Worldwide statistics estimate that one in every 1000 infants is born with severe hearing impairment and 6 in every 1000 are born with some degree of hearing loss. Children may also acquire hearing loss during their growth due to illnesses like measles and mumps. Causes of hearing loss in children which can be rectified include build up of ear wax in the ear canal, build up of fluid behind the eardrum and rupture to the eardrum. Conditions such as ototoxicity (damage to receptor cells of hearing as a result of drugs), infections which can damage brain after birth, problems with the development in the structure of ear and cancers can lead to permanent damage to hearing.
Risk factors for hearing loss
Some of the important risk factors related to hearing loss can be enumerated and an informal screening can help in determining whether to look out for warning signs of hearing impairment. The risk factors include: family history/background of hearing impairment, prenatal infections in the mother like rubella, toxoplasmosis and herpes simplex, abnormal development of the structures in head and neck region like cleft palate, atresia (absence of pinna).
Premature birth Hyperbilirubinemia medications given in neonatal period syndrome linked with hearing loss such as neurofibromatosis, Waardenburg, recurrent infections in the ear, nose, and throat, infections like meningitis, measles, mumps and head trauma.
Certain symptoms may be noticed by the mother or primary care giver of the baby that can call for a precise hearing assessment to be done. There is absence of startling response to a sudden loud noise.
There is also absence of response to familiar voices in older infants and when spoken out of the infant’s perspective. If a child does not use speech to ask, seek attention or call out.
Early intervention for hearing impairment
Early intervention is a term employed for the process of identifying conditions in children that may cause delays in development of cognitive skills, physical skills, communication, adaptive skills and social and emotional development. The major focus of early identification and intervention for a child with hearing loss is on developing communication skills, both spoken and sign language, to the maximum possible extent. Furthermore, if hearing impairment is related to other disorders like blindness, mental retardation, cerebral palsy, intervention program also addresses those requirements.
Hearing impairment is harmful to the normal speech and language development in such children. While speech and language are inborn skills of humans, these skills develop only by hearing, listening and incorporating the utilization of words, voice variations and the patterns in which words are strung together to form expressions.
Why early intervention?
It is currently recommended that a hearing screening should be done for every baby a few weeks after birth and follow-up appointments likely two years of age. With present-day technology of manual and automatic hearing testing patterns, congenital hearing loss is being recognized in children before they are 3 months of age. Recognition of hearing impairment is possible by checking out the risk factors, responses of the baby to sounds around and seeking professional assistance when the risks and signs point to a hearing problem.
Initial steps towards intervention
The first step towards the intervention scheme is to provide the satisfactory amplification for the child diagnosed with hearing loss using a cochlear implant or hearing aid. The aim of the intervention program should be to help the child to learn to communicate in speech, make use of residual hearing and also relate with the society. Everyone in the family and immediate environment of the child turns into a contributor in the intervention program.
The team of professionals in the intervention program includes Audiologist, Otolaryngologist, Speech and Language therapist, primary care physician and psychologist if required. They can aid in deciding whether the child can be assisted to develop spoken language skills, use of sign language or any other communication methods. This resolution is depended on the overall cognitive skills, physical ability and intelligence child with hearing impairment.
Auditory training after amplification
Children or adults with severe hearing loss may be able to hear low frequency sounds/pitch and this hearing ability in them is called residual hearing. It is important to maintain and use the residual hearing in the intervention scheme.
Amplification with cochlear implant or hearing aid will aid the child hear the sounds while the auditory training sessions will help the child make a distinction, discriminate and recognize the sounds he or she hears. The auditory training can be extended to speech sound discrimination and recognition, eventually helping the child to improve on verbal communication skills.
Critical period for language learning
A kid with normal hearing learns to spoken language and communication during the critical period for language development prior to two years of age. During this development, almost 80% of first language is learnt by the child, building up the lexicon thereafter. Studies have shown that if this period is missed for language learning, the language development may not be as natural. Early recognition of hearing impairment makes it possible to employ the critical period to the maximum extent.
Experts in the intervention program include the following:
Otolaryngologist: The ear, nose and throat specialist determines the requirement of cochlear implant based upon the residual hearing of the child. If the child is a well qualified candidate, the implant is surgically positioned.
Audiologist: An audiologist is responsible for fitting the proper hearing aid, supplying and management of a hearing aid. The expert can also advice the best use of residual hearing employing this newly acquired amplification, to enhance communication skills.
Speech and Language therapist: This therapist focuses on developing the use and control of voice, vocabulary, expressive language skills, manner of speaking words and sounds, use of language in conversation and more. Written language and reading/studying comprehension is also included. A number of non-verbal means of communication such as sign language, lip reading and use of appropriate signals is also taught to the child.
Teachers: The teachers at school for the child with hearing impairment can follow the scheme of the speech and language development program under the guidance of a speech and language therapist. This will help the child to use the skills learnt during the therapy sessions. If the child is attending a regular school, the teachers can make special arrangements to accommodate the hearing impaired child, to enable understanding via lip reading and other non-verbal signs.
Primary caregivers: Parents or primary health caregivers are the most relevant people in the intervention program for a child with hearing impairment. The sessions with the audiologist and therapist required to be followed on a regular basis and incorporated into the daily routine of the child. The siblings, relatives and friends of the child with hearing impairment also contribute in their own way. Integrating the child with this disorder (hearing impairment) into the world full of sounds and verbal and written language is the final goal of the intervention program. If the program is commenced early, the better is the result. Hearing impairment is often a latent defect. Early intervention and effective therapy can restore the child’s confidence and self esteem by enhancing social, cognitive and behavioral skills.
