Symposium: neurodisabilityHearing impairment in children

Permanent childhood hearing impairment is best identified through newborn hearing screening programmes. Early identification and effective management of hearing loss optimizes outcomes. By making sound audible from the first months of life through hearing aids, it is possible to harness auditory plasticity and maximize lifetime auditory potential. 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. This is best achieved using 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 in the UK with a greater reliance on surveillance. Many school-entry screens of hearing have been disbanded (with the joint understanding that community audiology services should be open to a wide range of referrals and easy to access) and there is risk of children with later-onset hearing loss being overlooked despite the recognised secondary effects of untreated hearing loss on speech development, social interaction and subsequent educational achievement. This article reviews the current knowledge base and discusses the appropriate methods of behavioural assessment techniques useful for healthcare professionals.