Hear Them Out

    ALMOST three lakh children below the age of six suffer from a hearing handicap in India. About 21,000 children have severe hearing problems in both ears. However, the good news is that just two simple screening tests can check a newborn’s hearing capability. It is ironic that almost 92 per cent of hearing disorders in children can be corrected, if detected on time. An early diagnosis – ideally between six and nine months – can lead to early treatment, which will deter the onset of deafness later. If the disorder is detected before the age of two in children who are deaf due to genetic or other causes at birth, complete deafness at a later stage can be avoided, say doctors.

SCREENING TESTS FOR NEWBORNS AND INFANTS

The two commonly used methods for testing the hearing capability for newborns and infants are the auditory brain-stem response and the otoacoustic emissions test (OAE). In the auditory brainstem response, sensors are placed on the head and neck to detect levels of brain activity in response to sound. OAE uses a soft rubber probe placed within the ear canal to measure the ear’s response to stimulus. These tests are offered free in government hospitals and could cost up to Rs 1,000, if administered privately.
“If deafness is diagnosed in infancy, some hearing can be restored through technological improvements like high-powered digital hearing aids and cochlear implants (although this procedure can cost up to Rs seven lakh), which are mechanical devices that produce digitally coded electrical signals transmitted directly to the auditory system,” says Dr Anand Shah, consulting ENT surgeon, Bombay Hospital. He cautions against rushing into cochlear implants stating that only if a hearing aid fails to help, should an implant be considered. That too, after a team of doctors, audiologists and counsellors unanimously endorse it.
Sadly, in India, neonatal testing for deafness is rarely performed and most parents, especially in the rural areas, realise that their child has an auditory problem sometimes as late as when the child is three years of age. This can have disastrous effects as time is critical. A deaf infant’s brain begins to adapt immediately to the lack of auditory input. The longer a child goes without hearing, the tougher it will be for him or her to learn speech. “It is imperative to keep the auditory pathway active, otherwise it will deteriorate,” says Dr JM Hans, ENT professor at Dr Ram Manohar Lohia Hospital, New Delhi.

CAUSES OF DEAFNESS
Almost 50 per cent of deafness is genetic. Aurally-challenged individuals pass the gene to their offspring. Some of these infants are predisposed to a gradual loss of hearing. The other 50 per cent who are born deaf, lose their hearing from congenital causes, including diseases passed from mother to foetus (such as cytomegalovirus). Other causes include foetal rubella, infant meningitis and birth defects due to trauma, injury or fracture.

YOUR CHILD MAY HAVE AN AUDITORY DISORDER IF HE OR SHE

Responds inconsistently to sound in general, and to your voice in particular.
*  Does not seem startled or upset by sudden and/or loud sounds like dogs barking or utensils falling.
*  Does not respond to the sound of your voice when he or she cannot see you.
*  Does not produce abundant sound spontaneously.
*  Has suffered from a head injury, meningitis, convulsions, ear infections, chronic colds and perforated eardrums.

THE FUTURE

Once the realisation and acceptance sets in amongst parents that their child is deaf, they need to undergo extensive counselling. “We try and empower the caregivers and teach them how to stimulate the baby with speech and language,” says Dr Vijayalakshmi Basavaraj, audiologist and deputy director, Ali Yavar Jung National Institute for the Hearing Handicapped, Mumbai. In most cases, the child is placed in a ‘special school’ as the problem is detected late. The ultimate aim, however, is to integrate the child in a normal school, by teaching to speak and lipread the teacher.