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Early Detection & Intervention

This is a very important issue regarding the low awareness and understanding of the significance of early detection, diagnosis, and intervention for hearing loss in children. Early identification of hearing loss is crucial because the first few years of a child’s life are a critical period for speech and language development.

During this period, children learn to recognize and interpret sounds, which forms the foundation for their language and communication skills. If hearing loss goes undetected and untreated, it can severely impact a child’s ability to hear and subsequently develop speech and language abilities. This delay in acquiring age-appropriate skills can hinder their cognitive, social, and academic development.

By implementing proper hearing screening programs and diagnosing hearing loss at an early stage, we can provide timely intervention, such as fitting the child with appropriate hearing aids.

This allows the child to access sounds and participate actively in their environment. With the aid of hearing devices, children can develop their language skills and reach their developmental milestones at par with their peers.

Early detection and intervention not only benefit the individual child but also enable their integration into mainstream society and regular schools. By addressing hearing loss early, we can minimize the impact on a child’s overall development and increase their chances of leading a fulfilling life.

It is important to raise awareness about the significance of early detection and intervention for hearing loss in children. Education and outreach programs can help inform parents, caregivers, and healthcare professionals about the importance of regular hearing screenings and the potential benefits of early intervention. By working together, we can ensure that children with hearing loss receive the support they need to thrive and succeed.

Audiometry

Audiometry or Pure tone audiometry (PTA) test measures a person’s ability to hear different sounds, across different pitches, or frequencies. A qualified audiologist can perform the test.

Audiometry tests can detect 

  • 1. sensorineural hearing loss – damage to the nerve or cochlea or 
  • 2. conductive hearing loss – damage to the eardrum or the tiny ossicles (bones).


Audiometry tests can be performed on children (who can respond consistently to pure tone) and even on adults. The children who can not respond to tests are assessed by an electrophysiological test like BERA and OAE.

BERA and OAE

Brainstem Evoked Response Audiometry (BERA) is an electrophysiological test to estimate the hearing capacity of the child. This test is carried out in a state of natural sleep or under sedation. The response of the eighth nerve and the brainstem to sound is picked up by the electrodes. This information is depicted as waveforms by the software to know the hearing acuity of the child. It is a reliable way of estimating the hearing threshold when behavioural responses are inconsistent. 

Otoacoustic emissions (OAE) is a physiological test that is used in screening for hearing loss in infants and children. It measures the activity of the outer hair cells in the cochlea (inner ear). Functional outer hair cells give a pass result and any dysfunction in the outer hair cell shows a refer result. A child with refer report is further recommended for complete diagnostic evaluation to know the hearing threshold.

OAE and BERA tests can be done on babies as young as 1 day old. 

Hearing loss is classified on the basis of audiogram as follows:

  • 1. Normal = -10 to 15 dB Hl
  • 2. Minimal= 16 to 25 dB Hl
  • 3. Mild = 26 to 40 dB Hl
  • 4. Normal = -10 to 15 dB Hl
  • 5. Normal = -10 to 15 dB Hl

Hearing aids and cochlear implant

Hearing aids can be analogue basic amplification devices or digitally programmable devices which help an individual with hearing loss to hear better. Digital hearing aids are preferable as they amplify the speech sounds and reduce the background noise which gives better clarity of speech. It can be adjusted by an audiologist to give the appropriate amount of amplification, to avoid any discomfort. Types of Hearing Aid:
  1. 1. Body-level hearing aid 
  1. 2. Behind the ear (BTE)
  2. 3. Receiver in the canal (RIC)
  3. 4. Completely in the canal (CIC)
  4. 5. Invisible in the canal (IIC)
A cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard of hearing. Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve. Signals generated by the implant are sent by way of the auditory nerve to the brain, which recognizes the signals as sound. The implant consists of an 
  1. 1. External portion: processor (sits behind the ear) 
  2. 2. Internal portion: implant (surgically placed under the skin. 

ENT & Audiological testing

Hearing aids can be analogue basic amplification devices or digitally programmable devices which help an individual with hearing loss to hear better. Digital hearing aids are preferable as they amplify the speech sounds and reduce the background noise which gives better clarity of speech. It can be adjusted by an audiologist to give the appropriate amount of amplification, to avoid any discomfort. Types of Hearing Aid:
  1. 1. Body-level hearing aid 
  1. 2. Behind the ear (BTE)
  2. 3. Receiver in the canal (RIC)
  3. 4. Completely in the canal (CIC)
  4. 5. Invisible in the canal (IIC)
A cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard of hearing. Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve. Signals generated by the implant are sent by way of the auditory nerve to the brain, which recognizes the signals as sound. The implant consists of an 
  1. 1. External portion: processor (sits behind the ear) 
  2. 2. Internal portion: implant (surgically placed under the skin.