Unilateral Hearing Loss in Children

These instructions are for patients who have unilateral hearing loss or hearing loss in one ear.

Important information about unilateral hearing loss:

A child with unilateral hearing loss (UHL) may experience more difficulties than a child with normal hearing in both ears. They may have a more difficult time listening from a distance, for example from another room or outside. In these situations, they may hear someone talking but may not always understand what is being said. They may also have trouble understanding speech in noisy situations. When both ears have normal hearing, it is easier to filter out noise to better hear speech. A child with unilateral hearing loss cannot do this as well.

A child with unilateral hearing loss may also have trouble figuring out which direction sound is coming from. This is known as localization. Localization is important when talking and listening in groups of people. It helps direct us to who is talking at any moment. Localization is also important for safety. For instance, if your child is near the street, riding a bike, or driving, they may have trouble localizing a car horn.

A child with unilateral hearing loss may be a candidate for a hearing device, such as a hearing aid, contralateral routing of signal (CROS) device, bone conduction hearing device (BCHD), or cochlear implant. Your audiologist will discuss whether a device is recommended and which is best for your child’s type and degree of hearing loss. They may also recommend other types of devices to help your child in school.

Patient instructions:

Supporting your child's hearing

• Raise your voice slightly when you are talking to them at a greater distance.

• Get your child’s attention before talking to them or giving directions.

• Make eye contact and use facial expressions when talking with your child.

• Look for cues that your child understands what you are saying.

• Try to be aware of competing noise sources that may make it more difficult for your child to understand what is being said (dishwasher, room air conditioner, TV, radio). Operate noisy appliances when your child is not home or is sleeping.

• Make your home “listening friendly.” There are things you can do to reduce noise. If possible, use carpeting and cloth curtains. Consider using corkboards instead of magnetic boards.

• Be aware of where your child’s “normal” hearing ear is facing in different situations. For instance, choose their seat at the dinner table, a restaurant, or in the car based on where they will hear and understand the best.

• In a group, try to position your child in a place where they can see everyone clearly.

Caring for your child with unilateral hearing loss

• Talk with your child’s daycare or school about ways to help your child in the classroom. Your audiologist can give you written information to provide to their teacher. Request the services of a hearing support professional (teacher of the deaf, educational audiologist) from your school district or county. These individuals will help your child’s teacher better understand the impact of hearing loss and determine ways to help your child in their classroom.

• If your child starts to show signs of an ear infection, take them to your primary care provider as soon as possible. Signs may include pain, tugging on the ear(s), increased irritability, difficulty sleeping, or fever. If your child has an ear infection or fluid in their ear, it could cause temporary hearing loss. Middle ear fluid may cause hearing loss in your child’s normal hearing ear, or increased hearing loss in their impaired ear. Although middle-ear problems are common in young children, it can be more harmful to your child than to a child with normal hearing in both ears.

• Make sure your child’s ears do not get plugged by earwax. Although earwax is normal, when it blocks the ear canal, it can cause temporary hearing loss. If you notice that your child has excessive earwax, take them to their primary care provider.

• Has your otolaryngologist (ENT specialist) told you that your child has enlarged vestibular aqueduct syndrome (EVA)? This is a finding of the inner ear that can be seen on a CT scan or MRI. If your child has EVA, be aware that a bump to the head can cause the hearing to worsen. If your child is showing signs that they are having more difficulty hearing, schedule an appointment with your audiologist.

• Start to think about “hearing conservation.” This refers to caring for the hearing that you have. Have your child use earplugs or protective earmuffs when they are going to be at loud events (fireworks, concerts). Being around extremely loud sounds or listening (music through earphones) for a prolonged amount of time can cause additional hearing loss. If your child is using a personal listening device, make sure they keep the volume at a reasonable volume and that they take “listening breaks.” As your child grows, teach them about hearing conservation. It should become a habit.

Contact your audiologist with any questions or concerns.

Center for Childhood Communication
1-800-551-5480

For non-urgent issues, send your audiologist a message in the MyCHOP portal.

Reviewed March 2026 Sarah McKay, AuD