Why would a very minor hearing loss cause so much trouble for a toddler?

Edited to add. I just talked to the mom. They weren’t hearing aids, they were ear tubes to keep fluid out of his ear.

That’s great news! I’m so glad the doctor discovered what was really wrong.

I think it is perfectly understandable the child was acting out. Not being able to hear well is very frustrating. When it is a young child they can’t pick up on cues like an adult who later suffers a hearing loss, because they are still figuring out everything in life. If you think of an infant, they cry and cry, because they cannot talk when they are uncomfortable; their communication for being unhappy or frustrated is crying. This young child was kind of stuck or delayed in that phase, even though his brain was maturing. He may have not always been crying, but he was frustrated and lost in a world where everyone else had a different perception of the world. That frustration can come across as noncompliance, anger, and disobedience.

Being able to communicate is so very important. Not only important to what we think of as verbal communication, but also behavioral communication and behavior in general. The other kids were directing each other during play, and he wasn’t hearing all of it. He had trouble socially, because he was at a huge disadvantage.

That young age is when we learn the most, of couse it affected him negatively, poor little guy. :(

Maybe this calls for another question, but my friend insists that her son was treated unfairly by the first doctor and her demands for deeper testing were ignored because she was black. She thinks that if she and her son were white, her complaints would have been taken more seriously. When she talked about his lack of speech and his behavior, the first doctor just assumed low intellect.

She thinks it made all the difference in the world that she went to a black pediatrician this time.

@keobooks If she truly feels she was discriminated, or her son, on based on her skin color, she needs to take steps to remove that doctor by contacting the medical board in your state. You may ask @rarebear or @drhat about how to proceed.

@keobooks I think it is possible she is correct. When I went to a neurologist a while back an incredible amount of the children in the waiting room who obviously had fairly significant brain damage were all black in that office. I could see one of those doctors not investigating black children as well as white children for other causes, because they so often saw black children with significant deficits.

I think (not sure) on your other Q I said something like doctors tend to see us in their own specialty. I say that on many Q’s. Meaning a psychologist might be more likely to diagnose autism, an ENT more likely would find the hearing problem, a pediatrician it might be a toss up, but if he often sees black children with cognitive deficits, he might stereotype.

@KNOWITALL I don’t think it necessarily is racism, or that such extreme steps be taken. I do think the doctor should be made aware, so hopefully it helps another child in the future. It would be nice if he did more than that, but most doctors don’t. Like refund some money or something. I mention money, because what else can he really do but apologize for overlooking the diagnosis, which he probably wouldn’t do either.

@JLeslie One kindergarten didn’t let me in, and told my mom they thought I was ‘slow’ because I was shy and didn’t want to talk to them. People working with children should definately be more aware and knowledgeable before telling a parent that kind of thing. Unacceptable.

I feel bad because I wonder how much subconscious racism I had myself. When I heard her demand that her son wasn’t delayed or damaged I thought she was just in denial. When she hinted around that she thought she and her son were being discriminated against because they were black, I think I thought “Oh great. She’s pulling the angry black woman routine” and I thought she was seeing conspiracy where there was none. His behavior was SO typical of children I’ve seen with cognitive delays that I thought she was just grasping at straws and wishing the truth were different.

Well, its a GOOD THING she kept up with it and took him to a different doctor. Better she find this out when he’s 3 than when he’s older and already in the special education system and been labelled with low intellect and neurological problems.

I wonder if maybe there is something simpler than inherent racism. Maybe it was harder to see inside his ears because his skin was so dark and this other doctor knew to look harder because he was more aware that it was harder to find abnormalities in dark skin. And he was more conscientious about it because he and most of his clients had darker skin.

I am just making a wild guess. I don’t know.

@keobooks It might not be racism, it might just be the doctor sees a lot of autistic kids and not a lot of hearing impaired children. You basically made the mistake that specialists make.

Mom’s often know, and we need to encorage them to get second and third opinions and see various specialists who will have different perspectives. We need to do it for ourselves also when we have medical amd psychological problems.

I’m pretty negative about doctors, and this is exactly why, they all too often diagnose incorrectly and don’t listen to us. But, I also try to understand they are human and most do their best. It’s the only way I can psychologically handle the dissappointment, is to try to have empathy for their mistakes.

A hearing evaluation should be one of the first tests done for developmental assessments for this very reason. I worked for several years in an inner city children’s hospital and the hearing test was performed before any additional evaluations were done, because one must ensure that the child can hear the clinicians’ instructions for all the other assessments.

