Serious Hearing Loss in Children

There is a paucity of data describing the epidemiology of serious hearing impairment among children in the United States. This report provides information on the prevalence of serious hearing impairment among children born in the 1980s and living in a major metropolitan area. Data were drawn from a Developmental Disabilities Surveillance Program in Georgia.

Hearing impairment was defined as a bilateral, pure-tone hearing loss at frequencies of 500, 1000, and 2000 Hz averaging 40 decibels or more, unaided, in the better ear. Both severity and type of hearing loss were examined. The presence of mental retardation, cerebral palsy, vision impairment, or a seizure disorder was also assessed. An attempt was made to determine the probable etiology of a subset of the cases.

The average, annual prevalence rate for moderate to profound hearing loss was 1.1 per 1000. The prevalence rate increased steadily with age. Ninety percent of all cases for which the type of loss was recorded were sensorineural. The highest rate was seen among Black male children (1.4 per 1000). Thirty percent of case children had another neurodevelopmental condition, most frequently mental retardation. Black male children also experienced the highest rate of presumed congenital hearing impairment. The mean age at which children with congenital hearing impairment were diagnosed was 2.9 years. A probable etiology was found for 22% of cases.

(Van Naarden K. Prevalence and characteristics of children with serious hearing impairment in Metropolitan Atlanta. Pediatrics 1999; 103(3):570-575)

COMMENT: The failure rate for hearing screening in my district this year was 4.35% (43.5 per 1000). This is screening (not definitive diagnosis), and includes a number of children with middle ear effusions and only mild hearing loss.