Why Is Preschool Hearing Screening Important?

  • November 22, 2020
Why Is Preschool Hearing Screening Important?

Nearly all children born in the United States are screened for hearing loss soon after they are born. However, some types of hearing loss are not detected in these early screenings. Late-onset, frequency-specific and progressive hearing loss are all conditions that cannot be detected in these early hearing tests.

Approximately 15% of school age children in the United States exhibit some type of hearing loss. Preschool hearing screenings can detect childhood hearing problems. Failure to detect these health problems can lead to lifelong challenges including delayed language development, poor performance in school, attention problems, social issues, and emotional difficulties. Hearing trouble caught early can sometimes be reversed, and other times, children with hearing loss can be given the tools they need to function in society.

How Can You Tell If Your Preschooler Has Hearing Loss?

Knowing the symptoms that your child has hearing loss can help you decide when it’s time to see an audiologist. Common symptoms include:

  • Your child seems to hear some sounds and not others.
  • Your child responds to some calls and not others.
  • Your child doesn’t notice you until they’ve seen you.
  • Your child concentrates on making deep throat noises like gargling, instead of sounds that mimic vowels and consonants.
  • Your child has difficult-to-understand speech.
  • Your child seems to have poor attention or is often perceived as being resistant to following directions.
  • Your child had delayed speech.
  • Your child sits very close to the television and seems to prefer the television turned up very loud.

If your child displays any of these symptoms, get a preschool hearing screening. Some preschools offer hearing screening for children automatically. If your child’s preschool does not, seek out hearing screening from the audiologist.

What Happens During Preschool Hearing Screening?

A preschool hearing screening is not always the same as hearing screening for older children. The type of test that your child’s physician or audiologist selects for your child will depend on their level of maturity, symptoms, and the severity of the problem.

  • Play Audiometry: This test uses a machine that sends sounds into your child’s ears. The sounds play at different volumes and pitches. Your child will be asked to wear headphones. Every time your child hears a sound, they will be instructed to do something with a toy, or put a peg in a hole, or do something similar.
  • Pure Tone Audiometry: During this test, your child will wear headphones. A machine will play tones at different volumes and pitches in your child’s ears. Your child will be asked to raise their hand or make a gesture that in some way indicates they have heard the tone when it is played.

What Does It Mean if Your Preschooler Fails a Hearing Test?

If your child fails a hearing test, make an appointment to see an audiologist as soon as possible. Your child will be re-tested in the audiologist office. Sometimes young children fail hearing tests even though they can normally hear just fine. A blockage in the ear, congestion or even lack of attention can affect whether your child fails a hearing test. Your child’s audiologist will confirm whether your child really has a hearing problem and may then give your child more extensive tests to determine the cause. There are two types of hearing loss.

  • Conductive Hearing Loss: The result of an abnormality in the outer or middle ear or can be the result of fluid in the middle ear.
  • Sensorineural Hearing Loss: The result of a hearing abnormality in the inner ear. This type of hearing loss affects the nerves that carry messages to the brain.

Different types of hearing loss are treated in different ways. Some hearing loss is genetic, others are due to complications during birth, and still other types of hearing loss can occur because of illnesses or blockages. After determining the cause of the hearing loss, your child’s audiologist will set a course for treatment or therapy, either to help your child improve their hearing or learn to adapt to their condition.

What Treatment is Available if My Child Has Hearing Loss?

The type of treatment your child’s audiologist recommends will depend on the severity and type of hearing loss.

Wait and See

Conductive hearing loss because of fluid in the ear often goes away on its own. Fluid that doesn’t go away on its own can be treated with medications like decongestants and antibiotics.

Ventilating Tubes

Sometimes ventilating tubes are required to drain the ear of fluid trapped behind the eardrum. Tube placement is very common for children and is usually performed under general anesthesia as an outpatient surgery. Tube placement does not cause permanent damage to the ear drums and the tubes typically fall out of the ear drum on their own after several weeks. Children typically do not experience any post-operative pain and feel normal again within a few hours.

Hearing Aid

Hearing aids may be required if your child’s auditory nerve is damaged. In order to be effective, the hearing aid must be properly chosen for your child and their condition. Hearing aids are only effective when they’re turned on, their batteries are functioning, and they’ve been fitted and configured for your child’s particular needs. Sometimes it’s hard to tell when the hearing aids for a younger child are working properly. Parents of children with hearing loss must work with their audiologist to ensure that their child has a functioning hearing aid.

Cochlear Implant

A cochlear implant is a medical device used to help children who have severe or profound hearing impairment in both ears. Cochlear implants are only used in children who cannot benefit from use of a hearing aid. Early implantation is best, so if your child is 3 to 4 years old, work with your audiologist to determine as soon as possible whether your child could benefit from a cochlear implant.

Insertion of cochlear implants has risks, including possible infection months after the implant has been inserted. This type of medical device is not for everyone, so work closely with your child’s audiologist to ensure that the course of treatment selected for your child is best for them.

Noticed Signs of Hearing Loss? Get Your Child’s Hearing Tested As Soon As Possible

Children with hearing loss can be taught to adapt to their condition. Even children with severe hearing loss can learn sign language to communicate, and some can be taught to lip read as well. Getting started early can help your child learn to manage their condition.


  1. American Speech-Language Hearing Association, Childhood Hearing Screening – https://www.asha.org/practice-portal/professional-issues/childhood-hearing-screening/
  2. Healthy Children.org, Hearing Loss – https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Hearing-Loss.aspx
  3. Stanford Children’s Health, Types of Hearing Tests for Babies and Children – https://www.stanfordchildrens.org/en/topic/default?id=types-of-hearing-tests-for-babies-and-children-90-P02038#:~:text=A%20test%20that%20uses%20an%20electrical%20machine%20that%20makes%20sounds,is%20heard%20in%20the%20earphone.