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Early identification and Intervention

There is growing body of evidence that early identification and management of permanent congenital hearing impairment, prior to two to three months of age, can significantly benefit the child in speech, language & hearing development and the advent of Neonatal Hearing Screening Programme means that such intervention is now possible. Effective screening of hearing loss in newborns and infants is now possible due to the advancement in audiological science.

Late identification of infant hearing loss is a significant public health problem. Hearing loss is one of the most common major abnormalities present at birth and, if undetected, will impede speech, language, and cognitive development. Significant bilateral hearing loss is present in about 1 to 3 per 1000 newborns. Without screening, children with hearing loss are usually not identified until about 14 months, which results in delays in speech, language, social, cognitive, and emotional development, as well as costs to schools.

Also it is now recognized that early intervention is critical to speech, language and hearing development in hearing impaired infants and children. The hearing loss must be identified before the first two months of age and intervention should begin at least before three months of age for effective outcomes. Available interventions include fitting a hearing aid before six months or performing a cochlear implant as early as one year of age. Selection of the proper plan requires accurate, detailed information about the hearing loss at all frequencies important for speech and language development. Consequently, there is a greater demand for accurate and frequency-specific hearing assessment of these infants.

BENEFITS OF COCHLEAR IMPLANTATION
Cochlear implantation is designed for people with severe to profound hearing loss who derive limited benefits from hearing aids. The speech / language / hearing skills will improve following cochlear implantation. The improvement depends upon many factors.

BENEFITS FOR CONGENITALLY DEAF (PRE-LINGUAL)
It has been proven through research that the ability of the brain to process speech, language and hearing is more during the first three years of life. Cochlear implantation is generally done after the child attains one year of age. If done during this critical period, implantation will help develop near normal speech, language and hearing skills. However, the benefits depend upon the age of onset of hearing loss, age of hearing aid fitting, type of therapy received, age of implantation etc. Even after implantation, the child will need auditory verbal therapy for around two to five years for optimal speech, hearing and language development. If done after the age of six or seven, the benefits are likely to be limited, and may have to supplement implant use with lip reading.

BENEFITS FOR INDIVIDUALS WHO HAVE LOST HEARING AFTER THE ACQUISITION OF SPEECH, HEARING AND LANGUAGE SKILLS (POST LINGUALS)
If done sufficiently early after losing hearing, implantation can restore near normal speech perception in post linguals. Results gradually diminish over time as the brain, unless auditorily stimulated, loses its ability to recognise speech. Implantation should not be delayed after losing hearing especially in meningitis, as the new bone formation in the cochlea (ossification) can impede insertion of the implant.

BENEFITS FOR INDIVIDUALS WHO HAVE LOST HEARING DURING THE PERIOD OF ACQUISITION OF SPEECH AND LANGUAGE (PERILIINGUALS)
The benefits of cochlear implantation in perilinguals depend largely on the type / configuration of hearing loss, age of onset of deafness, type of intervention, hearing aid use etc, Your Audiologist / ENT surgeon should be able to predict this to a reasonable degree of accuracy.


 

     
 
 
     
 
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