Early detection and identification of congenital/early acquired hearing disability. Who takes the initiative?

Questionnaires were distributed to parents of hearing-impaired children (average of the hearing thresholds greater than or equal to 35 dB at 500, 1000 and 2000 Hz) in order to perform an evaluation concerning the initiators of the detection and identification of congenital/early acquired hearing impairment. In 59% (23/39) the parents were the first to suspect the hearing loss. In 13% (5/39) the child failed the auditory screening test. In 16% (6/39) the child was registered as at risk and in 13% (5/39) the suspicion was raised by trained personnel in nurseries. In 43% (17/39) more than 4 weeks passed from the time the first suspicion was raised until a valid hearing threshold determination was performed. This delay was caused by health personnel in 59% (10/17). The median age at the hearing threshold assessment was 20 months (range 4-48 months) in this group of children. Only 33% (13/39) were diagnosed at the age of 1 year, despite the fact that the hearing loss was either congenital or acquired during the neonatal period. It is concluded that the parents are the first initiators of the identification of their hearing-impaired child, but the point of time at which the hearing loss is identified is still unacceptably late in most cases. Proposals for an improved early detection and identification of hearing-impaired children are made in order to prevent developmental disorders in speech, language, psychological and mental behaviour.