Management of Children with Mild, Moderate, and Moderately Severe Sensorineural Hearing Loss

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Key points

  • Management of children with hearing loss requires collaborative, interprofessional teams focused on patient-centered goals and shared problem solving.

  • Referrals to otolaryngologists, audiologists, and speech-language pathologists with expertise working with children should be made for diagnosis, treatment, and management of hearing loss.

  • The hearing of every child should receive ongoing monitoring throughout childhood to detect late-onset or progressive hearing loss.

  • A variety of hearing

Overview: nature of the problem

Childhood hearing loss impacts almost all areas of child development: speech and language, psychosocial, and psychoeducational development, among others. The earlier management is implemented, the better chance there is to ameliorate the negative impact on development. Although we currently screen the hearing of 97% of newborns in the United States, a significant percentage of infants who fail the screening do not return for follow-up testing. According to the Centers for Disease Control and

Identification of childhood hearing loss

Before universal newborn hearing screening, a child born with congenital hearing loss was likely to be identified after the first 2 years of life. The evaluation and diagnosis of children was generally requested and often welcomed by the family, who suspected something was wrong based on their child’s lack of language development. For those families, the hearing loss of their child had an obvious impact on their lives, allowing them to accept the diagnosis and to see direct benefit from

Management goals

Studies have consistently shown that early identification of and intervention for childhood hearing loss results in improved communication abilities, including language, speech perception, and speech production.10, 11, 12 Physicians and other health care providers play a significant role in this process. Although the screening and diagnosis13 might initially appear as the “main event” in the family’s life, the longer journey begins after the identification of hearing loss. Fig. 2 illustrates

Summary

Children with hearing losses in the mild to moderately severe range are a varied group. Although, in general, we expect a positive correlation between degree of hearing loss and its impact on child development, the distinctions across these categories are influenced by many factors, including age of identification and intervention, technology selection and wearing compliance, and quality of intervention. The roles of pediatricians and otolaryngologists in referring children for appropriate

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    Disclosure Statement: Dr A.M. Tharpe is Chair of the Phonak Research Advisory Board and serves as principal investigator of a research grant from Phonak. Dr S. Gustafson has nothing to disclose.

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