Early Identification and Intervention in children with Hearing Impairment

Children progress in their development of early years of their life. Each child is unique and has their own strengths and weaknesses. Their development occurs in a particular sequence and fashion though the speed of the development varies from child to child. When there is a problem or difficulty in any area of their development they must be addressed and given special care and support. Early identification of child’s developmental delays helps us to understand the domains in which the child is lacking and helps us in intervention of those delayed domains.

Worldwide reporting of hearing loss finds that the prevalence of moderate and severe bilateral hearing deficit is 1–3 per 1,000 live births in well baby and 2–4 in 100 infants in an intensive care population. There are 5-6 infants who are hard of hearing out of 1000 neonates in India .

Most of them are not identified till they attain 2 or more years of age. Hearing loss is invisible disorder and can easily be detected. If the hearing screening procedures are not given to the child aspects such as language, emotional and cognitive development will be affected and in turn leading to academic and the literacy difficulties of child. It is the first 3 years of life that child’s speech and language develop most rapidly.

Yoshinago-Itano presented from several studies that supports the early intervention of hearing loss within first 6 months of life leads to better speech, language, and social emotional development than children identified after 6 months of age. When compared to children who were identified within first 6 months of age had language abilities withing the range of their peers with normal hearing than children identified 7-30 months of age.

As there is a need for urgency, Universal newborn Hearing Screening (UNHS) was set up as a strategy to identify the deafness or the hearing impairment. Over the past decades screening of neonates has become standard in many of the countries. The major objective of UNHS is to identify children with all kinds and degrees of hearing impairment, both bilateral and unilateral and to lower the age at the time of diagnosis for early hearing amplification, to maximize their linguistic competence and literacy development.

This procedure consists of screening infants using two objective measures. The tools used are Oto Acoustic Emission (OAE) and Automated Auditory Brainstem Response (AABR). Below is the hierarchy of the flow chart that is been followed.

The Joint Committee on Infant Hearing (JCIH) endorses early detection of and intervention for infants with hearing loss through integrated, interdisciplinary community, state, and federal systems of universal newborn hearing screening, evaluation, and family-centered intervention. The goal of early hearing detection and intervention (EHDI) is to maximize linguistic and communicative competence and literacy development for children who are deaf or hard of hearing. Without appropriate opportunities to learn language, these children will fall behind their hearing peers in language, cognition, and social-emotional development. Such delays may result in lower educational and employment levels in adulthood.

The current position statement of JCIH is that all neonates had to be screened and diagnosed within 1 month of age, 2 months of age to be fitted with amplification device and 3 month the intervention to begin.

These programs are dedicated to early identify hearing disorder and provide the intervention required like fitting with amplification device and stimulating the child through rehabilitation options such as AVT or speech therapy where the infant is intervened in all the aspects such as auditory, speech and language domains.

Hence, the importance of early identification and intervention is crucial for the child’s speech and language development which in turn affects the literacy and the academics of the child.

If your child hasn’t undergone hearing screening or if your child is required of any hearing services may it be audiological or ENT services please do contact Bangalore Hearing and Implant Institute.