How to find and intervene the hearing disorder in early stage?

Many people think that a baby has no hearing at birth, but in fact, a normal newborn has the ability of hearing orientation. Therefore, caring for the next generation should start from paying attention to children’s hearing health

< img SRC = "http://sky.hearingaid.cc/data/images/2019-10-21/283edf8efdceca7f2f612c132451402. JPG" ALT = "baby" >

Why should we pay attention to children’s hearing impairment?

Human beings perceive the world through their senses. In all sensory experiences, people promote communication and social interaction through hearing, establish connections, participate in daily activities, sense danger and experience all kinds of life. 5% of the world’s population (about 360 million people) is accompanied by hearing loss with deafness and disability, of which more than 32 million are children, mainly distributed in low-income countries.

The incidence of congenital hearing impairment of newborn is 1 ‰ – 2 ‰. With the increase of age, the incidence of permanent hearing impairment will continue to increase. The incidence of hearing impairment will rise to 2.7 ‰ before 5 years old, and 3.5 ‰ at puberty. Childhood is a critical period of speech development. In this period, if hearing impairment is not found in time and effective intervention measures are taken, the minor can lead to speech development and behavior problems; the major can lead to serious speech development disorders, and even affect children’s emotional, psychological and social interaction ability development. Therefore, the early detection and early intervention of children’s hearing impairment are very important.

02. What is hearing impairment?

Hearing impairment refers to the difficulty of hearing in both ears due to various reasons, and the inability to hear or hear the environment sound and speech sound. The degree includes the following:

Mild (hearing threshold 26-40dB HL): it is difficult to hear the conversation sound;

Moderate (hearing threshold 41-60db HL): it is difficult to listen to loud speech;

Severe (hearing threshold 61-80db HL): shouting at the ear can only hear a few words;

Extremely severe (threshold above 81db HL): no words can be heard by shouting to the ear.

< img SRC = "http://sky.hearingaid.cc/data/images/2019-10-21/80fe3f2fb4cc0892f5eefda2ea5e5ebb. JPG" ALT = "hearing loss level" >

03. What are the common causes of children’s hearing impairment?

There are many causes of hearing impairment, including congenital and acquired factors. The former refers to congenital hearing loss at birth or shortly after birth, and the latter refers to hearing loss in childhood. Hearing impairment may be the result of multiple factors, but sometimes it is difficult to find out the exact cause. The possible causes of hearing impairment in children include:

Genetic factors: about 40% of children’s hearing loss is caused by genetic factors. The evidence shows that the offspring of close relatives who marry or have close relatives have a higher probability of hearing loss. Congenital malformation of ear or auditory nerve caused by gene or environmental factors may be the cause of hearing loss.

Factors during labor: including premature delivery, low birth weight, neonatal asphyxia (refers to diseases caused by hypoxia at birth) and neonatal jaundice.

Infection: rubella and cytomegalovirus infection during pregnancy may cause hearing loss of newborn, in addition, meningitis, measles and mumps may also cause hearing loss.

Ear diseases: common ear diseases such as cerumen embolism (earwax accumulation) and eustachian tube blockage (non suppurative otitis media) caused by water in the ear canal can also cause hearing loss in children.

Noise: the use of smart phones, MP3 and other personal audio playing devices with large volume for a long time may cause hearing loss. High decibel noise such as fireworks and firecrackers may cause permanent hearing loss. In addition, the equipment noise of NICU can also cause hearing loss.

Drugs: used to treat neonatal infection, malaria, drug-resistant tuberculosis, cancer and other drugs, because of its ototoxicity, can lead to hearing loss. Ototoxic drugs are often used to treat common infections in children in many areas, especially in areas where drug use is not standardized.

04. How to prevent and avoid?

WHO estimates that about 60% of children under the age of 15 can avoid hearing loss. Among them, the proportion of low – and middle-income countries is higher, up to 75%, and that of high-income countries is 49%. The above-mentioned gap is mainly due to the high infection rate in the areas with poor social resources and the sound maternal and child health service system in high-income countries.

