by The Welthi Bureau 3rd March, 2019
The ring of the school bell at the end of the day, friends calling us to play cricket or football,mother humming our favourite lullaby, our favourite song on the radio…
For many of us, thesesounds are an inherent part of the happy, nostalgia-evoking memories of our childhood. But not everyonegets to enjoy such memories.Every day in India, over 300 babies are born with some degree ofhearing loss. In addition to missing out on the wonderful sounds the rest of us take for granted,the lack of sound (auditory stimulation) makes it difficult for these children to pick up languageskills – which has a profound impact on the way they relate with others for the rest of their lives.
Unfortunately, it is easy to miss the early signs of hearing loss in infants.However, if recognizedearly, timely intervention can help these children pick up speech and language skills, enablingthem to integrate more seamlessly into the mainstream world of sound.
What makes early intervention so crucial?
The ability to hear starts much before birth. By 15 weeks, the growing child in the womb beginsto hear sounds from the ‘outside’ world, including the sound of their mother’s voice, her heartbeat and sounds from her digestive system as well! Once outside the womb, a baby listens andgradually gets attuned to the sounds of his/her parents cooing, talking, singing and reading, inaddition to environmental sounds. These sound cues and signals picked up during the first 3years of life, when the brain is still developing and maturing, are crucial for a baby to developlinguistic skills.
Unaddressed hearing loss affects language development. However, if these babies get help earlyin life, they are often able to develop language skills that are on par with their hearing peers.Sadly, many of these babies are not identified until their second birthday, by which timesignificant damage has already occurred.
The 1-3-6 rule for screening
The earlier we diagnose loss of hearing in a child, the sooner we can intervene, and the better theoutcome.
Screening hinges on the 1-3-6 guideline issued by experts:
• Screen for hearing loss within 1 month from birth
• Diagnose and confirm hearing loss by 3 months of age
• Organize early intervention services by 6 months of age
The right intervention at the right time helps the child develop normal speech and have a regulareducation.
The benefits of early intervention
Hearing aids are usually the first line of treatment for children with permanent hearing loss.Hearing aids amplify sound – meaning, they make sounds louder – and can be fitted within thefirst month of life. For children with significant hearing loss, a cochlear implant may berecommended. While these implants do not restore ‘normal’ hearing, they directly stimulate thenerve (auditory nerve) responsible for hearing and the brain recognizes these as sounds. In myopinion, cochlear implants must ideally be fitted around 12 months of age. This is the optimaltime for children to be exposed to sounds to help them comprehend language and music and pickup speaking skills.
There was a time when children with hearing loss had no option but to pick up sign language andlearn to cope and adjust for the rest of their lives. Today, the situation is thankfully very different.At our hospital, a child as young as 13 months old has been fitted with a cochlear implant, thoughI believe that elsewhere globally, a child as young as 6 months has successfully received theimplant. What a difference these make to their lives! Within a year from the implant, thesechildren have normal speech development. As a doctor, it is so encouraging and satisfying for meto watch these children play with their siblings, communicate with other kids their age and beexposed to an entire world of sound that would have otherwise been completely foreign to them.
In many other countries including the US, UK and Australia, every newborn is screened forhearing loss. It is my belief that Indian experts must also recommend that a similar guideline isput in place very soon in India as well.
This World Hearing Day, March 3, 2018, it is important that we remember just howmuchhearing matters.
Early identification and intervention
Early identification of hearing loss would help a hearing-impaired child to develop spoken language on par with other normal hearing children. Deaf children (who have no hearing) would be unable to develop spoken language without interventions. Children with hearing loss (who can hear but not as well as others) can have delayed language development. Those with untreated total or near total hearing loss would grow as deaf mute and communicate with sign language.
The earlier the hearing impairment is diagnosed and treated, the better the chances of the child growing up as any other normal child.
How should parents or caretakers suspect that the child has hearing problems?
0-3 months : Startle response, eye blinking response to loud sounds
4-6 months : Sound localization, head turning towards a sound
7-10 months : Responds to name calling, recognizes familiar sounds
11-15 months : listens when spoken to
5-8 months : babbles, gurgling sounds
9-11 months : Imitates sounds like ma ma or ta ta
1 year : one or two words
1-2 years : Puts two words together, acquires new words on a regular basis
2-3 years : Simple sentences, 2-3 word phrases
3-4 years : sentences with 4 or more words
Any significant delay in hearing or speech milestones needs a Specialist’s check up as soon as possible.
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