Description of Degree of Hearing Loss
Versus Potential Effects
Every child is different. The potential effects of a hearing loss depends on many factors including degree of loss, but also upon early identification and amplification, early intervention services, and parent involvement.
MILD 16 - 35 dB May have difficulty hearing faint or distant speech. A child with mild loss may miss up to 10% of speech signal when speaker is at a distance greater than three feet, or if the environment is noisy. Likely to experience some difficulty in communication & education settings. Consider need for hearing aid and intervention.
MODERATE 36-50 dB Understands conversational speech at a distance of 3-5 feet. Amplification may enable listener to hear & discriminate all sounds. Without amplification, 50% to 100% of speech signal may be missed. Speech may be affected unless optimally amplified.
MODERATE/SEVERE 51-70 dB Conversation must be very loud to be heard without amplification. A 55dB loss can mean 100% of the speech signal missed. May have difficulty in settings requiring verbal communication, especially in large groups. Delays in spoken language & reduced speech intelligibility expected without intervention & amplification.
SEVERE 71-90 dB If loss is pre-lingual, spoken language & speech may not develop spontaneously, or could be severely delayed unless modifications & interventions are taken. With optimal amplification, should be able to detect all the sounds of speech and identify environmental sounds. Without amplification, is aware of loud voices about one foot from the ear and likely to rely on vision for communication.
PROFOUND 91 dB or greater Aware of vibrations more than tonal pattern. Many rely on vision rather than hearing as the primary avenue for communication and learning. Speech and oral language will not develop spontaneously without modifications and intervention. Speech intelligibility often greatly reduced and atonal voice quality likely. Residual hearing can benefit from amplification. Potential candidate for a cochlear implant. Use of a signed language or a signed system may benefit language development.
UNILATERAL HEARING LOSS Until recently, children with unilateral hearing loss did not have their hearing loss detected until they were in school. Now, with the advent of newborn hearing screening, we are detecting the presence of a unilateral, hearing loss during the first year of life. A review of the literature indicates that children with unilateral hearing loss may be at risk for speech and language delays and/or academic challenges. We don't know, however, which children are at risk. We also do not know at precisely what age the unilateral hearing loss has an impact. The Colorado Home Intervention program (CHIP) offers consultation to families of children with a unilateral hearing loss until that child reaches 3 years of age. As part of the consultative service, we suggest parents participate in an evaluation of the child's development. In this way, we can detect if and when the hearing loss affects the child's development. A research team at the University of Colorado Boulder is collecting information about the development of children with unilateral hearing loss. While some children will never exhibit an effect from the hearing loss others may experience some challenges. It would be helpful for us, as a profession, to determine which children exhibit an effect and at what age the impact of the hearing loss is observed. We want to determine if the impact occurs before 3 years of age, during the preschool years (from 3-5 years of age) or after the child enters kindergarten.
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