Never too early for cochlear implants
To learn language, children must be able to hear clearly.
CHILDREN learn to talk by listening to speech. In order to learn language, these children must be able to hear clearly. With hearing impaired children language development might be hampered if it is not detected and treated early.
When this is addressed it is likelier the child will develop speech and language skills on par with hearing children.
The most popular intervention for children with hearing loss are cochlear implants.
Cochlear implants improve audiology performance as it transforms sounds into electrical energy that stimulates the auditory nerve.
In recent decades, cochlear implants have become the best solution for children with severe to profound sensorineural hearing loss.
Cochlear implants improve hearing thresholds so that children learn to understand speech sounds.
Impact of hearing loss
Hearing impaired children were reported to have difficulties with communication skills (speech and language), academic performance, psychosocial behaviour and emotional development.
This is due to poor quality input from a degraded auditory system resulting in hearing loss, which can impact the outcome of a child’s life.
Although children with severe and profound hearing loss are often the focus of concern when it comes to education, past studies have reported that even slight and mild hearing loss can also influence academic performance, cause problems with speech recognition and hinder psychosocial development.
Therefore, it important to identify children with hearing loss at an earlier stage as to ensure they receive early intervention services consistent with their individual needs, resources, priorities, and the concerns of their families.
The ability to speak is closely related to the ability to hear. A child will have difficulty learning to speak correctly if the child is not able to hear. Hearing provides feedback which is used by the child to correct or improve his/her speech production skills. Auditory feedback is therefore very important for learning how to speak, and cochlear implants can provide that.
Early intervention is key
Early identification of hearing loss among children is not only the first but also the most important step in increasing the chances of developing normal language skills.
Available data indicates that late detection and intervention would pose challenges toward effective intervention of hearing loss.
A recent study conducted at the Health Ministry revealed that the median age of diagnosis was two and a half years old, which is very late compared to what has been suggested by the Joint Committee on Infant Hearing, which suggests that hearing loss be diagnosed when the child is three months old and intervention initiated at six months.
Past research indicates that identification of hearing loss and appropriate intervention before the age of six months can increase the possibility of normal language development.
The next step
Hearing technology such as cochlear implants help the child to hear at optimum, however, this technology alone is not enough. Making a commitment to train the brain to hear using this technology is the first step in a journey that would open the doors to new possibilities.
For babies and young children born with hearing loss they need to learn how to listen and talk after cochlear implantation, which is known as habilitation.
The main aim of habilitation is to make the sounds that come through the implant meaningful. Hearing habilitation includes learning speech and language, learning to listen with the cochlear implant, finding the best ways for the child to communicate and training on how to take care of their implant.
During habilitation sessions, an implantee is trained to understand sounds and intonations so that they may develop speech and language which will allow them to orate as a primary mode of communication similar to hearing children.
Regular habilitation is extremely important for a successful outcome and is carried out by a trained auditory verbal therapist.
Active participation of the parents is also vital in this process. Studies show that the active involvement of parents during habilitation resulted in the child performing better. Parents are often taught and given instructions on how to adapt this training in a home environment.
Dr Deepashini Harithasan is a Researcher and Lecturer at Institute of Ear, Hearing and Speech (Institute- HEARS), Universiti Kebangsaan Malaysia. Institute – HEARS is a service institute in UKM and provides ENT, Audiology and Speech Therapy services for Individuals with Hearing Loss. For information, e-mail hears@ ukm.edu.my, visit www.ukm. my/i- hears or call 03-9289 5132.