[Analysis of reasons for late diagnosis of hearing impairment in children].

INTRODUCTION: Hearing loss in children will cause cognitive deficits in the central areas which are dependent upon hearing and is therefore responsible for delay in the speech development, poor language skills and disorders in psychological and mental behavior. An early identification of educationally significant hearing loss in infants and young children is an essential prerequisite for effective aural rehabilitation and educational intervention. Maturation of the auditory path takes place within the first 18 months of life and is dependant on the adequate acoustic stimulation. To ensure the optimal therapy a definite diagnosis of the hearing impairment should be made until the sixth month of life. Current health care standards recommend the confirmation of the neonatal hearing loss before the age of three months and the appropriate intervention before the age of six months.

MATERIAL AND METHODS: The study consisted of the prospective analysis of data collected for 70 children with suspected hearing loss. According to the hearing level determined by the objective diagnostic methods (Brainstem Evoked Response Audiometry) the whole group was divided into three subgroups. We analyzed the average age when the hearing loss was detected, the reasons for the late identification of the hearing loss, as well as the risk-factors for hearing difficulties.

RESULTS AND DISCUSSION: Of 70 children with suspected hearing loss, we found normal hearing or mild hearing loss in 17 cases (group 1), 16 children were suffering from moderate and severe hearing loss (group II), and 37% children were suffering from profound hearing loss (group III). Until the age of 2, the diagnosis was made in 40% of 70 children, most in the group III 58.8%, 25% in the group II and 17.64% of children in the group I. The average age when the hearing loss was suspected was 1.62, 2.38 and 1.41 in the groups I, II and III respectively, whereas the average age when the hearing was examined was 2.83, 3.32 and 2.32 in the groups I, II and III respectively. In 22 children (21.5%) no cause of hearing impairment could be determined Nineteen children (15.7%) had the history of familial hearing loss, 37 (52.8%) children suffered from acquired hearing loss. Risk- factors: the presence of the hearing impaired in the family as well as risk-factors was not the reason for parents to check the hearing status of their child.

CONCLUSION: The mean age of children diagnosed to have the hearing impairment is still over 2 years in our region. However, the introduction of a universal screening programme would result in significantly earlier detection of the hearing impairment in children.