A Review on Audiological Management of Early Childhood Hearing Loss

Abstract: Hearing loss in early childhood can significantly impede speech, language, cognitive, and emotional development. Childhood hearing loss carries a significant burden, with serious consequences for the affected children and substantial economic impact. Unfortunately, in many developing countries, there is limited focus on initiatives that support early identification, intervention, and rehabilitation for these children. Timely audiological management during these developing years is crucial in minimizing long-term effects. There are ranges of audiological assessment tools available for detecting hearing loss in children, emphasizing their appropriateness across different developmental stages, infancy toddlerhood, preschool, and school-age. At the neonatal stage, objective tools like tympanometry help to assess the integrity of the middle ear functions. For infants and toddlers, Behavioral Observation Audiometry (BOA) and Visual Reinforcement Audiometry (VRA) assessments are conducted which is vital for timely intervention and provide valuable observations when used alongside other methods then complemented by Otoacoustic Emissions (OAE) and Auditory Brainstem Response (ABR) test. As children mature into preschool and school-age years, more interactive assessments, including Conditioned Play Audiometry and Speech Audiometry can be used and provide helpful results. Standard Pure-Tone Audiometry (PTA) can be done after five years or sooner if the child can participate. Hearing loss is classified as sensorineural, conductive, or mixed. Sensorineural hearing loss is the most prevalent type among newborns, depending on the underlying cause with approximately 50% of cases attributed to genetic factors. In contrast, acquired hearing loss often arises from infectious illnesses particularly meningitis neurological trauma, exposure to excessively loud noises, or the use of ototoxic medications. This review underscores the need to review current strategies and audiological management of early childhood hearing loss.