Rehabilitation in children with hearing loss

1. Hearing screening systems<br>The transition and the present situation of worldwide and domestic newborn hearing screening are reported. The incidence of bilateral hearing loss was about 0.7∼1.5 in 1,000 infants. About 0.4∼0.5 and 4.8∼22 in 1,000 low-risk and high-risk infants had bilateral hearing loss, respectively. According to the survey questionnaire that was sent to all domestic department of otolaryngology which were recommended by the Otorhinolaryngological Society of Japan, 75% of the infants referred to the department of otolaryngology accepted audiologic and medical evaluations before 3 months of age and 15.6% of them had early intervention services. On the other hand, 14.3% of the infants who passed newborn hearing screening but were referred to the department of otolaryngology had hearing loss. The transition and the actual situation regarding hearing screening for three-year-old children which is legislated in Japan are also reported. Eight hundred and forty-eight thousand, two hundred and eighteen children underwent hearing screening in 2007. Six hundred and twenty-seven of them (0.07%) had hearing loss. The number of children who had bilateral sensorineural hearing loss in 2007 was the same as it was in 1997. Both reports clarified that hearing rescreening systems subsequent to newborn hearing screening should be provided.<br>2. Audiological and medical evaluation for infants, toddlers and preschoolers<br>Audiological and medical evaluation for infants, toddlers and preschoolers is quite different from such evaluation in adults. As for audiological evaluation, developmental assessment is also necessary to arrive at appropriate measures. The procedures and points in mind for behavioral audiometry (behavioral observation audiometry, conditioned orientation response audiometry, peep show test and play audiometry), auditory brainstem response, auditory steady state response and otoacoustic emissions are explained. The medical evaluation is as follows: physical examination, clinical history, family history of childhood and onset of permanent hearing loss, identification of syndromes associated with early- or late-onset permanent hearing loss and radiologic and laboratory studies. Knowledge of pediatric hearing loss is mandatory so that otolaryngologists can evaluate synthetic and comprehensive hearing loss in children.<br>3. Rehabilitation of children with hearing loss<br>Although the current situation regarding rehabilitation of children with hearing loss in Japan still presents some problems, these children and their families now have more options for a possible institute and/or method for rehabilitation than before. Moreover, rehabilitation goal setting has been gradually changing, moving away from the idea of "working towards obtaining normal hearing" and rather approaching the viewpoint of "living with being hard-of-hearing" so that affected children can actively seek various possibilities in their own lives.