Situational assessment of age of suspicion, diagnosis, and intervention of hearing loss in pediatric population in India and factors that influence them

<h2>Abstract</h2><h3>Objective</h3> In the absence of newborn hearing screening, identification of childhood hearing loss is primarily mediated by parents' help-seeking behaviour. This study attempted to measure the variables age of suspicion, diagnosis, and intervention of congenital hearing loss in India in a large cohort to verify the efficiency of this approach. It aimed to study the influence of parental perceived awareness, accessibility, and affordability on these milestones. <h3>Method</h3> Data were collected through a survey method of research using a pre-developed questionnaire as the instrument. The study involved 384 parents of children with hearing loss receiving hearing healthcare services from various healthcare institutions and clinics in Karnataka, India. <h3>Results</h3> The mean age of suspicion, diagnosis, and intervention of hearing loss after data analysis were 18.6, 25.0, and 30.6 months, respectively. Earlier parental suspicion of hearing loss was associated with earlier diagnosis and intervention in the child. While less than 4 % of the cohort was diagnosed before three months, less than 1 % received intervention within six months of age. Lack of awareness, accessibility, and affordability significantly delayed these milestones. Among the participants, 15.03 % had experienced at least one of the three barriers (lack of awareness, accessibility, and affordability), whereas 35.28 % had reported two barriers, and 41.71 % had reported all three barriers for their help-seeking behavior. <h3>Conclusions</h3> Relying on parental help-seeking behaviour cannot result in early identification and intervention required for optimum pediatric hearing healthcare. India should implement comprehensive early hearing detection and intervention program that includes universal newborn hearing screening and addresses awareness, accessibility, and affordability of hearing healthcare services as critical components.