Early screening, diagnosis is key to ensue 'sound' future for children

NEW DELHI: 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, these sounds are an inherent part of the happy, nostalgic memories of our childhood. But not everyone gets to enjoy such memories – every day in India, over 300 babies are born with some degree of hearing loss.

This World Hearing Day, March 3, it is important that we remember just how much hearing and early diagnosis matters in changing the quality of rest of their lives of hearing-impaired children.

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 language skills – which has a profound impact on the way they relate with others for the rest of their lives, said Janardhan Rao Jagini, Cochlear Implant Surgeon, KIMS Hospitals, Hyderabad.

Unfortunately, it is easy to miss the early signs of hearing loss in infants; however, if recognized early, timely intervention can help these children pick up speech and language skills, helping them integrate more seamlessly into the mainstream world of sound, observed Jagini.

According to him, the ability to hear starts much before birth. By 15 weeks, the growing child in the womb begins to hear sounds from the 'outside' world, including the sound of their mother’s voice, her heart beat and sounds from her digestive system as well!

Once outside the womb, a baby listens and gradually gets attuned to the sounds of his/her parents cooing, talking, singing and reading, in addition to environmental sounds. These sound cues and signals picked up during the first three years of life, when the brain is still developing and maturing, are crucial for a baby to develop linguistic skills, explains the doctor.

Unaddressed hearing loss affects language development. However, if these babies get help early in 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 time significant damage has already occurred.

"The earlier we diagnose loss of hearing in a child, the sooner we can intervene and the better the outcome. Screening hinges on the 1-2-3 guideline issued by experts: Screen for hearing loss within 1 month from birth; diagnose and confirm hearing loss by 2-3 months of age; organise early intervention services by 3-6 months of age," said Jagini.

The right intervention at the right time helps the child develop normal speech and have a regular education.

"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 the first month of life. For children with significant hearing loss, a cochlear implant may be recommended.

"While these implants do not restore ‘normal’ hearing, they directly stimulate the nerve (auditory nerve) responsible for hearing and the brain recognizes these as sounds. In my opinion, cochlear implants must ideally be fitted around 9 months of age. This is the optimal time for children to be exposed to sounds to help them comprehend language and music and pick up speaking skills.”

The doctor mentioned that there was a time when children with hearing loss had no option but to pick up sign language and learn to cope and adjust for the rest of their lives.

"Today, the situation is thankfully very different. At my hospital, a child as young as 9 months old has been fitted with a cochlear implant, though I believe that elsewhere globally, a child as young as 6 months has successfully received the implant. What a difference these make to their lives! Within a year from the implant, these children have normal speech development.

"As a doctor, it is so encouraging and satisfying for me to watch these children play with their siblings, communicate with other kids their age and be exposed to an entire world of sound that would have otherwise been completely foreign to them.”

He pointed out that in many other countries including the US, UK and Australia, every newborn is screened for hearing loss. He is of the view that Indian experts must also recommend that a similar guideline is put in place very soon.