Mixed hearing loss


3 million children under the age of 18 have some hearing loss, including 4 out of every 1,000 newborn infants.

There are 4 types of hearing loss:

  1. Conductive
  2. Sensorineural
  3. Auditory neuropathy/dysynchrony
  4. Mixed hearing loss

Mixed hearing loss or single sided deafness refers to a condition when there is no hearing or very little hearing in one ear and normal hearing in the other ear.  Many children with this condition are identified at birth through newborn hearing screening programs. If your child was not identified at birth, it can be challenging to recognize a problem exists.

The condition creates some unique challenges because your child will typically behave as being able to hear normally and will develop speech and language appropriately. However, the imbalance of hearing between the ears makes it hard to listen when background noise is present. This challenge can make it harder for your child to learn in school.

Patients can be seen by Texas Children's experts in Audiology and Ear Nose and Throat (Otolaryngology) and Speech Language and Learning.

Causes & Risk Factors

Causes include:

  • Genetic syndromes
  • Head trauma
  • Virus or other disease
  • Ototoxicity (literally means "ear poisoning"). This can be caused by exposure to drugs or chemicals that damage the inner ear or nerves inside the ear.

Symptoms & Types

Symptoms may include:

  • Difficulty listening when background noise is present
  • Difficulty pinpointing the direction of a sound
  • Difficulty hearing someone who is in another room or understanding what is said. Your child may be able to hear from a distance but may not always understand what is said.
  • Not seeming to listen or pay attention.
  • Responding incorrectly to a question or request.
  • Getting frustrated easily and acting out.

Diagnosis & Tests

Early identification and intervention of hearing loss usually results in favorable outcomes.

Your child will need a complete examination by an ear, nose and throat doctor (otolaryngologist). This doctor will:

  • Make sure wax build-up or fluid in the ear is not causing the hearing problem
  • Order special tests to see whether other factors are causing the hearing loss
  • Most likely refer you to an audiologist, a specialist who evaluates hearing

An audiologist will conduct tests to determine the degree of your child's hearing loss. This specialist will also recommend the type of equipment and treatment that are best suited to help your child's hearing.

Treatment & Care

Treatment may include:

  • Hearing aid: The type of hearing aid selected depends on your child's situation.
  • An FM system (a type of wireless system) along with hearing aids to hear better in noisy backgrounds.

Living & Managing

Speech and language should develop as expected; however, you can help.

For example:

  • Repeat words and expand your child's vocabulary by introducing new words ("terrific" instead of "wonderful")
  • Play listening games ("I hear the telephone ringing" or "Is that the front doorbell ringing?")

Your child faces additional educational risk due to listening challenges.

Ways you can help your child at home and at school in discussion with the teacher:

  • Learn about typical language development so you will be able to more easily notice if your child seems to be behind.
  • Get your child's attention before you talk.
  • Talk to your child on the side of the normal hearing ear.
  • Make eye contact when talking.
  • Be aware of your child's listening environment. For example, when talking, turn down the television.