Early Hearing Screening "necessity" in Manipur Hospitals

Dr. Rajkumar Umesh Singh *

Hearing screening programme for new born babies within the first weeks of life is crucial and beneficial for children, especially when interventions quickly follow the detection of any possible hearing impairment.

Normal hearing acuity level is highly essential factor to the development of speech and language and it is well known fact that early treatment of hearing loss, will give better results in the child's speech and language development outcomes.

As per Dutch studies (published in JAMA), Researchers had analysed outcomes of 570,386 babies born between 2003 and 2005, comparing children born in regions in which newborn hearing screening had already become the norm to those born where distraction hearing screening, a behavioural test conducted around the age of 9 months, continued to be the standard.

Among children undergoing newborn screening, fewer than one (0.78) of every 1,000 were diagnosed with hearing loss. Similarly, 0.73 of every 1,000 babies were diagnosed using the distraction hearing test. Compared to distraction screening (performed at around 9 months of age), the researchers had also found out that newborn screening led to early intervention more spoken words development and fewer signs, as well as better social and motor development at 3 to 5 years of age. These children also scored higher on measures of overall quality of life.

In the hospital, two different types of hearing screening tests may be used to screen hearing in newborns. In one of type of the tests, called oto-acoustic emissions (OAE), a miniature earphone and microphone are placed in the baby's ear, sounds are played, and an auditory response is measured. If a baby hears normally, an echo is reflected back into the ear canal and is picked up by the microphone. When the baby has a hearing problem, no echo is heard characterized by the absence of emitted responses from the cochlear.

Unfortunately, I have no idea that such a diagnosic instrument is available in Manipur or not. I hope so it is available, and such a basic facilities are the clinical norms in the NE RIMS, (Imphal).

In the other test, called auditory brainstem response, sounds are played in the baby's ears and band-aid-like electrodes are placed on the baby's head to detect auditory system responses. This test measures how the auditory nerve system responds to sounds and not only identifying babies with hearing loss, it can also estimate the degree of hearing loss within a specific frequency responses from 2khz. to 4khz.. Both tests are safe and comfortable, probably in ABR test sedation may be required.

If hearing loss is detected, then the treatment can be implemented such as middle ear medication, surgical intervention, hearing aids, inner ear implants and speech and language development rehabilitation programmes.

These treatments have benefits at all ages, but are maximally better if provided early in life, as that is the time at which the infant brain is 'primed' for this kind of experience and learning. We can't just forget utilizing these critical age period (0-2yrs.)for the speech and language learning processes.

In this Modern era of 21st century, cognitive and communication abilities are at a premium. Our developing societies growths are dependent on high levels of literacy.

Understanding and producing spoken words is a key to literacy. Thus, providing programmes, such as newborn hearing screening help achieve higher developmental outcomes and quality of life and become important for the future well-being of society.

Unfortunately, as the researchers noted, not all detected hearing problems in the study were followed by early interventions. Further, passing newborn hearing screening does not exclude babies from developing hearing loss later in childhood. In this context, I want to feel the senses of the people of Manipur, specially those of medical professionals and Government leaders.

We need instruments and technologies for the betterment of the society. Our professional must demand more efficient and effective services. I don't blame anyone, we are all doing our jobs but the question remains! Are we up-to-date in technology applications?

Parents should take newborn hearing screening results seriously. If a child does not pass his newborn hearing screening, the child should be evaluated and tested by a specialist within the first few weeks of life. But the question remains in Manipur, where is the OAE and ABR machines?

Isn't it the high time for our ENT departments need to be well equipped? I hope we'll find the timely answer from the authority!