Early Intervention of Hearing Loss - What? Why? and How?

Updated: Aug 6, 2020

Hearing loss or hearing impairment is a partial or total inability to hear. It may range from a mild hearing loss (about 15-20%) up to a profound hearing loss (more than 90%). Hearing loss often goes undetected during the early stages, as it does not affect an individual’s lifestyle drastically. Surprisingly enough, according to the National Sample Survey Organisation (NSSO) 58th round (2002), hearing disability was 2nd most common cause of disability and top most cause of sensory deficit and it was estimated that 291 in 1000000 people have a hearing loss. Although the effects of hearing loss may not be very prominently seen in the initial stages, they can have a huge impact on a person’s quality of life - including social isolation, fatigue, annoyance, difficulty hearing over the phone, among others. However, hearing loss from birth poses a larger challenge, as it not only affects the child’s hearing abilities but also his speech and language development. This further reflects negatively on the child’s academic performances and limiting his career options. In short, hearing plays an important role in shaping a child’s entire life!


It is therefore very important to watch out for signs that might be indicating that your child has a hearing loss, no matter how subtle it may be. It would be much wiser to look out for possible risks that may cause a hearing loss. After all, wise were those who said “A stitch in time saves nine”. Following are some of the red flags that may indicate that your child may have or be at risk of developing a hearing loss:

Red flags during pregnancy or during delivery:

  • History of maternal infections

  • Positive family history of hearing loss

  • Alcohol consumption during pregnancy

  • Fall during pregnancy that may have affected foetal growth

  • Mother having any serious illness during pregnancy

  • Delayed birth cry

  • Premature birth

  • Any genetic abnormality resulting in a syndrome (Waardenburg syndrome, Turner’s syndrome, etc)

Red flags after the birth of the child:

  • Low birth weight (<1500g)

  • Jaundice

  • Admission to neonatal ICU for any reason

  • History of brain fever, mumps, measles

  • Child not responding to environmental sounds

  • Child does not recognize familiar voices, like mother’s voice

  • The child has not uttered his first word even after 1 year of age

  • Frequent ear infections

  • Child seems to hear well sometimes and then not respond at other times

  • Child wants louder TV volume than others

  • Says “what?” more often

  • Poor performance in academics

  • Inattentiveness in class

If any one or more of these are observed in your child, consult your doctor or an audiologist immediately.


A child learns maximum during his first 3 years of life, as the brain undergoes maximum development and can be better moulded during this period. Hence, if a child’s hearing loss is identified at an early stage, treated and rehabilitated appropriately within this time period, the child has a better chance of learning better speech and language skills and does not have to rely upon sign language alone. This can improve child’s quality of life to a great extent. Joint Committee of Infant Hearing (JCIH) in 2000 suggested a 1-3-6 criteria which mandates a hearing screening for all new-borns (most importantly those that are at high risk of developing a hearing loss) within 1 month of age, and if they do not pass the screening, confirming it through a detailed diagnostic test within 3 months of age and planning a suitable intervention program for the child with hearing loss with appropriate amplification and providing auditory and verbal therapy within 6 months of age. The committee believes in mainstreaming the child.

On the other hand, children who have profound hearing loss in both ears and are not obtaining much benefit from hearing aids even after 6 months are eligible for cochlear implantation, which provides better and higher amplification. Cochlear implants are bionic prosthetic devices that replace the function of the damaged inner ear. They are surgically implanted into the patient’s cochlea to provide sound signals directly to the brain. They are a viable option for children with severe to profound hearing loss.


Following amplification, proper speech and language therapy is required for the child. Auditory Verbal Therapy (AVT), a form of aural rehabilitation is provided, which makes use of child’s natural ability to hear to give maximum speech and language stimulation. This helps in reducing the child’s hearing handicap to a minimum and mainstreaming the child into a normal society. The child can therefore be integrated into a regular school. Different compensatory and repair strategies can later be taught to the child, based on his needs, such as a better seating arrangement in the front row that offers better listening conditions and an easier way to lip read the teacher, asking for repetitions if he cannot follow the topic of conversation, facing the speaker during a group conversation, etc. Various advanced options such as directionality of microphones, tele-coil mode, Bluetooth options, streamers, etc. have further made quality of hearing better. Needless to say, integration of the child into a regular school not only helps him in being exposed to a normal peer group and compete with them, but it also helps in better academic performance, career options and a better quality of life.


Immense support from the state and central governments has established an added support in improving the quality of rehabilitation of the hearing impaired. The Government of India offers various schemes that are in support of individuals with hearing loss. The ADIP scheme assists the disabled persons financially for procuring modern assistive devices like hearing aids and cochlear implants. It not only waives off the cost of the devices but also supports the costs of surgery for implantation, and post CI rehabilitation. Also, the central and state governments each offer annual allowance for disabled students, scholarships, railway and travel allowance, reservation of jobs, tax exemptions and concessions for parents of disabled children. To ensure that these facilities are served at par, the central government, in accordance with the respective state governments has passed various acts like National Trust Act (1999), Persons with Disabilities Act (1995), Right to Information Act (2005) and Rehabilitation Council of India Act (1992). A separate body called the Rehabilitation Council of India was founded in 1986 to govern efficient implementation of these acts and policies.

Being well informed about hearing loss, its causes and its implications helps us to effectively prevent it. We can all make the world a better place by understanding and detecting the hearing loss as early as possible and educating each other about the same. As a great man once said, “Don’t be deaf for the deaf”!!


Further reading:

http://pedsinreview.aappublications.org/content/19/5/155

http://healthcare-communications.imedpub.com/the-importance-of-early-identification-and-intervention-for-children-with-hearing-loss-part-1-human-development.php?aid=21698

http://www.indianjotol.org/article.asp?issn=0971-7749;year=2016;volume=22;issue=2;spage=73;epage=76;aulast=Varshney

http://www.jorl.net/otolaryngology/hearing-in-india-all-aspects.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4689099/

https://www.researchgate.net/publication/38031835_Deafness_Burden_prevention_and_control_in_India

http://www.academia.edu/5246133/DEAFNESS_IN_INDIA-_REVISITED_


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