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 more so in children. One of the rising concerns that have been observed in children is hearing loss.
For a growing child, speech and hearing are way 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 in their surrounding especially related to speech and language. The delay in treatment or action can lead to delay in speech and/or language development, social behavioral issues and academic difficulties.
According to WHO, 60% 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 of hearing loss can be treated if timely identified. Early intervention remains the keystone for better outcomes in terms of hearing and speech.
The hearing loss in children are of two major categories that is 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).
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 losses.
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 eg. 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
• Excess of exposure to extreme noise, such as fireworks or loud music
• Diseases like otosclerosis or Ménière's disease
• A serious injury to the head
• Ototoxic medication
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 8 months of age with the help of cochlear implant surgery. Following cochlear implant surgery, the child can undergo aural habilitation and develop good hearing and speech. This will enable 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 2 years. 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, poorer the 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 in the child include:
• Turning up the volume of the TV excessively high
• Not responding appropriately to questions
• Not replying to call
• Watching others imitate what they are doing
• Have articulation problems or speech/language delays
• Academic struggle
• Earaches, ear pain or head noises complaints
• Difficulty in understanding what people are saying
• 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 and make sure they are provided with early diagnosis, early hearing aids fitting/cochlear implant surgery if needed, early initiation of special education programs that can help enhance the child’s hearing and understanding and ensure better development early on. If not taken note of, hearing loss is a lifetime loss for a child who will face developmental challenges, emotional issues, self-esteem struggle, and societal challenges for their entire life.
Contributed by Dr. Rohit Udaya Prasad, Consultant- ENT & Cochlear Implant Surgery, Aster RV Hospital