It has been long known that unidentified hearing loss at birth can adversely affect speech and language development as well as academic achievement and social-emotional development. In the past, moderate-to-severe hearing loss in young children was not detected until well beyond the newborn period, and it was not unusual for diagnosis of milder hearing loss and unilateral hearing loss to be delayed until children reached school age. The most important role for the family of an infant who is deaf or hard of hearing is to love and nurture and communicate with the child.
From this foundation, families normally develop an urgent desire to understand and meet the special needs of their infant. Families gain knowledge, insight, and experience by accessing resources and through participation in scheduled early intervention appointments including audiological, medical, and educational sessions. This experience can be enhanced when families choose to become involved with parental support groups. In addition, informed family choices and desired outcomes guide all decisions for the child.
(Hyde & Brown, 2002) A very important function of the family’s role is ensuring direct access to communication in the home and the daily provision of language-learning opportunities. In time, the child benefits from the family’s modeling of partnerships with professionals and advocating for their rights in all settings. The transfer of responsibilities from families to the child develops gradually and increases as the child mature, growing in independence and self-advocacy.
Pediatricians, family physicians, and other associated health care professionals, working in partnership with parents and other professionals constitute the infant’s medical home (American Academy of Pediatrics, 2002). A “medical home” is defined as an approach to providing health care services with which care is accessible, family centered, continuous, comprehensive, coordinated, compassionate, and culturally competent.
The primary health care professional acts in partnership with parents in a medical home to identify and access appropriate audiology, intervention, and consultative services that are needed to develop a global plan of appropriate and necessary health and habilitative care for infants identified with hearing loss and infants with risk factors for hearing loss. All children undergo surveillance for auditory skills and language milestones. The infant’s primary health care professional (i. e. pediatrician) is in a position to advocate for the child and family.
(American Academy of Pediatrics, 2000) Individuals who provide services to infants with hearing loss should have specialized training and expertise in the development of audition, speech, and language. A speech-language pathologist can provide both evaluation and intervention services for language, speech, and cognitive-communication development. Furthermore, educators of children who are deaf or hard of hearing integrate the development of communicative competence within a variety of social, linguistic, and cognitive/academic contexts.
In order to provide the highest quality of intervention, it is suggested that more than one provider be required. Conclusion The diagnosis and management of Otitis Media in children continue to be challenging and controversial. The conflicting ability of families to cope with a child with recurring or persistent Otitis Media and the lack of data that show a causal relation between conductive hearing impairment and subsequent behavior problems or delays in language development require the clinician to seek and to consider parental preferences regarding treatment.
Primary care providers who serve a high risk pediatric population should prioritize patients with Otitis Media for developmental screening and possible referrals; to the extent that environmental stimulation may mediate the impact of Otitis Media on speech-language development, programs that provide language stimulation and enriched day care may help prevent delays related with the disease for high-risk children. References American Academy of Pediatrics (2000).
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