Effects Of Hearing Loss In Children by Harvik Speech & Hearing Clinic

Generally, a hearing impairment greater than 25 dB in adults may lead to difficulties in communication. For children, a hearing threshold greater than 15 dB may lead to difficulties in speech-language acquisition and production. The table below details the effects of a hearing loss on children. It also shows recommended countermeasures.
Normal Hearing: -10 to +15 dB HL
Children have better hearing sensitivity than the accepted normal range for adults. A child with hearing sensitivity in the -10 to +15 dB range will detect the complete speech signal even at soft conversation levels. However, good hearing does not guarantee good ability to discriminate speech in the presence of background noise.
Minimal (Borderline) 16-25 dB HL
May have difficulty hearing faint or distant speech. At 15 dB, a student can miss up to 10% of speech signal when the teacher is at a distance greater than 3 feet and when the classroom is noisy, especially in the elementary grades when verbal instruction predominates. • May be unaware of subtle conversational cues, which could cause the child to be viewed as inappropriate or awkward. May miss portions of fast-paced peer interaction, which could begin to have an impact on socialization and self concept. May have immature behavior. Child may be more fatigued than classmates due to the additional listening effort needed. • May benefit from mild gain/low MPO hearing instrument or personal FM system dependent on loss configuration. Would benefit from sound field amplification if the classroom is noisy and/or reverberant. Favorable seating will help. May need attention to vocabulary or speech, especially with recurrent otitis medical history. Appropriate medical management necessary for conductive losses. Teacher must be educated to understand the impact of hearing loss on language development and learning.
Mild 26-40 dB HL
child can miss 25-40% of speech signal. The degree of difficulty experienced in school will depend upon the noise level in the classroom, distance from teacher and the configuration of the hearing loss. Without amplification, the child with 35-40 dB loss may miss at least 50% of class discussions, especially when voices are faint or the speaker is not in line of vision. Will miss consonants, especially when a high frequency hearing loss is present. Barriers beginning to build, with a negative impact on self esteem as the child is accused of "hearing when he or she wants to," "daydreaming," or "not paying attention." The child begins to lose the ability for selective hearing, and has increasing difficulty suppressing background noise, which makes the learning environment stressful. Child is more fatigued than classmates due to additional listening effort needed. Will benefit from a hearing instrument and use of a personal FM or sound field FM system in the classroom. Needs favorable seating and lighting. Refer to special education for language evaluation and educational follow-up. Needs auditory skill building. May need attention to vocabulary and language development, articulation or speechreading and/or special support in reading. May need help with self esteem. Teacher training required.
Moderate 41-55 dB HL
conversational speech at a distance of 3-5 feet (fact-to-face) only if structure and vocabulary are controlled. Without amplification the amount of speech signal missed can be 50% to 75% with 40dB loss and 80% to 100% with 50dB loss. Is likely to have delayed or defective syntax, limited vocabulary, imperfect speech production and an atonal voice quality. Often with this degree of hearing loss, communication is significantly affected, and socialization with peers having normal hearing becomes increasingly difficult. With full-time use of hearing instruments/FM systems, the child may be judged as a less competent learner.