6692Why is your child dull?

In a previous edition, we discussed the dream of every parent: a child which will excel in school and his chosen endeavour. We went on to discuss one of the factors which could mitigate against the realization of the dream. In this edition we shall discuss partial deafness as one other factor which could make a parent’s dream a mirage.

What Is Partial Deafness?

The loudness of sound is measured in decibels (db). The normal child hears sound whose loudness is between zero (0) and thirty (30) decibels. When a child fails to hear a sound whose loudness is 30 decibels or below, that child is said to be partially deaf. Partial deafness could affect one or both ears.

What Are The Warning Signs of Partial Deafness?

Parents and teachers are in best positions to recognize partial deafness early. Therefore they must always look for the warning signs which are listed below.

1.            Failure to carry out simple instructions correctly at home. In most cases, the child did not quite hear the instruction given and so carries out what he felt could have been the instructions. Such children are sometimes punished in ignorance.

2.            If a child listens to very loud music or turns on the television very loudly much to the discomfort of others in the living room, then he could have some hearing problem.

3.            If a child seems “inattentive” at home, then the parents should suspect hearing problem.

4.            If speech development is delayed in a child, hearing problem should be suspected. Normally, by the age of 6 moths, a child is able to localize sound and should turn and look directly at the source of sound; by the age of 2 years, he should understand simple commands and put words together. Failure to do this could mean partial or total deafness.

5.            If a child fails to easily hear what the teacher says in class even when in front of the class, then hearing problem should be suspected.

What Are The Causes Of Partial deafness?

a.            Discharge from the ear. This appears to be a common cause of partial deafness in our environment and is due to an infection of the middle ear. If a hundred school children are examined today, about 5 per cent will be found to have ear infection. Some parents do not take ear discharge seriously and so the infection is allowed to smoulder on leading occasionally to persistent “cold”.

b.            Wax. Wax is also very common in our environment. Wax prevents sound waves from reaching the ear drum and middle ear where it is augmented. If about 100 school children are examined, over 40 will be found to have wax in their ears.

c.             Foreign body: Some children are fond of putting foreign bodies such as bead or bean seed in their ears. If not removed, such a foreign body could prevent sound wave from reaching the ear drum and could cause infection in their ear. Both effects could lead to partial deafness.

d.            Infections: Certain infections like meningitis (infection of the covering of the brain) mumps and syphilis could produce severe hearing damage.

e.            Infection during pregnancy. If a woman is infected by German measles (rubella) during the first three months of pregnancy, the risk of deafness in the child is about 30 per cent. Syphilis is also incriminated but the risk is not as high as that of rubella.

f.             Neo-Natal Jaundice. If poorly managed, neo-natal jaundice could affect the inner ear leading to deafness.

g.            Birth injuries. Injuries to the head of the baby during child birth could lead to partial or total deafness. If the oxygen supply to the brain is compromised during child-birth, partial or total deafness could also result.

h.            Drugs. Certain drugs such as streptomycin or neomycin could cause deafness in the baby.

i.             Heredity. Certain malformations of the ear run in families especially the inner ear. Children born into such families are certainly at high risk of being deaf and so should be screened early through for early diagnosis and treatment.

Treatment.

Some of the causes of partial deafness are amenable to treatment and hearing restored to normal.

All cases of ear infection or pain in the ear should be seen by a doctor. Most of the infections succumb to appropriate antibiotics. Wax in the ear passage can be safely removed by trained personnel either by picking it out or by syringing. Foreign bodies can also be easily removed by use of instrument. Chronic ear infections will normally be referred by the general practitioner to the ear, nose and throat surgeon for expert management.

If hearing loss does not improve on treatment, then the use of hearing aid is recommended. Hearing aids may be available at E.N.T. clinics and hearing and speech centres in Nigeria.

Some of the conditions require surgery. Should the doctor advise an operation, the earlier it is done, the better for the child.

Prevention

1.            All children at risk (those who had neo-natal jaundice, birth injuries, etc.), should be    screened between 6 and 12 months to determine their hearing status. If partial deafness is diagnosed, a hearing aid can be fitted at 12 months of age to ensure proper development of speech.

2.            All children should be screened for hearing defect on entering primary school. This screening involves physical examination and audiometry.

3.            Ear discharge in children whether “milky “ or clear should be reported to the doctor for appropriate treatment. Even after treatment, these children should be seen regularly by the doctor to exclude any hearing loss.

4.            All pregnant women should take drugs prescribed by the doctor. Drugs such as streptomycin and neomycin should be avoided.

5.            Cleaning of the ear passage should only be done by trained personnel. Untrained personnel using cotton buds only succeed in pushing the wax further.

6.            All children should be immunized against measles by 9 months of age.

7.            Cases of persistent “cold” in children should be reported to the doctor. If left untreated, fluid could accumulate in the middle ear leading to partial deafness.

8.            Persistent fever should be viewed with seriousness and medical attention sought. It could be due to encephalitis or meningitis.

9.            Pregnant women exposed to rubella should still report same to their doctor so as to be given gamma globulin for protection.

10.          All children who are awkward, inattentive or slow in understanding should be taken to a doctor for hearing test.