Levels of Hearing Loss in Children

An audiologist plots a child’s responses to sounds on a graph called an audiogram. Test sounds vary in pitch from low to high pitch, measured by frequency in cycles per second. These sounds also vary in loudness (measured in decibels – dB). How loud a sound must be in order to be just barely heard represents the degree of hearing loss.

0 – 15 dB: Normal Hearing

Responses within this range suggest that a child has normal hearing ability. When understanding their ability to hear/understand speech it is important to consider their listening environment. A child with normal hearing ability can still have difficulty understanding in background noise at home or in school. Because a child is still learning language they need better hearing and a quieter environment than an adult to understand speech.

16 – 25 dB: Minimal Hearing Loss

  • has difficulty with quiet or distant speech
  • can miss up to 10% of the speech signal when the speaker is more than 3 feet away or there is background noise
  • unaware of subtle conversation cues
  • tires in listening situations and becomes restless
  • has implications for learning language and following verbal instruction in the classroom can be conductive or sensorineural (temporary or permanent)
  • may require hearing aid amplification
  • may require special classroom amplification and instruction

26 – 40 dB: Mild Hearing Loss

  • may miss 25-40% of the speech signal
  • depends on visual cues to understand speech in background noisev
  • appears very inattentive, “daydreams”
  • becomes very tired in situations where just listening is involved
  • needs hearing aid amplification and classroom amplification
  • needs referral for follow up with a speech language pathologist

41 – 55 dB: Moderate Hearing Loss

  • misses 50-100% of the speech signal, depending on the listening situation
  • requires visual cues in conversation
  • will have delayed language, limited vocabulary and imperfect speech
  • communication is significantly affected and socialization becomes an issue
  • requires hearing aid amplification and classroom amplification
  • special education / resource may be required depending on when the loss is identified and treated
  • speech – language pathology services needed

56-70 dB: Moderate Severe Hearing Loss

  • normal conversation must be on a one – to – one basis, with no background distractions
  • visual cues essential during communication
  • child will have delayed language, poor speech intelligibility and atonal voice quality
  • requires hearing aid amplification and classroom amplification
  • resource help in the mainstream classroom
  • speech – language pathologist to follow

71 – 90 dB: Severe Hearing Loss

  • with proper amplification, should be able to identify environmental sounds and detect sounds of speech
  • speech and language will be significantly delayed
  • may choose a Total Communication approach to language and prefer the company of other children with hearing loss
  • requires hearing aid amplification
  • may need placement in a class for the hard-of-hearing, for some subjects
  • may benefit from personal FM system

91 dB – > : Profound Hearing Loss

  • more aware of vibrations than tonal patterns
  • rely heavily on visual information for learning and communication
  • adopt Total Communication or Sign Language
  • education in program for the deaf to emphasize language skills and academics
  • amplification choices include hearing aids, personal FM systems, vibrotactile hearing aids and cochlear implants

Unilateral hearing loss (one normal hearing and the other ear with hearing loss):

  • difficulty with faint of distant speech
  • difficulty localizing sound and voices
  • difficulty in background noise
  • difficulty detecting speech from the ‘bad’ ear, especially in group discussion
  • often treated as though they have ‘selective’ hearing
  • tire in noisy listening situations, may appear inattentive or frustrated
  • may benefit from personal or classroom FM system
  • in quiet settings, a CROS hearing aid may be of benefit
  • need favourable seating and lighting
  • educational services as the needs arise