Importance of early identification of hearing loss in children
Hearing loss can impact children in myriad ways throughout their early years and into adulthood. Early identification is the key to mitigating against many of these impacts, making the provision of newborn hearing screening protocols and widespread testing in school-age children essential so that prompt intervention can be provided and the best outcomes achieved.
The WHO World Hearing Report (2021) outlined the potential impact that early identification and prompt intervention can have for children with hearing loss. Research shows that children with undiagnosed and untreated hearing loss may experience delayed speech and language development, which is likely to continue into adulthood. Furthermore, this can result from even mild or unilateral hearing loss, despite it being sometimes overlooked. Children identified with hearing loss as infants – i.e. before six months of age – were found to have better outcomes from interventions.
Language and communication key for children’s development
Language and communication key for children’s development studies show that when infants with hearing impairment cannot access language stimulation early in life, their overall development can be impacted. In later stages, academic outcomes for children with untreated hearing loss may also be negatively affected
With hearing loss known to be the most common congenital sensory disorder, research has shown that hearing screening in newborns, when followed by prompt and appropriate interventions, is effective in ensuring that those born with significant hearing loss do not experience the typical range of adverse impacts as they age. While screening can be universal or targeted, it is widely accepted that a universal approach is preferable given that only 50-60% of infants with permanent hearing loss display any risk indicators. One population study on the long-term outcomes of children identified with permanent hearing loss contrasted three screening programmes: a universal programme; an “at-risk” programme; and an opportunistic programme. The results clearly illustrated the benefits of a universal programme, in terms of age of diagnosis; receptive and expressive language; and receptive vocabulary (in children without intellectual disability), when compared with the other two screening types1. In addition, new developments in medtech have made the widespread hearing screening of newborns possible, with portable, objective automated devices now available.
Need for follow-up and rehabilitation
Experts caution, however, that any screening approach must be complemented by the appropriate follow-up and rehabilitation. There is much evidence to support the enhanced benefit of newborn screening linked to early intervention programmes, with the effectiveness increasing the earlier the hearing loss is identified and rehabilitation commences; “the benefits of early detection are associated with early intervention rather than screening per se,” as stated in the WHO World Hearing Report. Early identification of children with progressive hearing loss or hearing loss due to ear diseases, and connecting them with care, remains challenging but solutions must be found.
Ongoing screening is therefore necessary; school screening programmes are known to be a useful tool in mitigating the effect of unaddressed hearing loss and ear diseases and may help to identify those with minimal hearing loss in infanthood. With the appropriate referral system in place, and access to hearing care provided promptly, screening programmes will achieve the maximum benefits.
