HEARING ASSESSMENT PART 1

Lately,  this topic is in the limelight, with a renewed  global interest in ECD (  Early Childhood Development )  as all of us realise the immense potential  of  Brain Development in the first three years of a child, for acquisition of intellectual capabilities . 

 Hearing is the vital input for Speech and Language skills, Academic Progress and growth of Personal + Social + Emotional talents. 

Early identification of Hearing Loss is crucial and be done step wise,  as under :  ⬇️

  •  Screening by one month age. (  by OAE test ) 
  • Assessment by three months age (   by ABR TEST,  also named BERA ) ,plus , 
  • Appropriate interventions   by six months  this is the International Norm, for adoption of   universal screening of all newborn babies.

 Hearing Loss could be  either  :

  •  CONGENITAL 
  •  Delayed Onset or 
  •  Progressive type

 Our present concern is the first variety of CONGENITAL HEARING LOSS . This needs to be quickly identified before 3 months age ( or even earlier ) by specific tests.

1-2 newborns per 1000  Live Births have moderate to severe 40 DB bilateral Hearing Loss .  This is more than all other SCREENABLE DISEASES at birth. Is it therefore  important to screen all infants for Hearing ASAP. Already practiced in Developed Nations.

 POINTERS to a probable Hearing Deficit
  •  Caregiver’s concern regarding Hearing and Speech Delay 
  •  Family history of Hearing Loss 
  • NICU CARE of more than 5 days, with :

ECMO

 Ventilator Care 

  Ototoxic Medications like Gentamycin /  Tobramycin.

Loop Diuretics like Lasix

Hyperbilirubinemia requiring Exchange Transfusion. 

  •   In-Utero Infections : CMV,  Herpes,  Rubella, Toxoplasmosis & Syphilis. 
  •   Craniofacial Anomalies involving Pinna,  Ear canal,  Ear Tags and Temporal Bones. 
  • Syndromic Deafness – like Waardenburg, Alport Syndrome and 15 others. 
  • Bacterial & Viral Meningitis ( esp. Herpes + Varicella) 
  • Recurrent or Persistent Otitis Media for 3 months 
  • Head Trauma.

Early Manifestation of Hearing Loss could therefore be Congenital or Acquired in the first few months 

Comprehensive Audiological Evaluation will be detailed in part TWO of this thematic Blog,  on next weekend.

Dr . Dhananjay Shah
Ped. Practice of 40 years
@ Rajkot. Gujarat.

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