The importance of early intervention of hearing impaired children

Hearing Impaired:
The term "hearing impaired" is often used to describe people with any degree of hearing loss, from mild to
profound, including those who are deaf and those who are hard of hearing. The Individuals with Disabilities
Education Act (IDEA), defines “hearing impairment” and “deafness” separately. Hearing impairment is
defined as an “impairment in hearing, whether permanent or fluctuating that adversely affects a child’s
educational performance.” Deafness is defined as a “hearing impairment that is so severe that the child is
impaired in processing linguistic information through hearing, with or without amplification.”

Early Intervention (0-3 years)

Hearing loss can affect a child’s ability to develop speech, language, and social skills. The earlier a child
who is deaf or hard-of-hearing starts getting services, the more likely the child’s speech, language, and
social skills will reach their full potential. Early intervention program services help young children with
hearing loss learn language skills and other important skills. Research shows that early intervention services
can greatly improve a child’s development. Babies that are diagnosed with hearing loss should begin to get
intervention services as soon as possible, but no later than 6 months of age. Early intervention of hearing
impaired children depends on type and level of severity of hearing impairment. Type of intervention
has severity level specific Individual.

Types of Hearing Loss:

There are four types of hearing loss are Sensorineural, Conductive, Mixed (sensorineural and conductive).
Auditory neuropathy spectrum disorder (ANSD).

Sensorineural Hearing Loss:

This type of hearing loss occurs when the inner ear or the actual hearing nerve itself becomes damaged.
This loss generally occurs when some of the hair cells within the cochlea are damaged. Sensorineural loss
is the most common type of hearing loss. It can be a result of aging, exposure to loud noise, injury, disease,
certain drugs or an inherited condition. This type of hearing loss is typically not medically or surgically
treatable; however, many people with this type of loss find that hearing aids can be beneficial. ‘Sudden
Sensorineural Hearing Loss’ may occur very suddenly or over the course of a few days. It is imperative
to see an otologist (a doctor specializing in diseases of the ear) immediately. A delay in treating this
condition (two or more weeks after the symptoms first begin) will decrease the chance that medications
might help improve the problem.

Conductive Hearing Loss:

This type of hearing loss occurs in the outer or middle ear where sound waves are not able to carry all the
way through to the inner ear. Sound may be blocked by earwax or a foreign object located in the ear canal;
the middle ear space may be impacted with fluid, infection or a bone abnormality; or the eardrum may have
been injured. In some people, conductive hearing loss may be reversed through medical or surgical
intervention. Conductive hearing loss is most common in children who may have recurrent ear infections
or who insert foreign objects into their ear canal.

Mixed Hearing Loss:

Sometimes people can have a combination of both sensorineural and conductive hearing loss. They may
have a sensorineural hearing loss and then develop a conductive component in addition. Hearing testing is
critical for discovering exactly what type of hearing loss you have, and will help determine the hearing care
solution that is right for you. Hearing aids are available in many sizes, styles and technologies; there are
also many alternatives to hearing aids.
Auditory Neuropathy Spectrum Disorder (ANSD):
It is a hearing problem in which the ear detects sound normally, but has a problem sending it to the brain.
Someone with ANSD may have trouble telling one sound from another. They may also have trouble
understanding speech clearly. The sounds may fade in and out or are ‘out of sync’. Children with ANSD
may have hearing responses that vary or worsen over time. A child with ANSD may appear to hear one day
and not hear the next. This can be very frustrating for parents and can make a getting final diagnosis
difficult. Hearing loss can vary greatly in children with ANSD, from normal hearing to profound hearing
loss.

Hearing Loss in Adults:

People over age 50 may experience gradual hearing loss over the years due to age-related changes in the
ear or auditory nerve. The medical term for age-related hearing loss is presbycusis. Having presbycusis
may make it hard for a person to tolerate loud sounds or to hear what others are saying. Other causes of
hearing loss in adults include: Loud noises, Heredity, Head injury, Infection, Illness, Certain prescription
drugs, Circulatory problems such as high blood pressure.

