If you suspect or if you know that your child has a hearing loss, you may not find it easy to come to terms with it. As you have the desire to find the best possible solution for your child, many questions will occur to you. This section attempts to provide answers to some of your questions and tells you where you can find professional help.
• Discovering hearing loss – methods
• Accepting the hearing loss and obtaining support
• Solutions –technology, practical tips etc.
• Oliver program - adding fun to function
• Brochures about hearing solutions for children and related themes
for download
• Milestones –the history of the development of Phonak technology
for children
Expert Speak on Pediatric Fitting:
Mrs. Meenakshi Wadhera is a qualified Audiologist and Speech- Language Therapist with over 19 years of experience in this field. She has worked in the premium institute like AIIMS and PGI Chandigarh, apart from various basic and advanced level international training on Auditory verbal therapy. Pediatric Audiology and Cochlear Implantation. She is neonatal Audiologist and Cochlear Implant consultant for various Hospitals.
What drives you towards rehabilitation of Pediatric Population?
After 18 Yrs of working with hearing Impaired Children, I learnt that appropriate amplification with little effort in the right direction (Auditory habilitation) can do wonders for these children. This gives a hearing impaired child an opportunity to listen, speak and communicate and hence help them to integrate in mainstream society. It is very satisfying and motivating to see such outcomes of your efforts. It gives me a great sense of achievement to successfully habilitate a hearing impaired child. The excellent and ever improving results, thanks to the technological advancements such as digital hearing aids and cochlear implants, keep inspiring me.
Is there any age limitation for Diagnosis of Hearing loss in Pediatric population?
There is no age limitation for diagnosing hearing loss. The neonates can be screened and diagnosed for hearing loss within few days of birth. It does require few repeated tests both objective and behavioral to confirm the diagnosis.
What could be the earliest age to start habilitation in children?
The Intervention (Amplification and habilitation) should immediately follow the diagnosis. Early Diagnoses of hearing Impairment without proper treatment and intervention is of no benefit. We have effectively fitted amplification even for a two month old baby. So as early as possible should be our motto. But definitely before 6 months . There are many studies that indicate that if intervention is delayed beyond 6month it can lead to permanent delay in speech and language development.
What do you think about the currently available Hearing instrument technology? Is it sufficient to fulfill all the listening needs of Hearing impaired child?
The currently available hearing instrument technology has come a long way. We have seen a major shift from analog to digital signal processing to even high gain BTEs. Current digital hearing aids are certainly exciting, and the future possibilities are endless. Before long, digital hearing aids will replace their analog counterparts altogether. We must, however, present this technology to patients in an informative and educational manner. Like many other high-tech devices, high expectations often accompany digital hearing aids. Counseling patients about appropriate expectations will continue to be more--not less--important as technology continues to advance. Digital hearing aids can't be described as if they are a separate entity from analog hearing aids. "Digital" simply indicates that the analog waveform is converted into a string of numbers for processing; and unfortunately, there is nothing inherently magical about this process. A linear, output-clipping, digital hearing aid could easily be built that would provide sound quality and speech recognition inferior to many analog hearing aids. Therefore, digital isn't superior just because it's digital, but because DSP allows manufacturers to create hearing aids with enhanced processing and features.
Each new generation of hearing instrument represents another step forward for the hearing impaired. We have recognized that hearing instrument usability is just as important as the technology itself.
Fortunately, for both dispensing audiologists and patients, there are features and advanced signal processing schemes available in current digital hearing aids that do have significant advantages over those found in analog instruments. Potential digital advantages include Gain Processing, Digital Noise Reduction (DNR), Digital Speech Enhancement (DSE), Directional Microphones, DSP, and Digital Feedback Cancellation (DFC).
According to you what are the challenges you face with regard to Hearing aids specifically for infants & babies?
There are lots of Challenges in fitting Hearing Aids like Size of Power hearing aids is too big for infants and babies. Moulds or taking impression is also a challenge as the canal is very narrow.
Moreover, Hearing aids cannot fulfill the listening needs of all hearing Impaired Children. They work well for children till Moderately Severe to Severe Hearing Loss. But for Children with Severe profound degree of deafness hearing aids provide limited benefits. In Such children Cochlear Implant is the best option.
Being a hearing healthcare professional what do you think should be ideally done to increase the awareness about hearing loss & its identification & management in Indian Population?
We all know that It is estimated that 15 to 20 per cent of the population suffers from some form of deafness mild, moderate or severe. The estimated incidence of profound and total deafness varies from one to four in every 1,000 live births. It is sad that these children go undetected. Hence the biggest challenge for an Audiologist in India is to spread awareness regarding the need and importance for early detection and intervention of hearing loss. We must keep organizing the public awareness program and awareness programs explaining the need for neonatal hearing Screening and early intervention for our professionals and allied professionals like pediatricians , Gynecologists etc.
The Minimum Average Age of detection of hearing loss is decreasing. Few years back it was 5-6Yrs and now at least in urban population it has come down to 2Yrs. But we still have a longer way to go.
The single most overwhelming challenge for pediatric audiologist is to reliably know exactly what a child is hearing .
How can we monitor performance of babies with hearing aids to know if & when changes needs to be made to the amplification needs.
Very true it is very challenging to fit amplification to babies. As the babies can’t tell us what they are hearing how is the amplification, wether it is comfortable or loud. So we do need a verification tool. We in India rely more on Behavioural observations like Aided Free Field Assessment using BOA or VRA and aided ASSR. In west they use Real Ear Measurements as verification tool. Very soon we are also going in this direction and are investing in Real Ear Measurements.
We can monitor the auditory performance and Speech and Language development of babies using various speech-Language assessment scales and tests and auditory skills development scales. If the baby is not performing as per hearing age amplification needs to be reassessed.