Hearing loss in children


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Hearing loss in children

  1. 1. Tarek Ghannoum , M.D. Audiology Unit , ENT DepartmentKasr Alainy Hospitals- Cairo University
  2. 2. Hearing loss :
  3. 3. Hearing loss:*Any degree of impairment of the ability to apprehend sound.*Being partly or totally unable to hear sound.
  4. 4. CHILD:*A person between birth and full growth.Infant:*A person not more than 12 months old.
  5. 5. Prevalence of Hearing Loss:* Prevalence estimates vary across studies.*Estimated that 1 to 3 per 1000 infants willhave permanent sensorineural hearingloss. -1/1000 from well baby nursery. -10/1000 from the NICU.* Rate increases to 6/1000by school age.
  6. 6. Children with hearing problems may have difficulties in:*Language and/or speech development.* Listening and understanding in noisyenvironments.*Paying attention and participation in noise(class).*Hearing differences between sounds in words.
  7. 7. Hearing loss:Impaired all brain functions:*Speech and language development.*Cognitive functions and intellectual abilities*Social activities.
  8. 8. Hearing mechanism
  9. 9. Neurological Issues:We hear with the brain—the ears are just a way in. Children can’t listen like adults 1. The higher auditory brain centers are not fully developed (15 years). 2. Children cannot perform sophisticated automatic auditory cognitive closure.
  10. 10. SoInfants and children need: Quieter environment (S/N ratio) Louder signals than adult
  11. 11. Hearing loss is not about the ears, it’s about the brain.Any-time the word hearing is used, think about “auditory brain development”Acoustic accessibility of intelligible speech is essential for brain growth (CAP).Hearing is the first order event for the development of spoken communication and literacy skills.
  12. 12. Summary of NeuroplasticityGreatest in the first year of life.The younger the infant, the greater the neuroplasticity.Rapid brain growth requires prompt intervention, including amplification and habilitation programs.In the absence of sound, the brain re- organizes itself to receive input from other senses, primary vision- cross modal reorganization. This reduces auditory neural capacity
  13. 13. Goals for hearing screening:All infants must access hearing screening no later than 1 month of age.All confirmed cases should receive early intervention not later than 6 months of age.
  14. 14. ReminderA pass on newborn hearing screening does not guarantee typical hearing forever.High risk babies should undergo retesting every 6-12 months.Any child with delayed language development should be retested.Average age for identification of hearing loss is after 3 years of age.
  15. 15. High risk babies:Prenatal Perinatal Consanguinity Pre-eclampsia Similar condition Low birth weight Viral infection Birth trauma Ototoxic drugs Hyperbilirubinemea Cyanosis Congenital anomaly
  16. 16. High risk babies (cont.) Post natal NICU
  17. 17. Normal chart of language development:Cry (at birth)Pseudocry (2-3 weeks)Babling (3-4 months)Lalling (6 months)Echolalling (9 months)One word ( one year)Two words (2 years)Three words (3 years)Full language maturation (School age)
  18. 18. Degrees of hearing loss
  19. 19. AUDIOGRAM
  20. 20. AUDIOGRAM0-15 dB Normal.15-25 dB Minimal hearing loss.26-40 dB Mild hearing loss.41-55 dB Moderate hearing loss.56-70 dB Moderately severe hearing loss.71-90 dB Severe hearing loss.>90 dB Profound hearing loss.
  21. 21. Speech banana
  22. 22. Audiological evaluation: Objective audiometry:Otoacoustic emission: ABR/ SSEP
  23. 23. ABR & SSEP
  24. 24. Subjective audiometry: Play audiometry PTASpeech audiometry
  25. 25. Circumaural environment
  26. 26. Hearing Technology OptionsHearing aids: Ear level Bone conduction. BAHA.Cochlear implant:FM system.
  27. 27. Hearing Technology OptionsHearing aids: Ear level Bone conduction. BAHA.Cochlear implant:FM system.
  28. 28. Hearing Technology OptionsHearing aids: Ear level Bone conduction. BAHA.Cochlear implant:FM system.
  29. 29. Hearing Technology OptionsHearing aids: Ear level Bone conduction. BAHA.Cochlear implant:FM system.
  30. 30. Hearing Technology OptionsHearing aids: Ear level Bone conduction. BAHA.Cochlear implant:FM system.
  31. 31. Benefits of hearing aids fitting1-Improve discrimination.2-Improve communication3-Prevent sensory degradation.4- Alleviation of tinnitus5- Alerting device.