Ages + Stages | Child Health + Development | Ages 11–14 | Ages 15–18 | Family Safety

Say What? Why Your Teen's Hearing May Be at Risk

How ear buds, iPads and other environmental factors are a risk to teen hearing and what you can do about it

Teens aren’t generally known for their superb listening skills. But if yours constantly responds with “What?” when spoken to, insists on blistering music volume and seems frustrated or withdrawn at school or home, something larger could be at play. Rates of hearing loss in adolescents have spiked dramatically in recent years. Your teen could be one of millions with noise-induced hearing damage, a condition that could have an impact on everything from safe driving to school success.

Sounding off

The chorus of “What?” is getting louder; hearing loss in adolescents has increased 31 percent since 1988, according to a 2010 study, with one in five teens now affected. For many, the hearing loss is noise-induced, and it’s permanent. The Journal of Pediatrics reports that 12.5 percent of kids ages 6–19 have suffered permanent damage to their hearing from excessive exposure to loud music, video games and environments.

That’s a growing problem, because according to a new Pennsylvania State University report, school hearing screenings don’t detect noise-exposure hearing loss, leaving teens at risk for undetected hearing loss, which can put a strain on academic progress, college prep, relationships and home life. Even mild hearing impairment can undermine speech and language development, and require school accommodations such as speech therapy and auditory training.

But teens and parents who don’t know there is a problem can’t seek help. Noise-induced hearing loss in children and adolescents is underreported, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). Teens often don’t realize their hearing is subpar until they’ve already fallen behind in school, says Rebecca M. Fischer, Ph.D., a professor of audiology and director of the Communication Disorders program at Middle Tennessee State University.

“Teens don’t usually notice a gradual change or loss in their hearing,” she says. “Usually, the ones to notice a teen’s hearing damage are relatives and friends. And sometimes, hearing damage sustained during the teen years doesn’t show up as hearing loss until the 20s or 30s.”

A dull roar

What is hurting teens’ hearing? Most likely, it’s their behavior, Fischer says, specifically, the near-constant use of iPods and other personal listening devices. The Journal of Pediatrics study points to excessively loud earbuds for the spike in children’s hearing problems; the 115-decibel maximum volume on an iPod Shuffle is as noisy as a sandblaster or a loud rock concert, and loud enough to permanently damage hearing with regular use.

“Look around any high school or college campus, including ours, and you see teens and young adults with earbuds in, all the time,” Fischer says, noting that these devices aren’t regulated to protect young listeners. By contrast, the Occupational Safety and Health Administration (OSHA) strictly regulates noisy work environments to protect hearing.

Employers whose work environments are above 85 decibels (construction sites or airports, for example) have to provide a hearing conservation program for employees, including workshops, noise-protection devices like earplugs, and hearing tests, Fischer says. But a teen with an iPod or video game system can take in well above the level that OSHA deems safe, every day, for years.

Because personal listening devices are just that — personal — tracking and regulating teens’ use is difficult, says Stacey D. Watson, M.S., an audiologist with Seattle’s Swedish Medical Group. The sound is under the user’s control, and because teens are often away from a parent’s watchful gaze, parents probably won’t know if a teen is spending hours drenched in (literally) deafening sound.

Hearing 101

Hearing mechanics are complex, but essentially, sound enters the cochlea, the spiral-shaped structure in the inner ear, and causes cilia (tiny hairs) to vibrate. Thanks to the cochlea’s extra-sensitive nerve endings, the brain reads these movements as sound. But over time, exposure to high levels of sound can damage the cilia and impair hearing permanently.

Though hearing can be temporarily muffled after a single episode of loud noise — a raucous concert or a jet taking off — the inner ear usually bounces back from these relatively isolated incidents. But daily, extended, long-term earbud use is different, because the ear rarely gets a chance to heal when the listening device is always in use.

“Sound is really pressure,” Fischer says. “Think of the pressure of water on a grassy beach. Over time, the water comes ashore, and if the water has enough power, the grasses are washed away.” That’s how loud noise permanently compromises hearing — eventually, the pressure destroys the inner structure of the ear — and why constant exposure to high levels of it is so damaging, she says.

At first, this type of hearing damage affects the ability to hear higher frequencies of sound, including the softer sounds of speech, such as the “s” or “th” sounds, says deaf author and speaker Karen Putz, M.A., who penned The Parenting Journey: Raising Deaf and Hard of Hearing Children and writes the Deaf Mom blog.

“This can make it difficult for a teen to hear well in the classroom, in noisy situations and in crowds,” Putz says. “Women and children have voices in the higher frequencies, making it more challenging for a teen with noise-induced hearing loss to understand them.”

Sound safeguards

As attached as teens are to their earbuds, parents can exercise some influence, Fischer says. If a teen listens to a device or plays a video game at a “10” (maximum) volume, ask them to back it off to 8 or 9 for a week and stay there. “Over time, they’ll realize that they can actually enjoy sound without it being so loud.”

For daily iPod use, aim for the “two-thirds/one hour” rule: The volume dial should be turned up no more than two-thirds of the way, and teens should limit use to one hour at a time.

“If a teen can’t hear someone talk to them while listening to a personal music player, the volume is too loud,” Watson says.

For iPhone, iPad and iPod touch, parents can set a volume limit and prevent changes to that setting in the devices by entering “Settings” and viewing General/Restrictions. And hearing protection for concerts is a must; DownBeats earplugs are an affordable option that won’t offend style-conscious teens.

Teens don’t just need hearing protection for listening to music — they need it if they’re making music, too. Band members (whether the band is at school or in the family garage) and college music majors can be exposed to damaging levels of sound daily, Fischer says. Young musicians can protect their hearing with specially designed, high-fidelity earplugs that reduce sound without changing it, allowing musicians to hear bandmates. (Check out Musicians Earplugs.)

Complaints of ringing or other sounds in the ears (known as tinnitus), pain the ears or a feeling that the ears are “plugged up” are signs to ease off on personal music players for a few days. If hearing loss is suspected, an online hearing test can provide some insight, with follow-up by an audiologist if needed, Putz says.

Relatively minor lifestyle tweaks can make a major impact on hearing quality, and quality of life, for teens, Fischer says. “Our hearing mechanism is pretty wonderful” — and too valuable not to protect. 

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