Children under 10 are at significant risk of premature hearing loss Survey carried out for the 26th annual National Hearing Day on Thursday, 9 March 2

‘Around 1.3 million children under 10 have already seen an ENT specialist for tinnitus, according to their parents, and almost 660,000 children have been diagnosed with moderate to severe hearing loss’. A new JNA survey conducted by IFOP paints a worrying picture of the hearing health of children under 10. This survey of a representative sample of parents with at least one child under 10 is the first of its kind in France and forms a baseline. ‘We know that up to the age of 10, children’s ears are much more sensitive than those of adults. Alerted by doctors and those involved in prevention and healthcare to the dangers of noise for children, our association carried out this survey of parents and the results are terrifying. Our children’s ears are at risk! Hearing is the foundation for language development, socialisation and learning. We hope the government, specifically the Minister of Health and Prevention, take this on board’, said Prof. Jean-Luc Puel, President of the JNA Association. Facts and figures.

 9 figures to remember

• Around 1.3 million, or 14%, of children under 10 have seen an ENT specialist for ringing in the ears. This health issue is most prevalent in children over 5 (18%), the children of blue-collar workers (19%), those from the Île-de-France (23%) and children who use headphones or earphones every day (28%). 
• Almost 660,000 children under 10 who have seen an ENT specialist have been diagnosed with moderate to severe hearing loss. This figure is probably an underestimate as it only includes those diagnosed by an ENT specialist. 
• 55% of parents have already taken their child to an ENT specialist.
• 40% of parents said their child listens to music through earphones or headphones every day (less than 1 hour to 4 hours a day).
• 30% of parents said their child had already complained about noise.
• A third of parents (33%) have concerns about their child regarding hearing loss and tinnitus.
• A minority of parents (49%) feel well informed about hearing loss and tinnitus in their child and only 29% are aware of the relevant measures put in place by the government. 

Full analysis

Parents of children under 10 generally lack information on issues related to their child’s hearing compared to other issues

Asked about their knowledge of various health issues for their child, hearing loss and tinnitus are at the bottom of the list, with just under half of parents (49%) feeling well informed about the subject. This lack of awareness is the same as for autism. In contrast, Covid-19 (84%), screen addiction (79%) and obesity (74%) are the best understood health issues among parents, according to their responses. It should be noted that parents of children aged 5-9 consistently reported feeling better informed than those of children under 5; therefore, general knowledge of children’s health seems to improve as they get older.

More specifically, less than a third of parents (29%) said they were aware of measures related to hearing problems in children put in place by the government, of whom only 9% were ‘very familiar’ with them compared to 28% who were ‘not at all familiar’. Among the best informed on the subject are fathers (31%, +4% compared to mothers); young parents aged 18-24 (39%, +23% compared to those aged 50 and over); parents of children aged 5 and over (33%, +8% compared to those with children under 5); those who have three or more children under 10 in their household (39%, +11% compared to those with only one child); and parents living in the Paris area (34%, +8% compared to those living in rural areas). Blue-collar workers also reported being more aware of these measures than white-collar workers (38% for the former against 21% for the latter), since they are themselves subject to noise in their work and seek to protect their child from it.

Parents are less aware of the risks of hearing loss and tinnitus for their child than other, more topical issues...

32% said they were worried about hearing loss and tinnitus in their child, a similar percentage to fears related to obesity and Covid-19. This suggests that parents may identify these issues as more distant and easier to anticipate. The three most feared issues among parents are those with the most media coverage: cyber or school bullying (63%), environmental impacts (61%) and screen addiction (58%).

...But they consider themselves responsible for this issue and adjust their behaviour accordingly

The majority of parents (70%) said they could recognise if their child had trouble understanding speech, a percentage proportionate to the child’s age: 63% of parents with a child under 5, against 78% of parents with a child aged 5 and over (the age at which children are most able to express their feelings and make themselves understood). Again, blue-collar workers are more confident in their ability to identify these problems (76% against 63% of white-collar workers).

Parents also recognise the negative impact of noise on various aspects of their child’s life: fatigue (55%), sleep (47%), nervousness and aggression towards others (44%) and stress levels (43%), learning (44%) and use of screens (42%). Even so, they are less able to identify the impact of noise on their child’s hearing itself. Less than 4 in 10 think it could cause their child to have trouble understanding speech (37%), hearing loss (33%) or tinnitus (31%).

Asked whether they adjust the volume in various places in the company of their child, the majority of parents said they do, whether at home (76%, including 36% ‘often’), in their car (72%, including 33% ‘often’) or during parties at home (60%, including 24% ‘often’). This is particularly true with regard to young parents aged 18-24, Île-de-France residents and those on the highest incomes.

The vast majority of parents said their child had already been screened for hearing problems by a healthcare professional, usually a GP or paediatrician

In 84% of cases, their child under 10 has already been screened for hearing problems by a healthcare professional. The two most common providers of this test are GPs and paediatricians, each carrying out 46% of them. The former are consulted most often for children aged 5 and over (53%), by blue-collar workers (52%), by those who live in the provinces (47%) and by the poorest sections of society (50%), while the latter are the preserve of young parents under 35 (51%), those with children under 5 (50%), those from the Île-de-France (51%) and the most affluent (50%). 

