Early identification and management of hearing impairment.

Early detection and treatment of hearing loss can prevent a lifetime of difficulties. Severe sensorineural hearing loss is present in approximately one in 1,000 newborns. Many newborns have mild to moderate hearing loss, either conductive or sensorineural, that interferes with normal functioning. The family physician is in an excellent position to identify hearing impairment at an early stage. During well-child visits, simple checklists and screening tests can be completed to aid in detection of a hearing loss. The Joint Committee on Infant Hearing and the National Institutes of Health Consensus Statement recommend screening all infants for hearing loss, preferably during the newborn period. Children at high risk for hearing loss should be referred for auditory function tests, such as behavioral observation audiometry, auditory brain stem response, otoacoustic emissions testing, visual reinforcement audiometry and conditioned play audiometry. The advantages and limitations of each test should be understood by the family physician. An infant is never too young to be treated for hearing loss. The earlier intervention begins, the greater the chance a child will develop to maximum potential.