitis) that can cause ear damage.

Even the smallest suspicion of a hearing problem warrants audiologic testing, especially in a young infant. A child doesn’t have to be profoundly deaf to benefit from treatment; in fact, the child with only a mild hearing deficit may benefit most from therapy. Any hearing deficit that goes undetected and untreated can lead to poor language and learning skills, to a bright child being mistakenly labeled “slow” or even “retarded,” and to low self-esteem. For a list of the most common forms of hearing loss and the different kinds of treatment available, see page 722.