Chronic middle ear fluid can linger behind the eardrum and not be visible if there’s no active infection. This can cause mild to moderate degrees of hearing deficit, which can fluctuate making it even harder for the child to learn to replicate the words they hear because it can vary as their hearing changes. This frustrates them because they can’t express themselves clearly, so they act out. The fluid and pressure in the ears can also effect their balance.

The pressure sensation is uncomfortable and can be like a toothache. Considering how common it is for adults to complain when they can’t pop their ears (just on Fluther there are dozens of questions about it), so imagine how out of sorts it would render a toddler or preschooler. Most parents are amazed at how differently their child behaves after having the tubes placed, and I experienced it with my son when he was 1. Recent research is also looking into inner ear disorders and their relationship to developmental disorders, too.

Sadly, we often saw kids being mislabeled and misdiagnosed. I can’t speak to any bias on the part of the physician who did not rule-out hearing loss. It is very sad to hear that it was a pediatrician who missed something simple as middle ear fluid. I would suggest that the mother send the results of the ENT visits to them, so they can at least learn from their mistake.

@hearkat Thanks. I hope the mom does that, at the least.

That age is such a crucial developmental stage for a child. Not being able to put sounds to words is like trying to make a blind person read without brail. If he cannot make sense of the world around him, he’s likely to act out. What if you suddenly lost the ability to see and someone said “oh wow look at that beautiful scenery!” That’d be pretty frustrating wouldn’t it?

When a baby is born, within 6 months they can identify their own language from the difference in speech patterns and rhythms from languages foreign to their own. By 12 months, they do not have sensitivity to unfamiliar sounds. Babies hearing is that finely tuned and developed by 6 months!
Second, 80% of meaning is expressed through tone, inflection and prosody- or how you say things. Only 20% is expressed through actual words- or what you say. That’s a vital part of language development—it becomes crucial when the kid grows up and has to navigate the working world.
My point is—there was so much more going on than just speech delay. It sounds like this child’s cognition had developed beyond his language and he was immensely frustrated. That happens when a kid’s cognition isn’t on par with their language. It’s also possible he was trying to communicate using the muffled sounds and intonations he could hear- and wasn’t getting responses. That also exponentially increases a kid’s frustration.
Then sometimes the frustration becomes ennui and the kid gives up, creating more language delays. Your friend’s kid’s anger actually was reflecting his innate intelligence and persistence.
I’m thrilled the mom didn’t give up.

@linguaphile – I was wondering if the odd sounds he made were his attempts to make the sounds he heard people saying. He’d just stare at us and say “Mehhh meeee mahhh.” a few times and then start screaming for no reason we could see. It was probably frustrating for him that we seemed to be saying stuff to each other but when he tried to join in, people just stared at him. Also, it was probably hard for him to figure out why other people got drinks, food and toys after making a few random sounds and he didn’t.

He is SO much more mellow now. And he came over last night and I was amazed at all of the stuff he was talking about and while it’s still garbled, it was fairly easy to figure out what he was trying to get across. Mostly he likes pointing to things and saying the words for what they are. He’s very pleased when other people repeat the words he said back to him. He looks like he’s thinking “Ahh.. it’s working now!”

That’s wonderful! I deeply hate to see children not being able to communicate. I don’t think there’s much worse for a child than having thoughts that can’t be expressed.

One more thing… It’s also, in many ways, far more difficult for a kid to have some hearing loss than it is for them to be profoundly deaf. If a kid can’t hear anything, people notice sooner and make accommodations. If a kid can hear some, people expect them to do more than they’re physically capable of and that is another contribution to frustration levels.

Just thought of something- using baby signs might help him cope while his speech catches up.

I know I said this already, but I am really just so happy this boy was diagnosed. After reading @hearkat‘s answer, I am quite disgusted this was missed by the pediatrician. Forget race, it is pure incompetence. What @hearkat wrote makes perfect sense. I remember when I was around young children much more years ago that hearing was automatically questioned when a child didn’t answer to his name, or did not react to sudden noises. I guess if his hearing loss is minor he would still hear a sudden loud noise? We used to clap to the side rear of a child to see if they reacted, and then of course get their hearing tested.

I really hope the mom somehow lets the first doctor know what has happened. I know I haven’t followed through like that always, because my anger, dissappointed and sadness had made me want to almost deny what a doctor had done and the pain he had caused me. I hope she has more strength.