Conductive hearing loss

For family education. This resource is not an individual diagnosis or treatment plan. Discuss concerns with an appropriately qualified professional.

What it means

Conductive hearing loss occurs when sound is reduced as it passes through the outer or middle ear. The inner ear may still function normally. Hearing can be temporary, fluctuating, or persistent, depending on the cause. A child who hears loud sounds may still miss softer speech.

Causes and risk factors

Causes include middle-ear fluid, earwax blockage, eardrum problems, and differences in the ear canal or middle-ear structures. Acute infection can contribute, but persistent fluid may occur without infection. The cause determines whether observation, medical care, surgery, or hearing technology is appropriate.

Signs and everyday impact

A child may respond inconsistently to speech, need louder sound, struggle in noise, or show communication delays. Some have ear discomfort or balance changes; others show no obvious symptoms. A passed newborn screen does not exclude hearing loss that develops later.

Assessment and diagnosis

A pediatric audiologist measures hearing with age-appropriate behavioral and/or physiological tests. Otoscopy and middle-ear measures help locate the problem; an ear, nose, and throat clinician may examine the cause. Hearing levels in each ear and the impact on communication guide follow-up.

Treatment and therapy

Treatment may address wax, infection, persistent fluid, or structural problems. Some children need ventilation tubes or other procedures, while others are monitored with clear review dates. Hearing aids or bone-conduction options may support access when indicated. Language and communication support should proceed when access is limited, rather than waiting indefinitely for a medical solution.

Support at home

Gain the child's attention before communicating, reduce background noise, and face them where comfortable. Use visual cues, signs, or other accessible communication as needed. Coordinate with childcare and follow the hearing review plan. Do not put objects or unprescribed products into the ear.

When to seek help

Sudden hearing change, significant ear pain with fever, swelling behind the ear, drainage, or a serious balance change needs prompt medical assessment.

Questions for the care team

• What is causing the sound transmission problem?
• How much hearing access is reduced in each ear?
• What communication support is needed while treatment or monitoring continues?

Terms in plain language

• Conductive: involving sound transmission through the outer or middle ear.
• Tympanometry: a test of middle-ear function.
• Bone conduction: sending sound through vibration of the skull.

Podcast preparation

Use this resource to prepare a later episode: define the topic, discuss causes and signs, explain assessment, describe treatment and home supports, then close with urgent signs and a next step.

Reacting to some sounds does not prove that a child hears all speech clearly.

Verify current clinical guidance and obtain clinical review before public recording.

Sources

1. Types of Hearing Loss | Hearing Loss in Children | CDC - https://cdc.gov/hearing-loss-children/about/types-of-hearing-loss.html
2. Hearing Loss in Children - https://www.asha.org/practice-portal/clinical-topics/hearing-loss-in-children/
3. Ear Infections in Children, Babies & Toddlers | NIDCD - https://www.nidcd.nih.gov/health/ear-infections-children

Sources accessed 3 October 2026.