Children with slight hearing loss may do a little less well in school and may be a bit more likely to develop behavior problems, a new study suggests.

Hearing impairment that doctors and parents may have considered slight or mild "may actually be associated with both school performance and behavior," researchers write in JAMA Otolaryngology-Head and Neck Surgery.

Among nearly 5,000 Dutch elementary school children, slight or mild hearing impairment was linked with higher behavioral problem scores on questionnaires filled out by parents and with lower scores on standardized testing.

While the study can't prove mild hearing loss causes worse academic performance and behavior problems, "We would like to raise awareness that possibly slight hearing loss may have more effects in daily life than often assumed," said lead author Dr. Carlijn le Clercq, of Erasmus University Medical Center, in an email. "Children with slight hearing loss may benefit from a seat in the front of the classroom close to their teacher. And for children who seem to have trouble keeping up at school or whose attention span is limited, a hearing test could be considered."

Le Clercq and colleagues focused on children who had problems hearing tones below 25 decibels.

"Rustling leaves are approximately 20 decibels," le Clercq explained. "Maybe it is not a big deal if you can't hear rustling leaves. However, (for people who can't), almost all normal speech will be softer in their ears. You can imagine it takes more effort to understand that speech, especially if it is like that all day long."