Challenges in the detection and intervention of childhood deafness: Experience from a developing country

Abstract

The Objectives: To determine the age of suspicion, confirmation and amplification of hearing handicap in children and to assess the burden of parental delay in the evaluation of hearing loss. Methods: A prospective study was done at a tertiary academic hospital in South India on 61 children with bilateral sensory neural deafness who either warrant hearing aid fitting for amplification or those hearing aids found ineffective. Any significant motor, visual, sensory or genetic disorders were excluded. Interviewer administered a questionnaire to the parents, guardian or older children for evaluations of their awareness and knowledge of the special needs. Pure tone audiometry was done for all children older than 5 years and Auditory Brainstem Evoked Response (ABER) audiometry was done in those younger than 5 years and older children who were mentally challenged. All the children were prescribed hearing aid after a trail and those who were already aided were evaluated for the performance of the aid. From the data, the age of suspicion, identification and the amplification were determined. The various factors were noted; data entered and analyzed using Statistical Programme for Social Science (SPSS – Version 6). Design: Prospective case study Results: The mean age in months at first suspicion, identification and the amplification was 19.59 months, 24.82 months and 29.28 months respectively. The average delays between the age of suspicion and identification was 5.23 months and the time interval between the identification and amplification was 4.46 months. In 70.48% of children the hearing loss was suspected after one year of age and only 1.6% have confirmed to have hearing loss and amplified before 6 months. Conclusion: The substantial parental delay of suspicion and its subsequent delay in identification and the amplification of childhood deafness indicate that the attainable realistic goal of EHDI has not yet been achieved. Setting up EHDI through UNHS is a challenge in developing countries, however an unavoidable strategy. Hence cost effective national policies with community support should be considered to give greater chance of linguistic, psychological and social development to the hearing impaired children.