By Nora Heston Tarte

Hearing and vision problems in young kids often go undiagnosed. While school testing is designed to catch many ailments, kids are often suffering long before the school notices a problem or the tests aren’t designed to catch the type of hearing or vision impairment the child suffers from. This has a negative impact on the child’s academic performance, communication abilities and psychosocial development.

Diagnosing hearing and vision issues without proper testing is tricky because kids often don’t know they are suffering a problem since they don’t have a good baseline of what “normal” is. Luckily there’s a solution. Learn the signs and symptoms of hearing and vision ailments in children, the difference between tests and screenings and how, as a parent, you can intervene.


Hearing screenings are required by state law to be offered in all public, private and charter schools in Arizona and, before that, a child will have their first hearing test in the hospital as a newborn. “It is imperative to discover whether or not [your child’s] hearing levels are normal so that appropriate and immediate interventions can take place,” says Michele Michaels, hearing healthcare program manager at Arizona Commission for the Deaf and the Hard of Hearing in Phoenix.

These screenings and other tests can uncover a range of hearing problems from mild to profound loss. Often these issues are genetic and show up on a child’s first screening. Other times frequent untreated ear infections or injury cause permanent damage later in life. Some children experience issues not related to hearing at all but rather a faulty pathway between ear and brain such as auditory processing disorder or auditory neuropathy.

Parents can start looking for issues with hearing as early as four to six months old. By this time a child should be babbling and by age 1 they should be able to clearly say a few words. Even before then watching for a child to startle at loud noises is a good indicator of healthy hearing. A pediatric audiologist should be contacted if a parent notices any issues early on.

“There is no time to waste when it comes to a child’s ability to learn language. An older child who seems inattentive, says ‘huh?’ a lot, tugs or pulls at their ear, shakes their head repeatedly, turns the volume up on the television or has the volume so loud on their ear buds that you can hear it, may indeed have a hearing problem,” Michele says.

Having an informed parent helps. The screenings are painless, free and quick but test only for issues with hearing specifically (not other disorders as mentioned above). That means if a child passes a hearing test but is struggling in school or seems not to hear you often they may need additional testing to discover the root cause. Also, if a child fails a hearing test that doesn’t always indicate a permanent problem. Sometimes ear infections or congestion cause temporary hearing loss.

“A school screening by a trained and qualified screener is sufficient to detect any deviation from normal hearing and a child who does not pass the screening should be referred to a pediatric audiologist for a complete hearing test,” Michele says.

All hearing loss, even when mild, can have detrimental affects on a child’s academic and social life. Hearing is paramount for learning many lessons both at home and school. An inability to hear or process language correctly causes children to fall behind in school as well as in their social life because they cannot develop the peer relationships necessary to thrive.

If a hearing issue is detected there are steps parent and child can take to avoid setbacks. The state offers parents a comprehensive system of interventions to aid children in the classroom and help parents help their children. Hearing aids, cochlear implants, sign language, closed captions on the television, preferential seating and the use of sound fields and FM systems in the classroom have all been used to help kids who have less-than-perfect hearing.


Many parents are surprised to find out that there is a difference between a school vision screening or a traditional vision exam and an eye exam done by a pediatric eye specialist.  Vision screenings in schools are effective in catching issues with depth perception or stereovision (3D vision), color vision and distance acuity. A traditional eye exam will test for the items mentioned above as well as near acuity, eye alignment, refractive error, peripheral vision, neurological function, eye muscle movements, ocular health and eye pressure. However, there are other potential vision impairments that are not covered.

A comprehensive examination, done by a pediatric eye specialist, will also routinely look for how the eyes are working together while reading and doing near work.  Specifically, how the eyes work together, how they focus both up close and far away, and how well the eyes track and follow an object. These skills are vital for success in the classroom.

Vision screenings are recommended at 1 year, 3 years and 5 years of age and then every year after that.

“How the eyes track and follow is crucial for reading fluency so if this is delayed, this can cause problems in the learning to read stages which then can have a domino effect into the reading to learn phase,” says Alicia Feis, associate dean of academic affairs at Midwestern University, Arizona College of Optometry in Glendale.

Parents need to know the symptoms associated with vision impairments because children aren’t equipped to tell them they are struggling since they often don’t realize they aren’t seeing perfectly. Watch for these signs: a child complaining of eyestrain or tension headaches, poor academic performance, difficulty reading or no interest in reading, frequent squinting, tilting the head or closing one eye when viewing objects, constant eye rubbing after “near work” or work done close to the face, a wandering eye, seeing double, skipping or rereading lines often or letter reversal after age 8.

“Comprehensive vision exams can catch much more than how the eyes are ‘seeing’ but also how the eyes are developing and how they are working when the child is learning to read and doing things in the classroom that are related to learning,” Alicia says.

As with any ailment that could affect a child’s ability to learn, early intervention is key. The InfantSee program sees kids as young as six months old and it’s free. The testing checks for normal development and ensures the eyes are working well together. If there is a family history of eye turns or a “lazy eye,” infants should be checked early, as these conditions are often genetic.

Vision problems can have a lifelong affect on a child’s academic performance and with the ever-increasing presence of technology at school and home eye problems are more common than ever. If you’re worried, schedule an eye appointment with an eye doctor or ask your child’s teachers if they notice any troubling symptoms.






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