Types of hearing loss

Hearing loss may be mild, moderate, severe or profound and can be temporary or permanent. It can affect one or both ears.

Temporary hearing loss

Temporary hearing loss is mainly mild or moderate in nature and is usually caused by ‘glue ear’. Glue ear is caused by a build-up of fluid in the middle ear cavity which affects the ability of the ear to ‘conduct’ sounds to the inner ear. Glue ear is very common in young children during foundation stage and key stage 1 and for most children, this will not affect their progress and attainment in the longer term. For some children with persistent ‘glue ear’, health services may offer grommets or temporary hearing aids.

Permanent hearing loss

Permanent hearing loss may be conductive in nature, due to malformation of the outer or middle ear, or sensorineural, which is damage to the inner ear or the auditory nerve. The majority of children with a permanent hearing loss are usually issued with hearing aids and those with a severe to profound sensorineural loss may have cochlear implants. Children and young people may require some level of support by an Advisory Teacher of the Hearing Impaired. Some children or young people with hearing loss require minimal support and others will need a high level of individualised and specialised help (from the Speech and Language Therapy Service, for example).

Unilateral (hearing loss in one ear) or mild loss

What do you notice about the child or young person?

  • Child or young person sometimes mishears words or instructions and needs reinforcement and reassurance before beginning tasks.
  • They may appear not to be listening or following what they’ve been asked to do.
  • Fluctuations in attention; may struggle to listen for long periods of time.
  • Difficulty in understanding peers in group discussions, due to background noise or on the playground; this could lead to anxiety and feeling isolated.
  • For children and young people with a conductive element to their loss, frequent ear infections and absences for medical appointments.
  • A child or young person with a unilateral loss may struggle to locate sounds and voices, especially during sports or physical activities and when there is a lot of background noise.

Moderate to severe hearing loss

What do you notice about the child or young person?

  • Children or young people with a moderate or severe, bilateral, hearing loss will normally be prescribed hearing aids.
  • The child or young person may have delayed language development.
  • They may have difficulties in perceiving some speech sounds, especially at the end of words.
  • There may be ongoing difficulties in the acquisition of new and the understanding of subject specific vocabulary.
  • The child or young person may take longer to process and follow verbal instructions.
  • They may have difficulty accessing activities which involve listening without lip-reading. For example CDs, DVDs spelling tests, video, YouTube clips and any electronically recorded speech.
  • The child or young person may become tired towards the end of the school day due to having to concentrate so hard on listening, especially in more noisy environments.
  • They may find it harder to adapt and/or function in less favourable acoustic conditions or when there are high levels of background noise.
  • The child or young person may have issues with self-esteem, emotional well-being and social knowledge.
  • The hearing loss may affect the child or young person’s social interactions. For example, tendency to rely on peers, observing behaviour and activities to cue into expected responses, withdrawal from social situations and an increasing passivity and absence of initiative. Alternatively, children or young people may try to control and dominate conversation and social activity to ensure they can understand and take part.
  • Frustrations and anxieties arising from a difficulty to communicate, leading to associated behavioural difficulties and peer relationships.

Severe or profound hearing loss

What do you notice about the child or young person?

In addition to the difficulties described for a child or young person with moderate to severe hearing loss, the child or young person may:

  • Have difficulties with focusing and maintaining their visual attention for long periods of time – for example, lip reading different speakers and/or watching someone using sign support.
  • May have difficulties with literacy – for example, reading comprehension and grammatical structure and content in written English.
  • May not be able to benefit from usual approaches to learning to read.
  • May have delayed language development, gaps in vocabulary and general knowledge.
  • May have significant difficulty in processing verbal information at the same speed as their peers.
  • May miss out on incidental learning as they are unable to overhear conversations, programmes on the radio.
  • May need help with social interactions with their peers.
  • May find it difficult to maintain positive self-esteem and social confidence.
  • May need support to fully develop an understanding of others and maintain positive relationships with peers.
  • Without specialist support they will be at high risk of not achieving and maintaining levels of attainment in keeping with their age and abilities or making expected progress.