Hearing Loss in Children

Abstract

earing loss in children is common (Box 1); by age 18 years, it affects nearly 1 of every 5 children in the United States. Without hearing rehabilitation, hearing loss can cause detrimental effects on speech, language, developmental, educational, and cognitive outcomes in children. Hearing rehabilitation can mitigate those detrimental effects for many children, particularly when identified soon after birth or onset.The diagnosis and management of pediatric hearing loss have undergone significant changes in the past 30 years. In 1993, the National Institutes of Health recommended newborn hearing screening within the first 3 months of life. 1 The Joint Committee on Infant Hearing, consisting of representatives from many national organizations dedicated to ensuring early identification, intervention, and follow-up care of infants and young children with hearing loss, published statements in 1994, 2000, 2007, and 2019 to establish guidelines for newborn hearing screening and for early hearing detection and intervention programs, benchmarks for quality, tracking of outcomes, and initial management of infants with hearing loss. 2 Through the Individuals with Disabilities Act (2004), Part C provides free intervention services from birth to age 3 years for any child in the United States identified with hearing loss, and Part B provides educational assistance for children aged 3 through 21 years through individualized educational plans and programs for hearing disability.The multichannel cochlear implant was initially approved in the United States in 1990 for children 2 years or older; the age was lowered to 18 months in 1998, 12 months in 2000, and then 9 months in March 2020. 3 The combination of newborn hearing screening programs (Box 2), advances in cochlear implant and hearing aid technology, and legislative policy changes have allowed more than 75% of children with hearing loss to attend public schools mainstreamed with normal-hearing students. 4 The ability of screenings to detect hearing loss in infancy, the efficacy of hearing aids and cochlear implants to mitigate consequences of hearing loss, the proliferation of genetic studies expanding the understanding of genes involved with hearing, and the knowledge about the interaction between hearing and cognition have fundamentally altered the understanding about children with hearing loss. This review will summarize what is known about the current diagnosis and management of pediatric hearing loss, with a focus on some of the current controversies in management. MethodsPubMed was searched with the Medical Subject Heading term hearing loss with filters for English language, child (birth-18 years), and humans from 1993 through July 31, 2020. The search was IMPORTANCE Hearing loss in children is common and by age 18 years, affects nearly 1 of every 5 children. Without hearing rehabilitation, hearing loss can cause detrimental effects on speech, language, developmental, educational, and cognitive outcomes in children.OBSERVATIONS Consequences of hearing loss in children...

Hearing Loss in Children: Clinical-Epidemiological Data from Two Different Provinces of the Same Region

“…The prevalence of congenital hearing loss had comparable percentages between the two counties. In the literature [ 1 , 2 , 10 ], most industrialized countries report a prevalence of 1–3:1000 variations observed, and also reflect different criteria in the reporting results [ 11 ]. In countries without ongoing NHS programs, prevalence estimates vary between, for example, 19 per 1000 newborns in sub-Saharan Africa and 24 per 1000 in South Asia [ 12 ].…”

Comprehensive medical evaluation of pediatric bilateral sensorineural hearing loss

“…Sensorineural hearing loss (SNHL) occurs in 0.2% to 0.4% of live births, affects approximately 40 000 children annually in the United States (US), and affects both ears in nearly 2/3 of the cases. 1 , 2 Bilateral SNHL in children has been shown to cause poorer development of speech and language, even when the hearing loss is mild to moderate. 3 , 4 , 5 Therefore, early identification, determination of etiology, and appropriate treatment are essential for optimal outcomes.…”

Cochlear Implantation in Infants: Why and How

“…Using a family-centered approach, a multidisciplinary CI team can help the child’s caregivers decide upon the best approach for language development, considering each family’s unique characteristics. While guidelines for etiologic workup of hearing loss are outside the scope of this review, identification of an etiology of deafness, such as congenital cytomegalovirus infection or genetic mutation, can help to inform decision-making and bolster confidence in the results of both objective and behavioral measures of hearing in infants ( Lieu et al.,2020 ).…”