Hearing problems are one of the main causes for poor language development and can easily be undiagnosed till it manifest in later childhood. The key in treating these conditions is the early diagnosis as well as early intervention. In order to do this, all children needs to be screened at some point of time through screening mechanisms as well as being aware of certain signs as symptoms.
What are the signs of hearing loss in young children?
In infants, hearing loss can be suspected if the baby does not startle, turn the head towards a noise, wakes up due to a loud noises, cannot be soothed by voice, does not babble, poor response in pointing towards familiar faces...etc.
The condition may precipitate in a older infant or in a child as poor response to environmental stimuli, not responding to the first call, not locating the origins of sound, not watching TV or watches TV or listen to the radio with high volume, poor in making sounds as well as in imitating words as other children.
The school going children can be detected by their teachers due to their poor school performance and language skills as well as their overly reactiveness or frustration.
How do you screen neonates and infants?
All new born babies are screened using a simple test called Otoacoustic emissions (OAE) test or the automated auditory brainstem response (AABR) test. In OAE, a mike is placed in the ear and the response made to soft clicks will be recorded. The test detects abnormal responses from the inner ear. The AABR would detect brain activity for sounds given through ear phones.
What are the tests that can be performed if hearing deficiency is suspected?
Two more tests are being used for infants of more than 6 moths of age and these are the Diagnostic ABR and Visual Reinforcement Audiometry (VRA). The VRA make use of visual stimuli to reinforce the turning of a child towards sound stimuli.
Elder children can be tested through Conditioned Play Audiometry (CPA) and will make use of play activities of the child in response to a specific sound.
When these kinds of facilities are not available distraction tests can be performed by the health care worker in order to screen for hearing deficiencies.
What can cause hearing problems in children?
There are two types of hearing losses.
Sensorinural hearing loss Conductive hearing lossSensorineural hearing impairment can result from many causes and could be congenital or acquired. The congenital defects are mainly associated with cochlear disorders. Pregnancy related infections such a congenital rubella syndrome or even a genetic disorder can present as a congenital sensorineural type hearing loss.
Meningitis and mumps seems to be two infections which can be associated with this type of hearing loss.
The conductive hearing loss can be the result of persistent middle ear infections or glue ear. In certain instances there can be congenital abnormalities in the middle ear or the ear canal leading to conductive type of hearing loss.
What are the treatment options available?
The treatment should be initiated immediately, preferably by the 6th month of life if detected early. The reason being that childs ability to hear and comprehend will have to develop earlier before developing the ability to speak.
Once the child is diagnosed of having a hearing problem, professional advice should be followed in treating the underlying condition.
Hearing aids and implants:
Hearing aids are the commonly used devices for such children and perfectly fitting ear aids can be designed for the childs need. If the hearing does not improve with wearing a hearing aid, a cochlear implant will be the plausible option. This electrical device can convert the sound signals from the outside into electrical signals and will bridge the non functioning area of the ear.
As mentioned earlier, most of the congenital hearing problems (95%) affect the cochlear and about 25% of them would benefit from such a implant.
Special education and language training:
There are many things that's needed to be done in order to improve the language and social skills of the child. These will include, specialist training in language, learning of sign language, making use of visual cues, understanding lip reading...etc.
At times, simple devices like recorders and players will help the child to listen and comprehend class teachings and perform well in the class activities.
Family and social support:
Family and social support along with confidence building would facilitate the psychological effect of hearing problems and should be considered very important.