Unilateral Hearing Loss in Children

Unilateral hearing loss, or UHL, is hearing loss in only one ear. Children with UHL can have trouble hearing and knowing where sounds come from. An audiologist can help.

On this page:

About UHL

Your child may have had a hearing screening after they were born. It may have shown a hearing loss in only one ear. Or, the hearing loss may happen when your child is older. This type of hearing loss will not keep them from learning to talk. However, they may have some speech and language delays because of the UHL. We do not yet know why some children have problems and others do not. You should talk to your doctor if you are worried about your child.

Learn more about how speech and language develops.

UHL can sometimes get worse, but it usually does not. Hearing that gets worse over time is a progressive hearing loss.

Signs of UHL

It may be hard to see signs of UHL in babies and young children. A child with UHL may have:

  • Trouble finding where sounds come from, called localization. It helps direct us to who is talking at any moment. Your child may miss some of a message if they do not know who is talking. It is also important for safety. If your child is near a street, they may have trouble knowing where a horn is coming from. This could put them in danger.
  • Problems understanding speech in noisy places. It is easier to focus on sounds when you hear from both ears.
  • Problems hearing you from another room or from outside. Sounds seem louder when we hear with both ears. When two normal-hearing ears hear together, sound seems louder. With UHL, your child may hear speech but not understand what is said.

When your child has trouble hearing, they may:

  • Get upset at not being able to hear.
  • Be very tired by the end of the day. This happens when they have to focus on speech all day.
  • Seem like they are not paying attention.
  • Answer questions wrong.
  • "Act out" or have tantrums when frustrated.
  • Turn the TV or radio on too loud.

Testing for UHL

Any child with hearing loss should be seen by an ear, nose, and throat doctor, or ENT. The ENT will look in your child’s ears and check for fluid in the middle ear. The ENT may order special tests to find out why your child has UHL.

An audiologist can test your child’s hearing. This will include tests of his middle ear. The audiologist may do special hearing tests, if needed.

Your child may see a speech-language pathologist, or SLP. The SLP will test their speech and language. The local early intervention, or EI, program can see children under 3 years old. Your child may get services from the EI program. They can suggest activities you can do at home to help your child.

Treatment for UHL

Your child may be able to use a hearing aid. It depends on their age and the amount of hearing loss. Your audiologist will help you decide what is best for your child.

Your child may need speech and language treatment. An SLP can help your child learn to speak clearly. The SLP can teach your child to listen to sounds and find where they come from. Both the audiologist and SLP can suggest ways to help your child hear at home and at school.

Tips for Helping Children With UHL

There are things you can do to help your child hear and learn. They include:

  • Making sure that your child's "good" ear is facing sounds. Think about this when you are feeding your child and when you are in the car. Your child should face the person speaking.
  • Look at your child when speaking to them.
  • Talk about what you are doing. Say things like, "I am making a sandwich," or "It's time to wash the dishes." This teaches your child words and sentences.
  • Repeat words. Use new words to help your child say more.
  • Play listening games with your child. See who can hear the phone ring or who hears the dog bark.
  • Get your child's attention before talking to them. This may help them focus on what you say.
  • Help your child find where sounds come from.
  • Make sure your child puts the phone to their good ear.
  • Speak louder than usual, and face your child. Try not to talk to them from another room.
  • Teach your child to take care of their hearing. Have them wear earplugs when they are around loud noises. Make sure they do not turn the volume up too loud when using headphones.

A fun website for you and your child to visit is Dangerous Decibels. Your child might enjoy going to the "Virtual Exhibit" part of the site.

Tips for School

  • Look closely at the setup when choosing a day care center or preschool. Try to avoid situations where many classes are within one large area. This will be noisy.
  • Make sure that your child is seated near the teacher with their better ear facing the teacher. Being closer lets your child hear and see the teacher better.
  • Ask that the teacher give your child pictures and handouts to go along with verbal lessons.
  • Make sure that your child is not seated with their normal-hearing ear facing a noisy hallway or air conditioner.
  • Make sure the teacher knows how your child’s hearing aid or frequency modulation (FM) system works. Have extra batteries for these systems in the classroom.
  • Talk to your child's teacher to monitor your child's progress. If you or the teacher have concerns, ask for further testing.
  • Let your child's teacher know that your child may have trouble localizing sound. For example, they may not hear when someone calls their name on the playground.
  • Seek help if you notice your child is becoming frustrated or having trouble making friends.
  • Share with your child's teacher what you have learned about UHL. Give the teacher written information about UHL.
  • Ask to talk with an educational audiologist or other professional who works with children who have hearing loss. This person can work with your child and the teacher on strategies to help your child in school and with friends. This person can also make sure that the classroom has the best acoustics. These are changes to the room that lower noise levels.

Tips for Home

  • Make your home "listening friendly." There are things you can do to reduce noise. Use carpeting and cloth curtains. Replace buzzing fluorescent lights. Run noisy appliances, like the dishwasher or washing machine, when your child is not home or is sleeping.
  • Try not to let your child's normal-hearing ear face noise sources, like the dishwasher, air conditioner, or radio.
  • Do not have the TV or radio on while eating dinner or at other times when you are talking with your child.
  • Be aware of where your child sits at the dinner table. Try to have the child facing those who will be talking to them.
  • Be aware of where your child is seated in the car. For example, a child with hearing loss in their right ear should sit behind the passenger seat. This lets their normal-hearing ear face the other people in the car.
  • Do not give your child instructions from another room. They will likely hear your voice but may not understand what you are saying.
  • Teach others the things that you have learned about helping your child.
  • Make sure that your child’s hearing aid is working. A hearing aid that does not work is much worse than no hearing aid at all.

You can help your child with UHL learn to help themself. What you do now will make a difference!

The information on this webpage has been adapted from the doctoral project of Sarah McKay, AuD, CCC-A.

To find an audiologist near you, visit ProFind.

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