RISK FACTORS

Timely management of hearing loss leads to better speech, language and learning outcomes for children. The current WA Newborn Hearing Screening Program covers all public and private maternity services across the state. While such programs identify hearing loss in newborns, many children remain at risk of a permanent hearing loss developing in infancy and early childhood. Knowledge of the risk factors for late onset and progressive hearing loss is vital, along with continued vigilance in screening, monitoring and referrals.

Rates of permanent hearing loss increase during childhood, meaning that some problems develop (or worsen) only after routine newborn hearing screening is passed. Hereditary factors, infection, trauma are among the leading causes.

• Caregiver concern regarding hearing, speech, language or developmental delay
• Family history of permanent childhood hearing loss
• Neonatal Intensive Care Unit stay of more than 5 days
• Receiving medications known to damage ears and hearing
• Hyperbilirubinemia (Jaundice) requiring exchange transfusion
• Infections during pregnancy (CMV, Herpes, Rubella, Syphilis, Toxoplasmosis)
• Anomalies in the shape of the outer ear, ear canal, ear tags and pits
• Having a syndrome associated with hearing loss
• Meningitis
• Head trauma requiring hospitalisation
• Neuro-degenerative disorders

In young children, detecting hearing losses through observation is problematic, especially if the problem is mild or fluctuating.  Timely referral for comprehensive audiological testing is needed if any problems are suspected.  Audiologists use a combination of electrophysiological and developmentally-appropriate behavioural tests to test hearing at any age and developmental level. Strict monitoring protocols may be required.

It is important to remember that conductive hearing associated with otitis media remains the most common childhood hearing problem and can cause social, developmental and learning delays comparable to those observed through permanent hearing loss.