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baby boy listens to put a hand to his ear.

 With early intervention, the exquisitely nuanced world of communication is well within reach of the hearing impaired.

Being hearing impaired does not mean your child will always be isolated. With modern-day treatment and devices, the hearing impaired child can enjoy every aspect of life to the full.

Sarah had no reason to suspect there was anything wrong with her daughter’s hearing. Kate had shown no response to buzz tests during her 20-week foetal assessment, but the gynae said she was probably sleeping.

A routine screening test conducted when she was two days old showed abnormalities, but the audiologist put their minds at rest, saying that the follow-up at 10 weeks, was essentially for peace of mind.  So, they were devastated to learn that their little girl was born profoundly deaf.

accurate hearing tests

Their story is a happy one, though. Kate’s ability to communicate has been fully restored through “bionic ears” (cochlear implants).

“If picked up sufficiently early, hearing loss needn’t be an issue for any child,” Anthony insists.

But that’s just the problem, says an audiologist. Many parents don’t realise that hearing tests  have such high sensitivity and produce accurate results for even newborn babies. “The test should be performed, at the latest, when the child is six weeks old,” says the audiologist.

early intervention is key

The audiology team at Cape Town’s Carel du Toit Centre, a school for hearing impaired children, agree that the sooner the tests are conducted, the better. A baby diagnosed with deafness by six months can immediately be fitted with hearing aids. And, they can be on a par with hearing peers by their second birthday, provided an intervention takes place as soon as hearing loss is detected.

Delayed intervention carries significant impact. The world of silence can be an isolated one. Children become frustrated quickly without the ability to communicate their wants and needs. This ultimately affects their self-esteem. Moreover, because hearing loss makes communication with hearing parents tricky, children with hearing loss have difficulty acquiring speech. This may become even more challenging if diagnosis comes when the child is older than six months.

reading cues

Sue* has witnessed first-hand the difficulty that children with hearing loss experience. Her son, Luc* was found to be deaf at around six months. He too has a cochlear implant. Luc has learned to communicate with a blend of oral language, sign language and gestures.

Hi Hopes is a Johannesburg group that facilitates interventions for parents of hearing impaired children. Hi Hopes has been extremely beneficial to Luc’s development, says Sue. Luc has been assigned a parent advisor and a deaf mentor, providing him with a role model and building his self-esteem.

He has made good progress in acquiring language, however without auditory skills, he is misses subtle cues related to giving and receiving messages.

Read our article on hearing health.

possible causes

.Dr Phillip Pio, a Johannesburg ear nose and throat specialist, says : “The cause, most often, is something that occurs during the intra-uterine period.” Viruses during pregnancy may play a role, as may maternal drinking or smoking. A number of  syndromes, as well as premature birth or the parents’ family history can also play a contributing role. Further risks may be posed by common childhood diseases and even certain medications. Recurring middle ear infection can cause temporary residual damage to the middle ear, so treatment and management options should be explored as soon as possible.

The problem is that if parents are unaware of these risk factors, they may not know their child’s hearing has been compromised. “Parents don’t realise that even if a child can hear a loud sound, like a door slamming, they may not be able to hear very soft sounds, like those present in speech,” says the audiologist.

invisible challenge

“Hearing loss is an invisible challenge, so the early signs are easy to miss.,” says the audiology team. “Normally, you’d notice that the baby doesn’t startle at loud sounds. Or or may get a fright when you enter his visual range because he hasn’t heard your footsteps. Very young children may not be soothed by their parents’ voices.”

good news

There is hope, though. With a hearing aid, many children can achieve hearing within the normal range, says Pio. Even profoundly deaf children can be given access to sound with a cochlear implant.

But implants should not be viewed as a magic cure. These work by inserting an electrical device into the inner ear, which uses electrical impulses to stimulate the cochlear nerves similarly to the way the tiny hairs present in the ear. This gives access to sound (although the quality will not be the same as that experienced by a hearing person). A hearing aid, on the other hand, works by amplifying sounds.

However, the implant procedure is not recommended for all children with hearing loss. Not only is it extremely expensive, but it involves a lengthy and often difficult process of habilitating children to speech.

The procedure can only be performed on children who have normally developed inner ears. All candidates for the procedure are required to have first tried a hearing aid for at least six months. This is because the tiny hair cells that convey sound will be damaged with the insertion of the electrodes. It’s therefore necessary to first ascertain that the child is completely deaf, and that hearing aids have no impact, before going ahead with the operation.

other interventions

With the available interventions, a deaf child can happily attend a mainstream school, unless they have learning difficulties that make remedial classes a better option. However, schools for the deaf provide more intensive language learning programmes and the best therapeutic support for learners.

Pio believes that it’s a good idea for children to be taught oral communication and lip reading as well as sign language. This, he says, will smooth their transition into the hearing world.

  • Names have been changed.

Lisa Witepski