Hearing Impairment

Hearing imapairment

Hearing loss can be of different degrees varying from total deafness to hard of hearing. Early detection of hearing loss is very crucial because of the vital association between hearing and speech and language problems.

Detection of Deafness

Detection mainly depends on careful observation of the child over the first eight months of life. For the first 2-3 months, the infant will develop quite normally. After the 3-4 months, the normal child makes different types of sounds. By 8 months, he listens to speech, babbles and squeals. The child tries to copy the rhythm and pattern of the sound in speech. If this does not happen, careful examination by an experienced doctor should be carried out.


The loudness of sound is measured in decibels. The sound of ordinary conversation is about 60-70 decibels.

1. Mild loss  15 - 30 decibels
2. Partial loss  30 - 65 decibels
3. Severe loss  65 - 95 decibels
4. Profound loss  More than 95 decibels

Accumulation of wax or infections can cause deafness and can be medically treated. This is called Conductive deafness. These children can be helped by means of hearing aids. Perceptive deafness is caused by permanent damage to the nerve endings of the inner ear.

Speech Development

Hearing and speech development go hand in hand. For normal speech development these things are necessary.

  • Normal anatomical structure i.e. normal development of the ear and larynx
  • Conducive home environment for the child to concentrate on the sound received.
  • Motivation for the child to establish auditory communication, which will depend on his maturation and psychological development.

The best period to learn speech is first 3 or 4 years of life. So pre-school period spent at home is very important. Due to hearing impairment speech defects like staccato speech problems (found in CP children), stammering, monotonous speech pattern can be developed. If a child with hearing impairment masters his speech he can be integrated more readily into the mainstream society, and there won't be isolation problems. 


Even a congenitally deaf child has some degree of hearing that can be enhanced with the help of a hearing aid. The early training consists of teaching the parents, especially the mother, on how to teach the child. Secondly, the communication should be intelligible to the child. An appropriate action should be associated with the speech to make the message understood. Whenever the child is spoken to, she must be able to watch the movement of the mouth and lips of the person speaking. Education will include training in lip-reading, specialized language programmes, gesturing and finger spelling.


Stammering is a communication disorder in which the normal flow of speech is broken by repetitions, prolongations, abnormal stoppages of sounds& syllables. It usually starts before the age of five & peaks around age of eight or ten.

  • Putting extra effort into forming the words
  • Has tense and jerky speech
  • Can't seem to get started and stretching the word
  • Repeats part of word or stops halfway.

Techniques to deal with problem
  • Maintain eye contact with the child.
  • Do not ask the child to repeat.
  • Give the child time & enhance your listening skills.
  • Rhymes & singing helps to achieve fluency. 
  • Never force him to read aloud. Praise when he does well.

If you have any concerns about your child's speech, get advice ASAP because early intervention by a speech and language therapist help relieve stammering. 

(Source: Seema Hingorany
Clinical Psychologist and  Psychotherapist in TOI)

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