Diagnosis & Interventions

Assess your Child's Hearing

You can Assess your Child's Hearing

For good observation and assessment always make sure that you present the sound (clap, alarm etc.) in such a way that the child's reaction should be because he heard the sound and not because he saw you presenting it. When you make an assessment periodically ask yourself the following questions.

Assessment Questions

Sr.No.	Questions	Response
1.	Does your child fail to respond to loud sounds?	(Yes/No)
2.	Does your child fail to respond to soft sounds?	(Yes/No)
3.	Does your child turn his head to localize (locate the direction) the sound only when it is presented on one particular side of the ear i.e. either left or right?	(Yes/No)
4.	Did your child stop babbling after 6 to 8 months of age?	(Yes/No)
5.	Does your child show poor or no interest in playing with noise making toys like rattle, bell etc.?	(Yes/No)
6.	Has your 1½ year old child failed to start using meaningful words like mummy, daddy, bye–bye etc.?	(Yes/No)
7.	Do you feel that your child does not understand simple commands like wave bye–bye until unless your speech is accompanied by gestures?	(Yes/No)
8.	Does he/she insist on watching your face while you speak?	(Yes/No)
9	Is your child unable to respond to your call from a distance? of 5 ft to 10 ft?	(Yes/No)

If the answer is ‘YES’ to any of these questions, your child needs professional help.

Need of Early Identification Intervention

Why should Hearing Loss be Identified Early?

As mentioned earlier hearing impairment not only affects the child’s speech and language development but also impedes the child's social, educational and personality development.

If hearing impairment is identified early, these adverse effects due to hearing impairment in the child can be minimised.

Treatment/Rehabilitation Options

Drugs and surgery are useful in treating middle and outer ear problems. For ear discharge, regular and long term treatment is necessary to stop it completely. In case where the hearing impairment is irreversible, hearing aid fitting is recommended.

For details of hearing aids, its care and maintenance please Click for hearing aids and details.

The rehabilitation process includes training to make the best use of residual hearing, speech reading instruction, speech–language stimulation and therapy and the services of special educators. At the appropriate age preschool/school placements should be made after consulting a special educator.

Early identification and intervention family support are important factors which determine the success of a rehabilitation program. Therefore whenever a hearing problem is suspected immediate action is imperative.

On Suspicion of hearing problem by family or referral by doctor for hearing assessment, seek professional help. Provide case history for audiological assessment. Do 'Other assessment' such as Speech and Language, psychological assessment along with audiological assessment.

Hearing loss can be diagnosed as: Conductive hearing loss, Sensorineural/Mixed hearing loss or Normal hearing sensitivity.

For both Conductive and Mixed hearing loss, one can first refer to ENT specialist for advise or treatment and follow up audiological assessment after treatment.

For Mixed hearing loss (also known as Sensorineural hearing loss) apart from referring to ENT specialist one can directly do a hearing aid trail fitting; get counseling about use; and also learn to take care and maintenance of hearing aid.

After hearing aid trial, one can go for auditory training, Speech and language stimulation therapy and/or get help of special educators. After this one can go three ways: 1) redo Audiological assessment, 2) redo hearing aid trial 3) or as advised by educator join pre-school or school placement.

Depending upon the advise by educator, one can redo Audiological assessment or hearing aid trial or get pre-vocational and vocational training, which will finally result into job placement.

When diagnosed for Normal hearing sensitivity, follow-up evaluation after 6 months.

Flow chart for management of identified children with Hearing Impairment

Help From Professionals

The ENT Specialist:

A doctor who has specialized in dealing with diseases or problems of the ear, nose and throat.

The Pediatrician/Child Specialist

The Audiologist and Speech–Language Pathologist:

A professional who is trained in the diagnosis and rehabilitation of hearing and speech problems.

In case of children with hearing impairment this professional can:

Carry out the hearing assessment
Diagnose the type of hearing problem
Do hearing aid testing and fitting
Tell you how to use the hearing aid
Help you with a program geared at helping the child learn to make use of his hearing and develop speech and language
Remedy speech problems. i.e. provide speech therapy

The special educator for the deaf:

A teacher who has specialized in educational methods for children with hearing impairment.

These teachers use special methods to develop language and conduct educational programs for children with hearing impairment. They can assess the child’language abilities and guide you about the type of school placement best suited for your child.

Other Professionals:

Psychologist, Vocational Counsellor, Neurologist

All these professionals work as a team for the child with special needs. Your child may need the services of more than one professional at any given time.