Dr Paulose

 Jubilee Hospital, Trivandrum, Kerala, India

If your child is deaf, life can be a struggle with lot of efforts and sacrifice until you succeed by raising your child to an adult who become an independent and capable of enjoying a happy life. Your deaf child can do everything in the same way that all the hearing children of his same age can do. His only handicap and therefore his only difference is his “deafness.

It is not easy to raise a child with a hearing loss. Each day is a challenge. Sometimes many parents, for wanting to protect their children, tend to care for them a bit too much. That is, they overprotect them. Parents who overprotect may also try to isolate their children from things and from other people.

Parents should support the child in every way, but remember try “not give them fish; teach them how to fish” in this world.

About Deafness in children: An overview

Deafness or profound hearing loss means that a child has lost most of the hearing in one or both ears. Hearing impairments are described according to how much hearing has been lost. Loss is usually explained as mild, moderate, moderate to severe, severe or profound.

Levels of hearing loss

There are four different levels of hearing impairment, which are defined by the quietest sound that you are able to hear, measured in decibels (dB). These are described below.

Mild deafness

If you are mildly deaf, the quietest sound that you can hear is between 25 to 39dB. Mild deafness can sometimes make following speech difficult, particularly in noisy situations.

Moderate deafness

If you are moderately deaf, the quietest sound that you can hear is between 40 to 69dB. You may have difficulty following speech without using a hearing aid.

Severe deafness

If you are severely deaf, the quietest sound that you are able to hear is between 70 to 90 dB. People who are severely deaf usually need to lip-read or use sign language even with the use of a hearing aid.

Profound deafness

If you are profoundly deaf, the quietest sound that you can hear is 90dB or more. People who are profoundly deaf can often benefit from a cochlear implant. Other forms of communication include lip reading and sign language

Types of Hearing Loss

Conductive hearing loss: caused by a problem affecting the conduction system. Examples are excessive wax blocking the external ear canal, fluid in the middle ear preventing the eardrum from vibrating, or a disruption or fixation of the bones in the middle ear. Many conductive hearing losses can be treated and eliminated with medication or surgery. If a problem in the middle ear cannot be corrected, hearing aids and other assistive devices may be helpful.

Sensorineural hearing loss: caused by a problem in the inner ear hair cells (sensory loss) or auditory nerve (neural loss). Some or all of the hair cells in the cochlea may be damaged or absent. It is also possible that the auditory nerve from the cochlea to the brain may be damaged, incompletely formed, or there may be problems with transmission of sound across the auditory nerve.

Rarely the auditory nerve may have a tumor growing in it which is generally benign (acoustic neuroma).This type of loss is not reversible.

Most people with sensorineural hearing loss benefit from hearing aids. If the hearing loss is profound, a cochlear implant may be recommended. A cochlear implant can be thought of as a very strong hearing aid which is surgically implanted. It is important to monitor children’s hearing to determine the stability of their hearing loss. Young children should be tested at least twice yearly. Older children should be tested annually.

Mixed hearing loss: a combination of conductive and sensorineural losses

Causes of hearing loss

There are many causes of hearing loss. These may include:

and middle ear infections

and perforated ear drum

and inherited condition or genetic cause.

and infections that occur during pregnancy such as rubella (German measles) and toxoplasmosis

and infections after birth, such as meningitis, mumps

and abnormalities of the head and face that affect the structure of the ear

and premature birth, especially when the birth weight is less than 1500 grams

Treatment

and The treatment for hearing loss depends on the reason for the impairment, and the severity of the impairment.

and Most conductive hearing losses can be improved by medication or surgery.

and Sensorineural hearing loss usually cannot be treated. Different types of technology are used to help children with permanent hearing loss. Hearing aids and cochlear implants are used most often to improve hearing in children with permanent disabling hearing loss.

Hearing aids

A hearing aid is a device that makes sounds louder. Hearing aids are fitted to match the hearing loss of your child. Hearing aids will increase your child’s hearing but will not make hearing normal.

Different types of hearing aids are named according to where they are worn. Hearing aids can be:

and in-the-ear (ITE)

and in-the-canal (ITC). This is the passage between the outer and middle ear.

and behind-the-ear (BTE)

and body level hearing aids that clip on to a belt or clothing

Cochlear implants

A cochlear implant is sometimes called a bionic ear because it uses technology to allow the person to hear. A cochlear implant is designed to stimulate the surviving nerve cells in the inner ear (cochlea). This allows messages about sound to be sent from the inner ear to the brain.

(2 year old little kevin is having profound deafness and his parents are trying hard to raise him with two powerful hearing aids.Since his inner ear is not developed (Cochlear agenesis and neural deafness) he is not a candidate for cochlear implant. It is a great challenge for kevin’s parents to bring him up like a normal kid.)