“Jordan was a happy and friendly child who loved to learn new things and play with their friends, but something changed when Jordan was four years old. They started to have trouble paying attention, sitting still, and following instructions. Jordan would often daydream, get frustrated easily, and shout at people; sometimes hitting or biting others. Their parents and teachers thought Jordan might have a problem, such as ADHD or autism, but they didn’t know what to do. They tried talking to Jordan, they tried using discipline, but Jordan didn’t seem to understand or care or want help.
The school entry hearing screening team showed up at school to check on all the children’s hearing and, following the test, suspected that Jordan might have a hearing problem. Jordan was referred to the local paediatric audiology team, who confirmed that they had a conductive hearing loss meaning that the sound waves could not reach Jordan’s inner ear. Due to fluid in their middle ear, everything sound muffled and distorted, and it had affected their speech and language development. The audiology team explained that Jordan needed to have ventilation tubes inserted in their ears, which would drain the fluid and restore their hearing, but the waiting time for this procedure was 4-6 months. Not to delay Jordan’s treatment, the audiologists offered Jordan a bone conduction hearing aid: a device that bypasses the middle ear and sends the sound vibrations directly to the inner ear through the skull.
They fitted Jordan with the hearing aid and turned it on. Immediately Jordan heard sounds they hadn’t heard for a very long time in that way. It was their own voice. Jordan was amazed and delighted as they also heard the voices of their parents and the audiology team. It was too much, and Jordan took the device off again. Later, they tried again and outside they heard the sounds of the birds and the cars in the distance. They heard the music and the laughter. They heard the world.
Jordan wore the hearing aid every day and everyone noticed a big difference. Jordan could hear what people were saying and respond. Jordan could follow the instructions and do the tasks. Jordan could join the conversations and make jokes. Jordan was back to being the happy and friendly child they used to be. They were grateful to the school entry hearing screening team and the audiology team for finding out their problem and helping them.
Jordan’s parents had always wondered why Jordan’s 11-year-old sibling Auden was so shy and quiet. The teachers often commented that Auden would hardly participate in lessons and sometimes give very strange answers that were missing the point.
The parents decided to take Auden for a hearing test and discovered that Auden must have developed a permanent hearing loss soon after birth that had slowly worsened over the next 10 years. After having been given hearing aids, the true journey for Auden began, as only then Auden noticed what they were unable to hear, what they missed all those years and why learning in class was so difficult.
Children and young people can present in so many ways if they cannot hear. Some have only difficulties with some voices and not others. So, a very low threshold is helpful when suggesting a hearing assessment or hearing check for a child. Even if hearing was normal last week, a cold can still make it difficult tomorrow. Even permanent hearing losses can develop and progress over time.
For the classroom:
- A microphone for the teacher and speakers at the back of the classroom help pupils to understand better and enable a teacher’s voice to stay quieter. Shouting does not help anyone with hearing problems.
- Bare glass or concrete walls generate echoes (increase reverberation) and degrade the sound information.
- Most people can lip read to some extent, being able to clearly see a teacher’s face when they are talking helps.
- Avoid asking someone to listen and write at the same time – even if they wear hearing aids.
Please be curious and think HEARING. Teachers can make such a positive difference to children with hearing difficulties.
If you have a school entry hearing screen team coming, please help them to find a quiet room for testing and support them in seeing all children.
Our speech and language therapy team say:
Children with hearing loss are at risk for having difficulties with:
- language acquisition, with understanding of vocabulary and concepts a particular weakness
- speech sound development
- socialising with others
- attention and concentration.
If you are concerned about a child’s speech, language or communication skills, arranging a hearing screen to rule out hearing loss needs to be high on your to-do list.
More help and resources:
- The local sensory impairment team and Teachers of the Deaf (ToDs) from the local authority
- The Ewing Foundation: Ewing Foundation (ewing-foundation.org.uk) offers help with classroom acoustics and education
- Connevans School Soundfield (www.connevans.co.uk/catalogue/12/ School-Soundfield)
- The National Deaf Children Society: Improving listening conditions Reducing background noise (ndcs.org.uk)
Dr Sebastian Hendricks is a consultant in paediatric audiovestibular medicine at Great Ormond Street Hospital for Children & Medical Director (Hearing) of Thomson Screening. Sebastian has a dual accreditation as a specialist in paediatrics and audiovestibular medicine.
Thomson Screening’s SchoolScreener software is used in over 5,000 schools by NHS (non-clinical staff) screening KS1 children’s hearing and vision. A variant is now available for schools’ own use (from age 7) to assess whether an undetected hearing or vision deficit may be affecting progress or behaviour; SchoolScreenerforSchools includes automated reporting for SLT, parents and for Ofsted inspections: info@schoolscreener.com