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(Originally published in Summer 2005 SEE/HEAR Newsletter)

By Kate Moss (Hurst), Education Specialist, Texas Deafblind Outreach

Abstract: This article is about the importance of investigating the correctable problem of earwax buildup in visually impaired and multiply impaired children so that functional use of their hearing is maximized.

Key Words: Programming, ear wax, ENT

There are a variety of problems that can result in hearing loss. Deformities in the outer part of the ear or in the middle part of the ear can result in a conductive type of hearing loss. Fluid in the middle ear or an obstruction in the ear canal may also cause this type of hearing loss, which is typically mild to moderate and can typically be easily corrected. A mild to moderate hearing loss during critical periods of language development can greatly impact the child’s speech and language development. When the child is also visually impaired, having a mild to moderate hearing loss that goes uncorrected is a big deal.

Any child with visual impairments, but especially those with multiple disabilities needs to make good use of their hearing to learn many of the things they need to know in life and to accommodate for their reduced visual capacity. Children who are blind or visually impaired have only one reliable distance sense and that is their hearing. The development of good auditory skills is critical to learning in general and especially important for literacy. Orientation and mobility skills depend in part on using auditory cues and landmarks to know where you are in space. Special care should be taken with visually impaired or blind students to make sure there are no problems with hearing.

One problem that is often not considered, especially in a child with multiple disabilities, is a problem with earwax build up. Everyone’s ears produce earwax or cerumen. This yellowish wax is produced by glands in the ear canal and helps to keep the ear canal clean and healthy. The movement of the mouth and jaw help the wax to move out of the canal naturally, carrying with it dust, dirt, and dead skin cells. Sometimes, however, the wax becomes very hard and gets packed into the canal. When this happens, the effect is like putting in earplugs. Water may also become trapped behind the wax and create more problems. Because sound cannot get into the ear efficiently the person may experience a mild to moderate hearing loss. This may also cause a feeling of fullness in the ears, dizziness or even tinnitus (a ringing in their ears).

Some people naturally generate a great deal of earwax and some people are inclined to have wax impaction problems. But many people create wax impaction problems by pushing the wax into the ear canal as they attempt to clean it out of their ears with cotton swabs, pins and the like. Attempting to clean out earwax in this way can also result in eardrum perforations, infections in the ear canal, and/or dry, itchy ears. It is good rule to simply clean out the ears using your finger and a washcloth.

Children should be checked periodically for earwax build up. This can be done with an otoscope by the child’s pediatrician or ENT and may often be done as part of a regular physical. If there is a wax build up, the doctor may prescribe or suggest an over-the-counter drop to help remove the wax. If necessary he may need to remove the wax with warm water and a syringe, scrap it out with a curette, or use a device to suction it out.

Take note of how your child seems to use hearing, especially if he/she is visually impaired. Do there seem to be problems in certain situations? If so, make sure the doctor checks for problems with earwax buildup or other concerns. It is probably a good idea to have regular and periodic hearing tests done, even on your child with multiple disabilities. Hearing is too important a sense to allow correctable problems with hearing to go uncorrected.