Deafness in children: then and now

In celebration of the 70th Anniversary of the NHS, Dr Winifred Baddoo, Chair of the British Association of Paediatricians in Audiology, has written a blog looking back over the history of confirmation of deafness in children, and the ways in which habilitation for these children, through NHS services, has improved since the 1930s.

Deafness in children is an invisible disability. The effect of hearing loss on a child is great, affecting communication and social development, which then impinges on education.

The incidence of permanent childhood deafness in either one or both ears is one to two per thousand live births.

In the 1930s, the school entry hearing screen confirmed hearing loss at around five or six years of age which was extremely late, by today’s standards. By 1957 recommendations for training and implementation of the health visitor distraction test were made, and testing at seven months of age became widespread. This reduced the age at which habilitation started to around 15 months of age. However, deaf children had still lost out on a lot of time to develop.

The year 2000 brought the new-born hearing screen programme, which uses automated oto-acoustic emissions and auditory brain stem response testing to identify children with a moderate or worse hearing loss. In the UK, this became universal in 2005 and has led to habilitation with a multidisciplinary team by three months of age. Children are fitted with hearing aids, have the input from the teacher of the deaf, and are able to undergo aetiological investigations into the cause of hearing loss – all leading to more appropriate counselling of families.

These days, we expect normal development of speech and language for these deaf children who have the optimum habilitation offered to them within weeks of birth.