In India, approximately 1–3 out of 1000 babies are born with hearing loss. Newborn hearing screening is quite popular and significant in various parts of the world; however, in India, it is still done and practiced in very few hospitals. Generally, otoacoustic emission (OAE) and automated ABR is used for newborn hearing screening. If a baby fails during screening, he/she is done a detailed evaluation to find out whether they have a hearing problem and, if yes, the nature and extent of that problem. Proper diagnosis via detailed hearing
assessment needs to be done if any child is considered having any problem.
Hearing ability of a child can be assessed at any age after birth. According to the Joint Committee on Infant Hearing (JCIH) in the US, every child should be screened within 1 month and diagnosed within 3 months. Rehabilitation should start within 6 months for every child with hearing loss.
It’s good not to rely only on BERA or ABR, when doing hearing assessment of children. Along with BERA, behavioral observation, otoacoustic emission and tympanometry are equally important to be sure. According to JCIH (2007), even if there’s no hearing loss, ABR test might not be effective due to delayed development, neural immaturity or auditory dyssynchrony. In that case, conducting OAE becomes mandatory by which function test of cochlear outer hair cell can be done. If OAE is present and ABR is absent, then it is advisable to keep hearing loss and other factors in mind before diagnosis. Again, OAE can appear as ‘absent’ in test results due to outer ear wax or any problem/pathology in the middle ear. In that case, impedance audiometry or tympanometry tests are needed to find out if there is any problem in middle ear. However, before conducting any test, get a BOA test done to determine whether your child has a hearing loss.
If after conducting all these tests, it is found that the child has hearing loss, then ASSR should be done at the end. ASSR helps us determine the amount of hearing problems in various frequencies. ASSR response plays a crucial role during hearing aid trials.
If a child has permanent hearing loss, and the same cannot be cured by medicine or surgery, then the right hearing aid needs to be selected by trial. The child should wear the aid and get a speech and language therapy thereafter. Cochlear implants also work well for severe to profound hearing loss.
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