Unilateral hearing loss in children

January 27, 2015 by David Mayer

Surdité unilatérale

Unilateral hearing loss is hearing loss in one ear with normal auditory acuity in the other ear. Two to three school-aged children out of 1,000 have a unilateral hearing impairment greater than 45 dB. However, when losses of 26 to 45 dB are taken into account, prevalence may be as high as 13 children out of 1,000.

This kind of hearing loss is difficult for parents and teachers to detect, because the children seem to hear normally in everyday situations when the environment is favourable to communication. Children experience difficulties later on, often at school, where they have to listen in noisier surroundings. It also becomes difficult to follow a conversation in a gymnasium because of reverberation (the persistence of sound in an enclosed or partially enclosed space after the source of sound has stopped). These children sometimes seem to hear quite well, but at other times find it difficult to understand what is being said, confusing the people around them. This uncertainty delays consultation with an audiologist, resulting in a late diagnosis.

A very real disability

The ability to hear with both ears has many advantages that children with unilateral hearing loss cannot enjoy. They find it hard to locate where sounds are coming from and hear speech in noisy environments. Furthermore, the added effort needed to understand requires a great deal of concentration, which causes fatigue.

Unilateral hearing loss also has an impact on grades: these students are almost 10 times more likely to fail in school. They also have twice as many behavioural problems as their peers.

Possible interventions 

To counter the disability and support proper development, it is important to take action as early as possible and see an audiologist, who will conduct a hearing assessment and recommend a personalized intervention plan that takes into account audiometric, developmental, educational and other factors.

Being fitted with hearing aids is certainly one of the possible solutions when the unilateral hearing loss allows for it, as is the use FM systems. Good communication strategies can also be implemented in the classroom:

  • Allow the child to sit at the front of the class, as close to the teacher as possible.
  • Make sure the student understands what is being said by asking him or her to repeat instructions.
  • Use visual aids.
  • Rephrase certain instructions.
  • Reduce noise in the classroom.

A few statistics:

  • According to Speech-Language & Audiology Canada (February 2014), in Canada, the average age of hearing loss identification in children with no known risk factors and in the absence of universal screening for hearing loss is 2 to 4 years old.
  • According to Audiology Online, on average, unilateral hearing loss is identified in children at 8.78 years of age.
  • According to the Association du Québec pour les enfants avec problèmes auditifs, on average, unilateral hearing loss is identified in children at 7 to 8 years of age.
To obtain more information about unilateral hearing loss, speak to an audiologist; he or she will be happy to answer your questions.
References: (Other references are available on request.)
– Downs, M.P. “Contribution of Mild Hearing Loss to Auditory Language Learning Problems.” In R.J. Roeser, and M.P. Downs (Ed.): Auditory Disorders in School
Children: The Law, Identification, Remediation
, 4th ed. New York: Thieme, 2004, pp. 233-248.
– Mayer, D., and C. Poirier. “L’effet d’une surdité légère et d’une surdité unilatérale chez l’enfant d’âge scolaire.” Réadaptation de l’enfant ayant une déficience
. Université de Montréal, 2005.
– Nilsson, M. “Is There Evidence on Which to Base Recommendations for Amplification?” Lecture, Canadian Academy of Audiology Conference. Toronto, 2005.