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Published on: July 1, 2015
Identification of impaired hearing in early childhood
Insights
Early identification of congenital deafness is rare, delaying crucial speech and language development. Physicians must improve screening and referrals for at-risk infants to prevent long-term learning deficits.
Area of Science:
- Pediatrics
- Audiology
- Public Health
Background:
- Congenital deafness incidence is high, yet routine neonatal screening is not standard practice.
- Delayed diagnosis significantly hinders speech development, language acquisition, and learning in children.
- Physicians often overlook parental concerns and fail to initiate timely audiological assessments.
Purpose of the Study:
- To highlight the critical need for early identification of congenital or early-acquired deafness.
- To address the common barriers causing diagnostic delays in hearing-impaired infants.
- To advocate for improved screening and referral protocols for at-risk children.
Main Methods:
- Review of current diagnostic practices and barriers to early identification.
- Outline of screening methods suitable for non-specialist practitioners.
- Proposal for establishing a register of infants at high risk for hearing impairment.
Main Results:
- Diagnostic delays are prevalent, even in infants identified as high-risk.
- Physician-related factors (dismissal of parental input, inadequate screening, delayed referrals) are primary contributors to delays.
- Effective screening and prompt audiological assessment are crucial for optimal outcomes.
Conclusions:
- Implementing routine screening and establishing risk registers are essential for early deafness detection.
- Physicians, especially first-contact practitioners, must be vigilant for hearing problems in infants.
- Accessible, non-specialist screening methods can improve early identification rates and mitigate developmental impacts.
Abstract:
Although the incidence of congenital deafness is high, routine neonatal screening for this problem is not practised, and early identification of congenital or early acquired deafness is relatively rare. Delaying therapy until a child is 3 or more years old severely limits speech development, language acquisition and learning. The commonest causes of delay in diagnosis are the refusal of physicians to listen to the parents' observations, their failure to screen children for hearing and speech problems, and their reluctance to arrange prompt referral for audiologic assessment. Diagnostic delay occurs even though half the children who have impaired hearing are known to be at increased risk. A plea is made for the setting up of a register of infants known to be at risk for impaired hearing. First-contact physicians should be alert to the possibility of hearing problems, particularly in children at high risk. Screening methods for use by nonspecialist practitioners are outlined.
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