Approach to deafness in children

Once deafness is diagnosed the child is referred to an Otologist for assessment of cause and possible treatment.  A conductive deafness produced by middle ear effusion, common among children, should be diagnosed and the otologist should consider possibility of surgical correction.  In case of a pure sensorineural deafness, the audiologist and the otologist should plan auditory training for the child.  After fitting an appropriate hearing aid the speech therapist provides auditory training in the presence of the child’s parents.  It is important to arrive at an accurate measurement of both the type and degree of impairment in order to select the proper hearing aid.  An aid that is too powerful for a young child may irritate his ears and cause him to reject it.  If the aid is not strong enough, a child may receive little or no benefit from it and may object to wearing it.  The hearing aid enhances the residual hearing and the child learns to discriminate speech differences.  In those children wherein fitting even the most powerful hearing aids does not provide the desired results, it may be necessary to consider fitting the child with a cochlear implant.  A cochlear implant consists of an internal coil, embedded under the skin behind the ear, and an active electrode introduced into the inner ear.  Through this system it is possible to supply electrical current to stimulate the auditory nerve, current that cannot be provided by the damaged hair cells.  This device has to be inserted surgically under general anaesthesia after a thorough evaluation.