Heredity is one of the most important factors in the congenital deafness of newborn babies. Therefore, it is necessary to strengthen the pre pregnancy examination, especially for couples with family history of deafness or deafness, and couples who have had children with deafness, we should try our best to carry out deafness gene screening before pregnancy, so as to reduce the birth of children with deafness.

Many factors in pregnancy also affect the hearing of fetus, mainly including virus infection in early pregnancy (including rubella, cytomegalovirus, etc.), ototoxic drugs used in pregnancy (gentamicin, kanamycin, etc.), high-risk pregnant women (diabetes, low-grade a, etc.). Therefore, during pregnancy, we should avoid virus infection and use ototoxic drugs, and strengthen the monitoring of high-risk pregnant women. In addition, about 17% of hearing loss is caused by premature delivery, low birth weight, neonatal asphyxia and neonatal jaundice, which can be avoided by improving maternal and child health services.

Infection is one of the main factors of hearing loss in neonatal period. For example, cytomegalovirus infection (mostly in utero or during production) can cause inner ear and / or auditory nerve damage. Nervous system infection and hypoxia, severe hyperbilirubinemia can also affect the auditory nerve, leading to hearing loss. Improper use of certain drugs may also affect the hearing of newborns. Therefore, active treatment of primary diseases and rational use of drugs are important measures to prevent neonatal hearing loss.

< img SRC = "http://sky.hearingaid.cc/data/images/2019-10-21/a9e54255e39eb1f5ae37b899406f201e. JPG" ALT = "cause of hearing loss" >

There are many reasons for hearing loss in childhood. It is recommended to take preventive measures for the following situations:

For those who have a family history of deafness, it is suggested to carry out genetic testing and genetic counseling for deafness in order to prevent delayed hereditary deafness;

For high-risk infants with history of asphyxia, jaundice and virus infection in the neonatal period, if they pass the newborn hearing screening, they should have their hearing reexamined at least once or twice a year before the age of 3;

More than 30% of children’s hearing loss is caused by diseases such as measles, mumps, rubella and meningitis, which can be avoided by preventive immunization and good health habits;

To prevent hearing loss caused by head injury and entertainment noise;

If the child is found to pat or scratch the ear, or has ear itching, ear swelling and other discomfort, or the child is found to be slow in response to the voice or unable to hear clearly and ask more questions, the parents should take the child to see a doctor to eliminate secretory otitis media.

05. How to detect hearing impairment in the early stage?

In addition to the precautions mentioned above, it is very important to detect and diagnose children’s hearing impairment early. Specifically, it includes the following:

Newborn hearing screening: it refers to the non-invasive preliminary screening of baby’s hearing in the hospital during the period from birth to discharge. Newborn hearing screening is the most effective way to detect hearing loss in the early stage. If the newborn fails the primary hearing screening, the parents need to re screen the baby’s hearing in the hospital at 42 days. If the re screening fails, the parents need to go to the hospital with hearing diagnosis qualification when the baby is 3 months old for examination.

If the preliminary hearing screening fails, is there any problem with the baby’s hearing? Not necessarily, the hearing screening results are also affected by many factors, such as residual fetal fat in the external auditory canal, amniotic fluid, etc.; the baby’s crying is not quiet during the test; the environment is noisy; the middle ear effusion; the inspection operation is not standardized, etc. Of course, these factors can be excluded in the re screening or further hearing examination.

So in order to ensure the normal and smooth primary hearing screening, parents need to feed their babies before hearing screening, change their diapers, and make their babies in a comfortable state with thick and thin covers. Try to keep quiet during hearing screening, turn off communication equipment, avoid noise, and cooperate with doctors for examination.

Children’s hearing screening: according to China’s technical specification for children’s ear and hearing care, the age of children’s hearing screening is 0-6 years old, that is to say, after the newborn hearing screening, it will enter the 0-6 year old children’s health care system management and carry out ear and hearing care at the same time of health examination, including 6, 12, 24 and 36 months