Does your child hear normally? Normal hearing is important for language development, interpersonal communication, acquisition of new knowledge and responsiveness to environmental sounds. In the early years of life, hearing impairment may hinder one's development in language, social skills, learning and alertness. Hearing impairment can be congenital or related to factors such as disease, injury, drugs and aging. Mild hearing impairment may be difficult to detect. However, we may have some ideas about a child's hearing by observing his/her behaviours in daily life. The following are some indicators of hearing impairment in children : Main indicators has delayed response to soft sounds shows poor understanding of what other people are saying tends to lean forward or pay extra attention to the speaker's face while listening often complains that other people are not speaking clearly turns head to one side constantly while listening shows difficulty locating the sound source often requests for repetition by saying "Pardon?" or "Say that again" during a conversation has unclear speech often gives irrelevant answers or misinterprets instructions has earache or ear discharge complains of ringing/noise in the ears (tinnitus) understands speech much poorer than others in a noisy environment confuses words with similar sounds e.g. 'sin' and 'tin' Other indicators You may be aware that your child is having the behaviours listed below but you may never have related them to hearing impairment : has delayed speech / language development has poor attention in class has delayed responses to verbal instructions during group games or classroom activities, or responds only after watching peers' responses relies on peers' written notes more than teachers' verbal explanation during lessons prefers staying alone and is not willing to participate in group activities Hearing test Doing a hearing test is the most effective way of checking whether your child is hearing normally. Hearing screening test only takes a few minutes and the degree and nature of the impairment can be determined. During the test, the child needs to wear a set of earphones and respond to sounds as instructed by the tester. When combined with other assessments, the doctor or audiologist will be able to recommend a management plan for each individual case. Ways to protect hearing Never attempt to clean the ear canals with pointed or hard objects (e.g. ear pick) or put any foreign object into the ears. There is no need to clear the ear canals under normal circumstances because ear wax will move out of the ear canals by a self-cleaning mechanism of the canal skin Seek medical advice if any foreign object gets into the ear accidentally. Never attempt to get it out by yourself because you may end up pushing it further down the ear canal or damaging the ear drum Use earplugs during swimming and cotton wool balls while shampooing to prevent water from entering the ears. Dry the ears immediately afterwards with a soft dry towel or cotton wool balls to prevent discomfort and infection of the ears Loud noise may cause ear discomfort and tinnitus (ringing in the ears) and prolonged exposure to loud noise may result in hearing impairment. Preventive measures include : * Avoid lingering in noisy places such as video game centres, discos and karaoke boxes * Avoid playing toys/games that generate extremely loud sounds e.g. firecracker * Protect your ears by covering them with hands or using protective devices when exposed to loud noise e.g. construction works, low flying aircrafts etc. * Avoid using portable cassette/CD/MD players in noisy environments and try to keep the volume at or below "medium" . If grade 1 is the softest volume and grade 10 is the loudest, please adjust the volume setting to 5 or below. If you are using insert earphone, please adjust the volume to 4 or below. Please limit the listening time to less than an hour * Avoid prolonged use of earphones for listening to loud music * When using others' players or headphones, turn down the volume first and then gradually increase it to a suitable level Take medicines only under the advice of doctors or pharmacists. Overdosage of certain drugs can cause tinnitus and hearing impairment While blowing your nose, press on one of the nostrils and blow out the secretion gently from the other to prevent the secretion from contaminating the middle ear Watch out for hearing / ear problems in young children especially those with long-term nose problems Avoid injury to the head Seek medical advice if you suspect any problem with your child's hearing. Early detection and treatment can prevent the problem from worsening The Student Health Service of the Department of Health provides hearing test for school children. If you worry about your child's hearing, you can request for hearing screening during the annual health visit at the health centre