KOCHI: It is considered the second most common cause of disability after locomotor disability. However, it is often treated as a low profile disability, because of low awareness. Studies across the globe have shown that hearing impairment in infants can affect speech and language acquisition, academic achievement, and social development. Over 50,71,000 Indian citizens have hearing disorders out of which Kerala has over 1,05,000 hearing impaired population. Over 27,000 children are born deaf every year in India.
Universal Newborn Hearing Screening (UNHS) has been introduced as a medical procedure for early detection of congenital hearing loss. This test is vital in order to detect hearing impairment in newborn babies and to ensure early intervention. Dr. Abraham Paul, leading paediatrician and convenor of newborn hearing screening programme of Indian Academy of Paediatrics, while stressing on the importance of newborn hearing screening says, “In past 15 years, across 78 hospitals of three districts of Ernakulam, Kottayam and Thrissur districts, 1,40,000 babies were screened and 180 were confirmed with permanent hearing loss. Kochi is the first and only district in India to have a centralized newborn hearing screening programme.”
According to Dr. M.P. Manoj of Dr. Manoj’s ENT Super Specialty Institute & Research Centre, Kozhikode, there are three cardinal principles related to detection; firstly to screen for hearing loss before the first month; secondly to confirm the handicap by three months and thirdly, to intervene in case of confirmed hearing loss by six months. This is called the 1-3-6 rule. “If effectively implemented, this can lead to a drastic reduction, even elimination of the handicap. The entire strata of society - parents, social workers, pediatricians need to be sensitized to this very important rule,” he says.
“In an ideal world, children with hearing loss are fitted with hearing aids by six months and started on therapy. If the child does not catch up with this intervention, cochlear implantation surgery will ensure that every deaf child has the opportunity to learn language and hear and speak like anyone else. The cochlear implant surgery is safe and is now done in thousands of young children. But to be effective, it has to be done early,” he says
Ms. Jeena Mary Joy, audiologist, Department of Audiology, National Institute of Speech and Hearing (NISH), Thiruvananthauram, says, “Wearing a cochlear implant requires commitment from the recipient, as well as their caretakers, for optimal benefits. There are follow up procedures like fitting the external components, activation and programming of the implant, its microphone, speech processor and transmitter, necessary adjustments and reprogramming, and annual check-ups need attention. Another significant component post implant is auditory verbal therapy to enhance auditory, speech and language skills and eventually a good quality of life.”
While UNHS has been made mandatory in developed countries, India still has not included it in the list of mandatory health screening procedures for newborns. In the absence of a screening programme, parents are still dependent to identify hearing loss in children through language learning and comprehension over a period of time. Such delays cost children up to 24 months of precious time of cognitive development. Doctors around the world suggest there are primarily two types of deafness - nerve deafness and conductive deafness. Nerve deafness is mainly caused due to sound pollution and problems during birth, whereas conductive deafness is often caused by socio-economic factors including poor hygiene, lack of treatment, leading to chronic infection and deafness.
