Symposium on sensorineural hearing loss in children: early detection and intervention. Delivery systems in the management of hearing impaired children.

The management of a hearing impaired child involves the family as well as the child himself, especially when the child is very young. Delivery systems therefore must include the parents as an integral part of the delivery chain and be sensitive to the parents' need to understand the treatment or therapy and, when appropriate, to sustain it in the home. Health care services that have educational implications have been termed eduhealth, which in the case of the hearing impaired child, refers to such services as the early detection of hearing loss, the proper fitting of hearing aids, the prompt treatment of upper respiratory infections that might lead to further hearing loss, and vision screening. The otolaryngologist, audiologist, and parent all have eduhealth responsibilities. Professionals in medicine and allied fields, although well trained and experienced in their specialities, are rarely prepared to meet all the needs of the young hearing impaired child and his parents with appropriate services and in the manner most appropriate for them. Some agencies, however, have demonstrated comprehensive capabilities in this area. In referring a family to a delivery system, the otolaryngologist should establish to his own satisfaction that the requisite skills are present. Common complaints of parents of hearing impaired children are the lack of communication with the physician and clinician, which is frequently the result of the vocabulary used by the specialist and the limited time spent with the parents during visits. The result can be parental failure to follow instructions and possibly irreversible damage to the child's development of listening, language, and speech skills. The eduhealth delivery service index is a new attempt to measure the effectiveness of systems for the delivery of education and health care services to young hearing impaired children and their parents. It has been demonstrated in a limited population and may prove useful in the comparison of delivery systems. The otolaryngologist is urged to become better acquainted with the various elements of delivery systems and to be cautious in accepting claims of comprehensive quality services until verified by his own experience or the reports of actual consumers of the services offered.