Hearing loss and cerebral palsy
One Australian study of 685 children with CP between 1999 and 2004 found that 13 per cent had some kind of hearing impairment. Three per cent to four per cent had a severe to profound hearing loss.
The study found that those children with a hearing impairment were more likely to have a hypotonic or dyskinetic form of cerebral palsy and were also likely to be more severely affected than those without hearing loss.
Better developmental outcomes for children with hearing loss result when interventions of support and resources are put in place as early as possible.
View more information on the NCB website about early intervention for children with hearing loss, other guidance and sign posting for parents.
Types of hearing loss
Children with CP can have either a conductive or sensori-neural hearing loss. It is also possible to have a combination of the two. Possible treatments will depend on which kind of hearing loss a child has.
Conductive hearing loss occurs when sounds are unable to pass from the child’s outer ear to their inner ear as the result of a blockage or a disorder of the hearing bones.
In cerebral palsy this is commonly as a result of otitis media with effusion, also known as glue ear. This is defined as inflammation of the middle ear, accompanied by the accumulation of fluid in the middle-ear cleft.
Practitioners or parents who suspect a child has glue ear should seek an initial assessment from a GP or formal assessment from a paediatric audiologist.
Features that suggest a child may have glue ear include:
- Hearing difficulty (for example, mishearing when not looking directly at the speaker, difficulty in a group, asking for things to be repeated)
- Indistinct speech or delayed language development
- Repeated ear infections or earache
- A history of recurrent upper respiratory tract infections or frequent nasal obstruction
- Behavioural problems, particularly lack of concentration or attention, or being withdrawn
- Poor educational progress
Treatment of glue ear
Usually when a child has uncomplicated glue ear, no intervention is required - because the fluid clears spontaneously and the hearing recovers. Where the condition persists it is recommended that there is a three month period of observation to determine whether the condition passes spontaneously or requires further investigation.
Children with persistent glue ear in both ears causing a significant hearing loss after this time can be considered for the surgical insertion of ventilation tubes, known as grommets. A grommet is a very small tube that is inserted into the child's ear through a small cut in their eardrum. It drains away fluid in the middle ear and helps to maintain the air pressure in the middle ear cavity.
Hearing aids should be offered to children with persistent glue ear as an alternative to grommets where surgery is not considered acceptable.
Sensori-neural hearing loss occurs when the sensitive hair cells either inside the cochlea or the auditory nerve are damaged. It is a permanent hearing loss.
Children are screened for hearing loss in the first few weeks of life. The possibility of sensori-neural hearing loss can be identified at this time and will lead to a referral to an audiologist for more detailed tests.
Treatment of sensori-neural hearing loss
Finding out that a baby has a hearing loss early means that parents will get advice and support right from the start. If a sensori-neural loss is confirmed by testing by an audiologist they will explain what the results mean in detail.
The audiologist will be able to explain to parents which sounds their baby can hear and which sounds they may have difficulty hearing.
Children with a sensori-neural hearing loss may benefit from the use of hearing aids in one or both ears. They may benefit the child by magnifying sound vibrations entering the ear. Surviving hair cells inside the cochlea or auditory nerve detect the larger vibrations, and convert them into neural signals that are passed along to the brain.
Cochlear implants may be recommended for children with severe to profound hearing loss - if they do not get enough benefit from hearing aids after trying them for three months. A cochlear implant team should carry out an assessment to find out if an implant would help before they consider proceeding.
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Reviewed: May 2015
Review due: May 2017
First published: Monday 24 June 2013
Updated: Tuesday 22 December 2015