Early intervention crucial for children with hearing loss

Each of the sense organs in the human body enables a crucial function. Any defect in one or more of these sense organs can affect the entire body and overall growth, especially in children. Hearing loss is one of such concerns observed in children.

For a growing child, speech and hearing are more important than an adult as those are the instruments of learning, playing and building social skills during the developing years. If a child suffers from hearing loss and it goes undetected or untreated, there is a lot that the child misses out on.

Delay in treatment or action can lead to delay in speech and/or language development, social behavioural issues and academic difficulties.

According to the World Health Organization (WHO), 60 per cent of childhood hearing can be prevented. The temporary hearing loss in many children can be restored with medical treatment or minor surgery. If a child has sensorineural hearing loss, it is permanent.

However, thanks to the advances in medical science, almost all kinds of hearing impairments can be treated if timely identified. Early intervention remains key for better outcomes.

There are two kinds of hearing losses in children — congenital (present from birth) and acquired (occurring after birth). Hearing loss is also classified as pre-lingual (before the development of language), peri-lingual (during language development) and post-lingual (after language development). 

What are the causes?

Hearing loss in children can occur as a result of various possibilities, irrespective of being congenital or acquired. Children can suffer from conductive, sensorineural or the mixed form of hearing loss.

Some of the possible causes of congenital hearing loss are:

• Infections at the time of pregnancy (German measles, toxoplasmosis, and cytomegalovirus)
• Medication like Ototoxic used during pregnancy
• Birth complications
• Nervous system or brain disorder
• Genetic syndromes; for example, Ushers, Down’s and Waardenburg’s syndromes
• Family history of hearing loss

Acquired hearing loss is likely to happen due to some of the following reasons:

• Middle-ear infections left untreated
• Other infections like meningitis, mumps, measles or whooping cough
• Eardrum perforation
• Excessive exposure to extreme noise, such as fireworks or loud music
• Diseases like otosclerosis or Ménière’s disease
• Head injury
• Ototoxic medication
• Earwax

Early diagnosis and intervention

The most effective treatment is achieved through early diagnosis and intervention. Universal newborn screening is done at birth to identify children with potential hearing loss. When identified, these children can be further assessed with a series of audio logical tests and radiological assessment of the inner ear structures.

Children with severe to profound hearing loss can be treated as early as when they are eight months old with the help of cochlear implant surgery. With this surgery, the child can undergo aural habilitation and develop good hearing and speech. This enables the child to enter mainstream schooling and lead a normal life.

The neural emergency period in congenital hearing loss is up to the age of two. If intervention is done within this period, the best possible outcomes in terms of speech and hearing can be achieved. Delay in surgical intervention by cochlear implant surgery, can lead to poorer outcomes in hearing and expressive language.

Signs of hearing loss in children

For that, it is significant to observe the child for any signs of potential hearing loss. Some of the noticeable symptoms include:

• Turning up the TV volume excessively high
• Not responding appropriately to questions
• Not replying to calls
• Have articulation problems or speech/language delays
• Academic struggle
• Earaches, ear pain or noises in the head
• Difficulty in understanding what people say
• Appear to be speaking differently from other children his or her age

It is very important for parents, teachers, caretakers, guardians and physicians to carefully observe the child for any of the above signs. They should also make sure the child gets early diagnosis, early hearing aids fitting/cochlear implant surgery if needed, early initiation of special education programmes that can help enhance the his/her hearing and understanding and ensure better development early on. If not taken note of, hearing loss is a lifetime loss for a child that can lead to developmental challenges, emotional issues, self-esteem struggle, and societal challenges.

(Rohit Udaya Prasad is a Consultant for ENT & Cochlear Implant Surgery at Aster RV Hospital, Bengaluru)

(Views expressed are the author's own and don’t necessarily reflect those of Down To Earth)