Sensorineural hearing loss involves damage to the auditory nerve or inner ear, preventing the brain from receiving the correct signals. It is called mixed when both forms of hearing loss occur in the same individual.

Sometimes sensoroneural hearing loss has some potential for recovery. In those cases sound may still play a central role in activities. Here are some suggestions that you can use to facilitate recovery:

• Ensure that a visual or tactile clue accompanies all sounds which are presented to stimulate hearing
• It is helpful to provide toys which vibrate as well as sound
• If you place a child’s hands on a speaker they will feel the reverberation of the sound
• If you play a drum, the vibration can be felt as well as heard
• Try to find disco lights which flash in time to the music. It can help your child to develop a sense of rhythm.

It may help to judge as well as stimulate a child’s hearing if you gradually reduce the volume of a piece of music in a play session. Be expressive when you communicate. Use sign language as well as speech even if your child is not learning to communicate with signing.

If an infant does not seem to response to sound, the earlier the hearing damage is detected and confirmed the better. There are a variety of tests and techniques including: the behavioral audiogram, visual re-enforced audiometry and conditioned play audiometry, which are used by well-trained pediatric audiologists to diagnose hearing impairments.

Very young infants who are not responsive can be tested for hearing loss using an auditory-evoked potential which measures the lowest possible sound level which produces a brain wave in the child. The test can determine whether the child can perceive sound, sending signals to the brain along the auditory nerve. What it cannot determine is how the brain processes the signal.

Both types of hearing loss may be present in the child with cerebral palsy, and an examination by a well-trained pediatric audiologist can help measure the extent of hearing loss.

An infection (otitis media) is a common, minor ailment which can affect disabled and non-disabled children alike. Many children without disability have been wrongly thought to have developmental delay because of this condition. It is an infection of the middle ear which can have a serious effect on the child’s hearing due to the production of fluid ‘glue’ in the middle ear. It is slightly more common in pre-term infants than those born at term. For children with CP who have long-term problems with hearing due to brain damage, otitis media can occur in addition. Quite separate to any brain damage otis media can have a further, unnecessary, disabling effect on the child. It can be very frustrating to be unable to distinguish the sounds that are going on around you and have restricted mobility. It is already difficult enough to make your way through the developmental maze without the added complication of a curable infection. It is vitally important that you get your child’s hearing checked regularly as otitis media is much more difficult to pick up in a child who has CP. There is sophisticated machinery available which can detect this condition fairly easily so that treatment can be rapidly administered.

Depending upon the type of hearing loss, hearing aids can be very effective in helping the child to hear as much as possible. Hearing aids can be worn starting in infancy. One downside to hearing aids is that they amplify all sounds, background noises as well conversation so that it can be confusing for children who have additional types of disabilities to sort out the signals.

Try these ideas to keep your child's hearing aids and glasses on (should they also have vision impairments):

• Put special tape made for sticking to skin over the hearing aid to keep it on. Look for something called "toupee tape;"
• Keep glasses on with a headband
• Attach the hearing aid to the glasses
• Make sure your child's earmolds fit well so they don't slip out easily
• If your child uses a wheelchair with a headrest, make sure the pillow doesn't push on your child's ears. And make sure the headrest holds the head steady enough so the hearing aid doesn't get knocked out.

If your child has cerebral palsy and a hearing loss, he may need help that's different from other children with a hearing loss. It might be harder for him to learn how to talk, because both cerebral palsy and hearing loss can make talking hard. It might also be harder for him to learn sign language, because cerebral palsy can make it hard to control how his arms and hands move.

These movement (motor) problems make it harder for your child to express his thoughts. So try to make it easier for your child to communicate:

• Make up signs or gestures that are easy for your child to do. Watch how your child copies your signs. This will tell you what he can do at that time. Starting with signs that are easy for his hands and arms will help him communicate and feel proud of himself, too. His signing may improve over time.
• Ask your child's teachers and therapists for ideas about how to help your child communicate with you at home.
• When your child is very young, watch which way he's looking. Use this as a way to understand what your child wants.
• Watch where your child points or touches. This may show you what he wants to talk about. Then you will need to fill in the words or signs for him.
• Sometimes pictures can help. You can make a board with pictures or photographs of some things that your child may want, and teach him to use the board to ask for his bottle, cup, snack, television, etc.

Usually, children can understand others easier than they can tell others what they want. But your child may need extra clues to figure out what's going on. Your child will need some help to know where sound is coming from. This is because moving his body or even turning his head is hard work. And his hearing loss makes it even harder. Your child will need extra time to turn to the person who is talking to him. Slowing down all communication will help a lot. If things are said very fast, your child will miss important information.

Communicating with Pictures

Finding other ways to help your child to communicate is called augmentative communication. Your child needs to have a way to understand what other people are saying. He also needs a way to say things so that other people can understand him. If talking and signing are both too hard, ask the audiologist (specialist in hearing) about other ways to communicate. 

• Sometimes children can learn to use pictures to say what they are thinking
• Your child could use a special computer that helps him communicate
• Make a picture board so that your child can see, touch and feel things that can help him understand the daily schedule. (A picture of a toothbrush could remind him that you brush your teeth and get dressed in the morning.) Start out easy with things that he can see. Then build on what your child learns before talking about things that he cannot see or know.

Different children will need to get information in different ways - through pictures, gestures, sign language, speech, touch, and by doing things for themselves. This is called a "multi-sensory" approach to learning.

Communicating with friends and family

Help other people in your family communicate with your child.

• Ask your family and friends to make sure your child can see them before they start talking or signing. Sometimes children with cerebral palsy have trouble with their vision, and sometimes look out of the side of their eyes, which makes it harder. Being patient helps a lot because even turning and looking is hard work for some children.
• Explain to your family and friends that your child needs them to talk and sign slowly and clearly.
• Ask people to use more expression and gesture to keep your child's attention and interest.
• Ask them to be patient, and wait for your child to respond. Sometimes it is hard to understand the answer, so you may need to translate for others at first.

For proper language development and normal speech a child needs to be able to hear correctly. They need the auditory cues required for normal language development. Children who suffer hearing impairments frequently have a delay in developing language skills. A thorough understanding of the scope of impairment is mandatory in being able to give the child with CP the best education possible. Because 5 to 15 percent of children with cerebral palsy have hearing impairments, it is important to have your child’s hearing checked early and often.