Many children who are diagnosed with ADHD may have a common hearing disorder. According to Dr. Fred Bess, Vanderbilt Medical Center, five million school-aged children or 11.3 percent of all school children in the United States show some degree of hearing impairment. Dr. Bess found that 5.4 percent of children in schools have ''minimal sensorineural hearing loss'' (MSHL) that may go unrecognized. At the same time ADHD is the most commonly diagnosed behavioral disorder in childhood. Dr. Bess believes the two problems--ADHD and MSHL--overlap and are easily confused when children are observed.

Children who are deaf or hard of hearing may have ADHD, just like other children, but hearing difficulties may cause the child to appear inattentive, bored, and unable to focus. A recent study by an audiologist compared children with ADHD and MSHL. Both groups have academic difficulty and give inappropriate responses to questions. Neither group completed assignments and had trouble listening to oral presentations. Following directions was a problem. Both groups exhibited low self-esteem and tended to repeat grades.

In young children a common type of hearing loss called conductive hearing loss is generally correctable through medical and surgical options. Conductive hearing losses include broken eardrums, middle ear infections, ear fungus, or other hearing problems that may block the path of sound. Researchers have determined that 50 percent of children between birth and 5 years of age will experience a conductive hearing loss. Another study from the American Academy of Audiology noted that about 80 percent of elementary students suffer temporary hearing loss at sometime during the school year. These losses were generally undetected by parents and teachers.

A test called the Screening Instrument for Targeting Educational Risk (SIFTER) can diagnose the problem. Unfortunately, comprehensive audiologic evaluations are often not part of ADHD/ADD protocols.

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