Hearing impairment in children: Treatment
- Richard JH Smith, MD
Richard JH Smith, MD
- Professor of Otolaryngology
- University of Iowa
- Adrian Gooi, MD, FRCS(C)
Adrian Gooi, MD, FRCS(C)
- Assistant Professor
- University of Manitoba
The treatment of hearing impairment in children is reviewed here. The etiology and evaluation of hearing loss in children are discussed separately. (See "Hearing impairment in children: Etiology" and "Hearing impairment in children: Evaluation".)
Hearing loss in children is often a silent and hidden handicap. Children with hearing loss frequently appear to be normal, and often their handicaps are not apparent. Hearing loss that is undetected and untreated can result in speech, language, and cognitive delays. Early identification and effective treatment of hearing loss improves language, communication, and cognitive skills [1-6].
Treatment options for children with hearing loss depend upon the etiology. The underlying cause is addressed whenever possible. As examples, acute otitis media (OM) is treated with antibiotics, impacted cerumen is removed, and ototoxic drugs that cause reversible hearing loss are stopped if alternate therapy is available. Surgical intervention is necessary for some conditions. Amplification devices are recommended for children with bilateral sensorineural hearing loss (SNHL) or long-term conductive hearing loss. Cochlear implants are an option for children with profound bilateral hearing loss who do not benefit from traditional amplification.
Ideally, all children with permanent hearing loss should be managed by a multidisciplinary team that includes audiologists, otolaryngologists, speech pathologists, geneticists, and educational specialists. In addition, these children should be referred to a pediatric ophthalmologist, because they rely on sight for communication and learning .
The hearing-impaired child should also be referred to the appropriate educational agency. In some states, referral is mandatory within a limited time after identification. The local school district or early childhood intervention agency is equipped to provide educational guidance for the special needs of hearing-impaired children. This may include preferential seating or the use of frequency modulated (FM) systems at school (see 'Assistive listening devices' below). Educational options vary according to the degree of hearing loss and cognitive ability of the child. Development of communication skills is the basic goal of early education programs for hearing-impaired children. Most agencies work with the team of professionals to establish an individual treatment plan for each child.
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- MULTIDISCIPLINARY TEAM
- SURGICAL MANAGEMENT
- HEARING AIDS AND ASSISTIVE DEVICES
- Hearing aids
- - Selection
- - Fitting
- - Style
- - Electronic features
- Assistive listening devices
- Counseling and education
- BONE CONDUCTION HEARING DEVICES
- COCHLEAR IMPLANTS
- Indications and devices
- Preoperative evaluation
- Long-term follow-up
- - Risk of meningitis
- Modification of activities
- RESOURCES FOR FAMILIES