To a lesser extent, a third (33%) of parents turned to an ENT specialist and others carried out this screening without going through them: the school medical service (in 35% of cases) and the maternal and child health doctor (in 25% of cases). The latter works particularly with young parents aged 18-24 (31%), blue-collar workers (33%), those from the Île-de-France (34%) and the poorest sections of society (31%). 

Just over half of parents have already taken their child to an ENT specialist at least once, for various reasons affecting short- or long-term hearing

55% of parents have already taken their child under 10 to an ENT specialist. This is particularly true of fathers (59%, +7% compared to mothers); parents of children aged 5 and over (64%, +18% compared to parents of children under 5); blue-collar workers (59%, +7% compared to white-collar workers); those living in the Paris area (67%, +16% compared to those living in rural areas); and parents with several children under 10 (63%, +11% compared to those with only one child). Parents therefore tend to turn to an ENT specialist in big cities, where they are more prevalent and accessible, and when they have several children who may already have experienced hearing problems themselves.

The main reasons for the consultation are ear infection (41% of parents have consulted an ENT specialist for this reason), earache (31%) and earwax build-up (23%). The most worrying reasons relating to long-term hearing loss in children were cited by just under one in five parents: trouble understanding speech (18%), and ringing and buzzing in the ears, i.e. tinnitus (14%). Among the 9.5 million or so children under 10 in France, around 1.3 million have therefore seen an ENT specialist due to tinnitus[1]. This health problem is most prevalent in children aged 5 and over (18%), the children of blue-collar workers (19%), those from the Île-de-France (23%), and children who use headphones or earphones every day (28%).

Hearing problems that justify seeing an ENT specialist are often raised by close family and friends or a healthcare professional, and the child plays a leading role in detection

The majority of parents who have taken their child to an ENT specialist were alerted directly by the child (56%) and around four in ten by a healthcare professional (41%) or their partner (40%). It should be noted that although fathers generally reported being better informed about hearing problems than mothers, they were also more likely to report being told about their child’s hearing problems by their partner (52%, +23% compared to mothers).

To a lesser extent, fewer than one in four parents were alerted by a relative or friend (23%), their child’s teacher (19%), or someone looking after them, such as nursery staff (18%).

 The child is therefore the most likely source of reports of their hearing problems, and around a third of all parents (30%) said their child complained about noise, a figure that increases with the child’s age: 23% of children under 5 and 38% for children aged 5-9. This raises the question of how hearing impairment is expressed by younger children, who may be unable to speak or identify their feelings.

After consultation with an ENT specialist, hearing loss was diagnosed in just under half of cases, meaning that in total, one in four parents are affected by this issue

44% of parents who took their child to an ENT specialist received a diagnosis of hearing loss, of which 32% was mild and 10% moderate, not requiring a hearing aid, and 2% severe, requiring a hearing aid. Hearing loss has been diagnosed by an ENT specialist in a quarter (25%) of all children under 10, of which 7% is moderate to severe. Around 660,000 children under 10 in France are therefore affected, a figure that is probably an underestimate since it only includes those diagnosed by an ENT specialist[2].

Moderate to severe hearing loss is diagnosed most often in children aged 5 and over (8%, +3% compared to children under 5); children with at least two brothers and sisters (10%, +4% compared to only children); and those from the Île-de-France (10%, +4% compared to those from the provinces).

Using headphones is an aggravating factor in hearing problems in children reported by their parents

40% of parents think their child under 10 listens to sounds through headphones or earphones every day: 21% for less than an hour a day, 13% for between one and two hours, and 6% for more than two hours. Parents whose child falls into this category are more likely to mention their complaints about noise (47%, +28% compared to other children) and a diagnosis of moderate to severe hearing loss (14%, +12% compared to other children).

Single-parent families reported that their child has more hearing problems and are more aware of the relevant measures put in place by the government

Parents raising their child in a single-parent household are much more likely to report that they complain about noise: 44%, against 28% for two-parent households. Furthermore, 57% said their child uses headphones or earphones, against 38% in two-parent households. One of the consequences of this extensive use of headphones or earphones is that parents in a single-parent household are disproportionately likely to have taken their child to an ENT specialist. This is the case for 66% of them (against 54% in two-parent households) and hearing loss has been diagnosed in 40% of cases in total, of which 20% of cases are moderate to severe (against 22% and 5% respectively in two-parent households).  

Since their children are more affected by hearing problems, single parents are more aware of the vigilance measures put in place by the government (39% said they were familiar with them, against 26% in two-parent households).

Given this situation, parents expect the government to act to protect their child’s hearing, above all through campaigns to encourage screening

Three-quarters (76%) of them think the government should make children’s hearing a national public health priority, of whom 18% ‘strongly agree’. Looking at the details, they want most of all for campaigns to be put in place to encourage screening for hearing problems (similar to those related to dental or eye health): this measure is called for by 41% of parents, way ahead of greater vigilance by various medical and educational stakeholders (20%), regular information campaigns on the subject (15%) and an action plan for greater inclusion of hearing-impaired children. Parents therefore expect more concrete action after the damage has been done (through more routine screening) rather than preventive action, as if hearing problems can only be treated once detected, not prevented at the root cause.

  [1] This figure is based on data from the survey; when the parents surveyed had several children under 10 in their household, they had to answer for their youngest child under 10. The result may therefore be an underestimate.

[2] This figure is based on data from the survey; when the parents surveyed had several children under 10 in their household, they had to answer for their youngest child under 10. The result may therefore be an underestimate.