Risk factors for hearing loss
Some of the important risk factors related to hearing loss can be enumerated and an informal screening can help in determining whether to look out for warning signs of hearing impairment. The risk factors include: family history/background of hearing impairment, prenatal infections in the mother like rubella, toxoplasmosis and herpes simplex, abnormal development of the structures in head and neck region like cleft palate, atresia (absence of pinna).
Premature birth Hyperbilirubinemia medications given in neonatal period syndrome linked with hearing loss such as neurofibromatosis, Waardenburg, recurrent infections in the ear, nose, and throat, infections like meningitis, measles, mumps and head trauma.
Certain symptoms may be noticed by the mother or primary care giver of the baby that can call for a precise hearing assessment to be done. There is absence of startling response to a sudden loud noise.
There is also absence of response to familiar voices in older infants and when spoken out of the infant’s perspective. If a child does not use speech to ask, seek attention or call out.
Early intervention for hearing impairment
Early intervention is a term employed for the process of identifying conditions in children that may cause delays in development of cognitive skills, physical skills, communication, adaptive skills and social and emotional development. The major focus of early identification and intervention for a child with hearing loss is on developing communication skills, both spoken and sign language, to the maximum possible extent. Furthermore, if hearing impairment is related to other disorders like blindness, mental retardation, cerebral palsy, intervention program also addresses those requirements.
Hearing impairment is harmful to the normal speech and language development in such children. While speech and language are inborn skills of humans, these skills develop only by hearing, listening and incorporating the utilization of words, voice variations and the patterns in which words are strung together to form expressions.
Why early intervention?
It is currently recommended that a hearing screening should be done for every baby a few weeks after birth and follow-up appointments likely two years of age. With present-day technology of manual and automatic hearing testing patterns, congenital hearing loss is being recognized in children before they are 3 months of age. Recognition of hearing impairment is possible by checking out the risk factors, responses of the baby to sounds around and seeking professional assistance when the risks and signs point to a hearing problem.
Initial steps towards intervention
The first step towards the intervention scheme is to provide the satisfactory amplification for the child diagnosed with hearing loss using a cochlear implant or hearing aid. The aim of the intervention program should be to help the child to learn to communicate in speech, make use of residual hearing and also relate with the society. Everyone in the family and immediate environment of the child turns into a contributor in the intervention program.
The team of professionals in the intervention program includes Audiologist, Otolaryngologist, Speech and Language therapist, primary care physician and psychologist if required. They can aid in deciding whether the child can be assisted to develop spoken language skills, use of sign language or any other communication methods. This resolution is depended on the overall cognitive skills, physical ability and intelligence child with hearing impairment.
Auditory training after amplification
Children or adults with severe hearing loss may be able to hear low frequency sounds/pitch and this hearing ability in them is called residual hearing. It is important to maintain and use the residual hearing in the intervention scheme.
Amplification with cochlear implant or hearing aid will aid the child hear the sounds while the auditory training sessions will help the child make a distinction, discriminate and recognize the sounds he or she hears. The auditory training can be extended to speech sound discrimination and recognition, eventually helping the child to improve on verbal communication skills.
Critical period for language learning
A kid with normal hearing learns to spoken language and communication during the critical period for language development prior to two years of age. During this development, almost 80% of first language is learnt by the child, building up the lexicon thereafter. Studies have shown that if this period is missed for language learning, the language development may not be as natural. Early recognition of hearing impairment makes it possible to employ the critical period to the maximum extent.
Experts in the intervention program include the following:
Otolaryngologist: The ear, nose and throat specialist determines the requirement of cochlear implant based upon the residual hearing of the child. If the child is a well qualified candidate, the implant is surgically positioned.
Audiologist: An audiologist is responsible for fitting the proper hearing aid, supplying and management of a hearing aid. The expert can also advice the best use of residual hearing employing this newly acquired amplification, to enhance communication skills.
Speech and Language therapist: This therapist focuses on developing the use and control of voice, vocabulary, expressive language skills, manner of speaking words and sounds, use of language in conversation and more. Written language and reading/studying comprehension is also included. A number of non-verbal means of communication such as sign language, lip reading and use of appropriate signals is also taught to the child.
Teachers: The teachers at school for the child with hearing impairment can follow the scheme of the speech and language development program under the guidance of a speech and language therapist. This will help the child to use the skills learnt during the therapy sessions. If the child is attending a regular school, the teachers can make special arrangements to accommodate the hearing impaired child, to enable understanding via lip reading and other non-verbal signs.
Primary caregivers: Parents or primary health caregivers are the most relevant people in the intervention program for a child with hearing impairment. The sessions with the audiologist and therapist required to be followed on a regular basis and incorporated into the daily routine of the child. The siblings, relatives and friends of the child with hearing impairment also contribute in their own way. Integrating the child with this disorder (hearing impairment) into the world full of sounds and verbal and written language is the final goal of the intervention program. If the program is commenced early, the better is the result. Hearing impairment is often a latent defect. Early intervention and effective therapy can restore the child’s confidence and self esteem by enhancing social, cognitive and behavioral skills.