Review of diagnostic hearing problems in childhood

The main focus for identification of permanent childhood hearing impairment is through implementation of newborn hearing screening programmes. Early identification and effective management of hearing loss aims to optimize auditory plasticity for auditory potential through life, by making sound audible from the first months of life through hearing aids. For infants with profound hearing loss or auditory neuropathy the option of cochlear implantation may give improved hearing for speech, typically at around 12 months of age. The onus of responsibility for using hearing aids and providing a suitable sound environment for the child falls on the parents, thus requiring a family-centred model of audiology management rather than the traditional expert- or medical-models of intervention.For later-onset hearing loss, particularly conductive hearing loss secondary to otitis media or other middle-ear conditions, there is no longer a national screening programme, but instead a greater reliance on surveillance. Many school-entry screens of hearing have been disbanded and there is risk of children with later-onset hearing loss being overlooked despite the recognized secondary effects of untreated hearing loss on speech development, social interaction and subsequent educational achievement.