Down's Syndrome Scotland - Learning Resources

Childhood Hearing Loss

Approximately 70-75% of children with Down's Syndrome have some degree of hearing loss.

Early identification and treatment of any hearing impairment is associated with significantly improved developmental outcomes.

    Key Point

    Developmental outcomes for children with Down’s Syndrome can be improved by early recognition and treatment of hearing loss.


    Types of hearing loss

    There are two types of hearing loss:

    1. Conductive hearing loss

    This is the most common type of hearing loss associated with DS. It is where sounds do not reach the inner ear. This can be due to:

    • stenotic (narrowed) ear canals
    • bone formation problems in the middle ear
    • wax build up,
    • Otitis Media with effusion (glue ear)
    • ear infections

    2. Sensori-neural hearing loss

    The cochlea or the auditory nerve that carries impulses to the brain does not allow information about incoming sounds to effectively transmit to the brain (hearing loss usually permanent).This is more common in children with DS.

    It is also possible to have a combination of conductive/sensori-neural deafness.


    Key Point

    Hearing loss is more common in Down’s Syndrome than in the general population. The most likely cause is a conductive hearing loss, however there is also an increased incidence of sensori-neural hearing loss.


    Hearing Impairment in Adulthood

    Adult onset of hearing loss is common in Down’s Syndrome and can be easily overlooked. Lifelong surveillance for hearing difficulties that occur, recur or worsen in adulthood is advised.

    Important conditions to consider are:

    • Sensory neural hearing loss (Early onset presbycusis) - this is common and can occur from early adulthood onward.
    • Chronic ear perforations/Discharge – childhood difficulties with glue ear can persist in adulthood causing chronic problems. Perforations/ear discharge may be visable on examination.
    • Wax Accumulation - this can impact significantly on hearing


    Key Point

    Remember that the child or adult may not complain that their hearing is poor. Hearing loss may present with changes to behaviour or level of functioning.


    Treatment Options can include:

    • The removal of any impacted ear wax
    • Antibiotic and/or decongestant medication
    • Grommet insertion
    • Hearing Aids
    • Cochlear Implant


    Newborn babies are screened as part of the neonatal assessment. To identify any degree of hearing loss quickly a full assessment should be conducted between 6 and 10 months of age. Annual reviews should be conducted until the age of 5 years, thereafter every two years. However if problems exist then more frequent assessments maybe required.


    Quick Quiz

    How often should hearing be checked?

    6 monthly
    2 yearly
    5 yearly

    Which of the following is a common cause of hearing impairment

    Impacted ear wax
    Narrowed ear canal
    Ear infection
    All of the above