Age of suspicion, identification and intervention for rural Indian children with hearing loss

It is crucial to understand factors which delay the commencement of aural habilitation in children. Alleviating the factors will help reducing the delay to an extent in a developing country like India where universal newborn hearing screening programs is yet to begin at a national level. The present study aims to find age of suspicion, identification and intervention availed for children with hearing loss who approached hearing evaluation camps conducted in rural West Bengal. Data was obtained from evaluation of 209 children with moderately severe to profound degree of hearing impairment, present with a complaint of not being able to speak and hear. The family members, mostly mothers, suspected hearing loss in the child at a mean age of 1.5 years when the children did not respond to name-call, clap and vehicle horns. However the parents consulted any doctor primarily a specialist by an average age of 2.4 years. As many as 21% of the doctors during the first visit assured the parents not to worry as the child would learn language with age and only 33.4 % were referred for aural rehabilitation. The average age at which children were brought to an audiologist for the first time was 9.3 years yet 95% of parents did not perceive delay in the initiation of aural rehabilitation. Children with mild to moderate degree of hearing loss and with unilateral hearing loss who account for 40% of the childhood hearing loss do not attend even rural camps. Factors like child rearing practices, ignorance about the importance of intact hearing sensitivity and critical age for speech development along with lack of aural rehabilitation services contributed to the delay in identification and habilitation.