•Majority of Hearing Impaired Infants Fail to Receive Crucial Early Medical Attention that becomes a major obstacle in their normal growth & cognitive development
March 08 2016, 17.08 PM IST || Pocket News Alert
New Delhi, 8 March 2016: Hearing impairment is one of the most prevalent congenital disabilities in India, with an estimated 8 per 1000 infants born with moderate to profound hearing impairment. However, more than half of the children born with hearing defects fail to get timely medical intervention resulting in substantial language and speech development delay and a consequent loss of growth and cognitive development.
As we celebrate World Hearing Day (March 3), experts in the field are pointing out the need to establish better hearing screening mechanisms for newborn babies to ensure that all children born with hearing impairment are detected early on in life. The theme for this year’s World Hearing Day is ‘Childhood hearing loss: act now, here is how!’ It aims to draw attention to preventable causes of hearing loss, right health measures needed to prevent the same and importance of early identification and suitable, timely interventions in children afflicted with hearing impairment.
Unlike developed countries which have implemented near universal newborn hearing screening programs under which newborns are tested at birth, India lacks such a system. Consequently, hearing disability is discovered much later in a large number of children. Hearing impairment in children leads to substantial language and speech delay that causes cognitive and developmental challenges. This further leads to academic challenges and delays in learning. In the absence of a screening at birth mechanism, suspicion of hearing disorder by family members is still the main mode of detection of childhood hearing impairment, and this diagnosis often doesn’t occur as late as two years of age.
“Children learn 90% of their language in early childhood (0-3 yrs) incidentally. This is possible only when they are hearing well. A child absorbs a lot of information and cognitive ability in the first 2-3 years of life, this includes ability to speak, pick up languages and identify objects. Without ability to hear, much of this crucial time is lost on children and they may suffer significant cognitive losses. In most cases, children are brought to us much later, at 2, 3 or 4 years of age, sometimes even later. Most parents in India determine that their child may be suffering from hearing disability much after birth when they experience lack of response to sounds in a child or inability to speak. To improve this, we need a system where all children are tested at birth in hospitals. A cohesive universal system will prevent delay in intervention,” says Neevita Narayana, leading Audiologist and founder of Sphear Speech & Hearing Clinic.
Early detection of hearing impairment can prevent related disability of speech, language, cognition and overall development of the child. But, absence of neonatal hearing screening in the country delays identification, corrective measures and rehabilitation of such children. It is recognized that children identified with hearing loss prior to 6 months of age have better chance of developing skills equivalent to their peers by the time they enter kindergarten. The American Academy of Pediatrics recommends that hearing loss in infants should be identified and when possible treated before 6 months of age. Children identified much later may suffer from irreversible and permanent impairments in speech, language, and cognitive abilities.
“Permanent hearing loss is one of the commonest congenital disorders with the incidence being much more than the conditions newborns are routinely screened for. Despite existence of mechanisms to test auditory function of newborn babies, this screening is rarely done in the absence of an established universal screening program. Besides, due to major lack of awareness about new age solutions, many people believe a congenital hearing disability cannot be treated. However, today there are not only advanced diagnostic tools but also highly advanced solutions such as hearing aids, cochlear implants and auditory brain stem implants that can allow significant improvement in hearing ability of even completely deaf persons. We need to create greater awareness about the availability of such mechanisms. Today auditory brain stem implants can enable even completely deaf children to hear,” says Dr Ameet Kishore, Senior Consultant Surgeon, ENT & Cochlear Implants at Indraprastha Apollo Hospital, New Delhi & Sphear Speeh & Hearing Clinic.
Lacks of a universal program to screen babies remains a major obstacle in early identification of disability and quick corrective intervention in the form of hearing implants. Reducing the age of diagnosis is a major challenge for Indian healthcare. Universal screening at birth has found to have lowered the age at which infants receive hearing aids, from 13-16 months to 5-7 months in developed countries. This prevents a huge burden of secondary disability.
Children with a hearing disability are at risk of delayed speech and language development and poor academic performance as a result. In India, such children also sometimes face ridicule and may experience loss of confidence. When implanted on time, the new age devices can allow complete assimilation of a child into the mainstream – including schools and social activity.
How is the screening done?
The screening is done in two simple tests namely Otoacoustic Emissions (OAE) and Auditory Brain Stem Response (ABR). While the former involves placing a sponge earphone in the ear canal to measure whether the ear can respond properly to sound, in later, earphones are placed on ear, while electrodes are placed on the head and ears to measure the respond of the brain to emitted sound.
Notably, the hearing loss could be indentified in the first test itself, as during the test a measurable echo should be produced when sound is emitted through the earphone in case of a normal hearing. However, no echo could signify the feared impaired hearing.