Levels of Hearing Loss:

There are 5 different levels of hearing loss: mild, moderate, moderately-severe, severe and profound.
Mild Hearing Loss (26 dB- 40dB): this type of hearing loss is often associated with the inability to hear
soft sounds. These sounds often include rustling leaves, bird chirping, or the refrigerator humming. A
person with a mild hearing loss often has difficulty hearing speech in noisy environments.
Moderate Hearing Loss (41dB-55dB): This type of hearing loss causes difficulty hearing moderately loud
sounds (sound under 41dB). People begin having difficulties with speech sounds, especially the higher
frequency speech sounds like /f/, /s/, and /th/. In general, hearing speech with background noise becomes
extremely difficult.
Moderately-Severe Hearing Loss (56-70dB): This type of hearing loss causes difficulty hearing even
normal conversation in quiet unless the person of interest begins to raise their voice. Difficulties in groups
and in noise continue to become even greater as this group are no longer hearing sounds bellow a normal
conversation level.
Severe Hearing Loss (71dB-90dB): This type of hearing loss creates a communication boundary. People
with severe hearing loss are unable to hear speech sounds unless they are produced very loudly. Often
people have a hard time participating in group conversation, as listening and following along requires a lot
of effort. People with this type of loss have now lost the ability to hear sounds that are produced under 71
dB.
Profound Hearing Loss (91dB +): Some loud noises are still heard, however, communication is no longer
possible even with increased effort. People with this type of hearing loss can no longer hear sounds that are
produced under 91dB.

All types of hearing loss hinder our ability to communicate effectively. While this communication boundary
is greater in the more severe hearing loss categories, the milder forms of hearing loss also create problems
in communication. This communication deficit can be frustrating to those who have hearing loss because
communicating and connecting is the foundation of our everyday lives. Fortunately, we do have devices
that can help us hear more effectively, which in turn helps with this communication problem. It is important
to note that each form of hearing loss, including mild hearing loss, can benefit from hearing aids. Hearing
aids can help lessen the communication issue by giving the person more auditory information which is
essential in comprehending speech.
Treatment of hearing impaired child:
Treatment depends on the cause and severity of your hearing loss. Options include:

Removing wax blockage: Earwax blockage is a

reversible cause of hearing loss. The doctor may
remove earwax using suction or a small tool with
a loop on the end.
Surgical procedures: Some types of hearing loss
can be treated with surgery, including
abnormalities of the eardrum or bones of hearing
(ossicles). If you've had repeated infections with
persistent fluid, your doctor may insert small
tubes that help your ears drain.
Hearing aids: If child’s hearing loss is due to
damage to inner ear, a hearing aid can be helpful.
An audiologist can discuss with you the potential
benefits of a hearing aid and fit you with a device.
Open fit aids are currently the most popular, due
to fit and features offered.
Cochlear implants: If the child have more severe
hearing loss and gain limited benefit from
conventional hearing aids, then a cochlear implant
may be an option. Unlike a hearing aid that
amplifies sound and directs it into your ear canal,
a cochlear implant bypasses damaged or
nonworking parts of your inner ear and directly
stimulates the hearing nerve. An audiologist, along with a medical doctor who specializes in disorders of
the ears, nose and throat (ENT), can discuss the risks and benefits.
Importance of early intervention:
The most important time for a child to be exposed to and learn language is in the first three years of life. In
fact, children begin learning speech and language in the first six months of life. Research suggests that those
who have hearing impairment and get intervention have better language skills than those who don’t. The
earlier you know about deafness or hearing loss, the sooner you can make sure your child benefits from
strategies that will help him or her learn to communicate. With certain types of profound hearing loss who
do not benefit sufficiently from hearing aids, a cochlear implant may be considered. Unlike a hearing aid,
a cochlear implant bypasses damaged parts of the auditory system and directly stimulates the hearing nerve
and allows the child to hear louder and clearer sound. Early intervention is important to prevent language
delays. Research indicates that habilitation of hearing loss by age six months will prevent subsequent
language delays. Other communication strategies such as auditory verbal therapy, lip reading, and cued
speech may also be used in conjunction with a hearing aid or cochlear implant, or independently.
Early intervention may help to improve learning communication skills before neuroplasticity at early
childhood. Other than that, there are some important issues depends on early intervention-
Improved quality of life:
Hearing loss impacts every aspect of life: your relationships, your home life, your work, your hobbies, etc.
If you suffer from hearing loss, just think of all the times you’ve had to ask someone to speak up or repeat
themselves. early intervention may help to overcome these issues.
Prevention of further hearing loss:
A study conducted at the’ Massachusetts Eye and Ear Infirmary’ found that chronic conductive hearing loss
may lead to permanent hearing impairment if it goes untreated. Dramatic changes occur in the inner ear if
sound deprivation persists, including the loss of synaptic connections (which send electrical signals to the
brain). So if you have conductive hearing loss and neglect your treatment for long enough, even hearing
aids won’t be able to restore your hearing. Early intervention is extremely important to minimize this.
Prevention of cognitive decline:
According to a 2011 study and 2013 study, hearing loss may speed up age-related cognitive decline. The
researchers believe this may be due to cognitive load – because the brain must put in a lot of effort to
understand what the person is hearing, it has less resources to put toward memory. So early intervention
may reduce cognitive decline.