03.2020
Author Prof. J. Spranger, University Department of Pediatrics Mainz

Children with mild to severe hearing loss of 26-40 decibels or more exhibit poorer language development and school performance than those without. Dutch paedaudiologists examined the relevance of mild hearing loss (- 16-25 db) on school performance and behavioural problems [1].
In a cross-sectional study, they examined whether there is a link between the hearing of 2399 children aged 9-11 years and CITO test scores, which assess language and academic skills, mathematics and world orientation (which includes geography, biology, history). In addition, they examined whether there is a link between hearing capacity and the results from the Child Behavior Checklist, a validated parental questionnaire used to assess emotional and behavioural problems in children.
Taking into account covariates such as gender, birth weight and social background, a slight, but significant, correlation was found between hearing impairment and reduced CITO scores that provide information on school performance. Of particular interest were speech-in-noise tests that assessed the speech reception threshold in a noisy environment, as you would find in a classroom. Both language and mathematical skills were negatively affected in children with mild hearing loss. In the speech-in-noise test, girls with impaired hearing also had higher attention problem scores. Differences were found not only with bilateral, but also with asymmetric hearing loss.

Comment: A child with mildly impaired hearing does not need hearing aids but should probably be seated in the front of the classroom. Audiologists know that speech sounds softer to a person with mild hearing loss, which requires them to pay closer attention and causes them to become tired a lot quicker. Hearing impairments can especially be expected in children who previously suffered from neonatal problems such as hypoxia, hyperbilirubinemia, and sepsis [2].

References:
[1] Le Clercq CMP, Labuschagne LJE, Franken MJP, et al. (2020) Association of Slight to Mild Hearing Loss With Behavioral Problems and School Performance in Children. JAMA Otolaryngol Head Neck Surg. 146
(2): 113-120. doi:10.1001/jamaoto.2019.3585. [2] Butcher E, Dezateux C, Knowles RL (2020) Risk factors for permanent childhood hearing impairment. Arch Dis Child 105(2):187-189.