Audiological Assessment and Management

• Early and unremediated hearing loss is linked with:
  • Decreased language skills (auditory temporal abilities [, first and subsequent language acquisition)
  • Lower achievement at school, poorer reading skills in primary school
  • Lower IQ in later childhood in children already at risk of poor cognitive development
  • Reduced attention span
  • Speech and language disorders
  • Anxiety, depression and attention problems later in life
  • Higher unemployment
  • More difficulties with social relationships
  • Hearing loss that continues in adulthood

• FAMILY EDUCATION
  • All children with ear trouble will have some level of hearing loss
  • When children with significant hearing loss are not helped to hear well promptly, their learning of listening, language and communication skills may be held back.
  • These skills are important for making friends, getting along with others, learning at school, and later, getting a job. They are equally important for learning language, culture and traditions, and taking part in family and community life.
  • The first four years of life are the most important for learning language and communication skills. 
  • It is especially important that children hear well at this time.
  • Family are the most important teachers of language and communication skills. 

Listening behaviours and warning signs to ask parents about

When to refer

Diagnostic  audiology

• Health staff or parents suspect hearing loss, and/or
• Any other form of otitis media has persisted for 3 months or more.
• There are speech, language or developmental delays

• As OM can be long term and the hearing loss it causes can fluctuate, ongoing monitoring of hearing and repeated audiological assessments can be required.

Hearing assessment is recommended for the following reasons:

• Diagnosis of the degree and type of hearing loss
• Confirmation of middle ear condition
• Inform clinical care decision-making with respect to treatment and referral
• Monitoring the outcomes of interventions
• Planning hearing and communication (re)habilitation.

Speech Path

• if they have a confirmed hearing loss, or if they have other signs of speech and language delay.
  Warning signs which should prompt immediate referral for speech pathology:
  • 3-6 months: not communicating by vocalising or eye gaze
  • 9 months: poor feeding or oral coordination
  • 12 months: not babbling
  • 20 months: only pointing or using gestures (i.e. not speaking)
  • 24 months: using <20 words, not following simple requests
  • 30 months: no two-word combinations
  • Children aged 0-5 years with hearing aids should be supported to connect with an early intervention service that listening, language and communication skills development in children with hearing loss