Early hearing screening saves childhood potential

DAR ES SALAAM: IN a world defined by conversation, music, and constant activity, it is difficult to imagine life without sound. Yet for thousands of children born with hearing loss, silence shapes their earliest experiences. Exclusion often begins long before formal schooling.

It starts at home, in hospitals, and within communities that may lack the awareness or systems needed to respond effectively.

As the world observes World Hearing Day, an Ear, Nose, and Throat (ENT) specialist at Medinova Specialised Polyclinic, Dr Rizwan Rafeeque, is calling on families and policymakers to prioritise early detection and intervention for childhood hearing loss. He warns that untreated hearing impairment significantly affects speech development, learning capacity, and long-term academic performance.

However, when identified early and managed appropriately, children with hearing loss can thrive both in school and in society. Dr Rafeeque delivered these remarks during a recent health awareness training session for students at Empowered Minds Learning Centre, a school that serves children with various disabilities.

The event, held at Medinova Specialised Polyclinic in Dar es Salaam, was organised in partnership with Medinova Polyclinic and the Ella Foundation as part of activities marking World Hearing Day. Students received education on ear health and were introduced to assistive technologies such as hearing aids and cochlear implants.

He describes childhood hearing loss as both a medical and social issue requiring urgent and coordinated action. The most common causes among children include birthrelated complications and genetic factors. Because these causes are not always immediately visible, many parents only become aware of a problem after noticing developmental delays.

Today, hearing assessments can be conducted shortly after birth to determine whether a newborn has normal hearing sensitivity. Such screening is critical because hearing plays a central role in speech and language development.

Without exposure to sound, syllables, and pronunciation, a child cannot naturally acquire spoken language. When detection is delayed, speech delays become almost inevitable, often affecting academic progress and social interaction later in life.

For this reason, Dr Rafeeque advocates mandatory newborn hearing screening. In many countries, such testing is already standard practice. Consistent implementation, he argues, would significantly reduce preventable disability and improve long-term educational outcomes.

“When hearing loss is identified early, appropriate interventions can begin immediately,” he explains.

Children with mild or moderate hearing loss may benefit from hearing aids, while those with severe or profound hearing loss may require cochlear implants. Early intervention, combined with therapy and structured support, enables children to gradually develop speech and communication skills.

As children grow, additional risks to hearing emerge. Untreated ear infections remain a major cause of hearing impairment, particularly in low-income settings where persistent ear discharge is often ignored.

Chronic infections can damage the eardrum, leading to perforation and permanent hearing loss. In severe cases, complications may even become life-threatening. Dr Rafeeque stresses that ear discharge should never be neglected and that parents must seek medical attention promptly.

He also cautions against inserting objects into the ear canal, including cotton buds. Such practices can injure the eardrum and result in long-term complications. If itching or irritation occurs, professional medical consultation is far safer than attempting home remedies.

Noise exposure presents another growing threat. Prolonged exposure to loud environments such as factories, entertainment venues, or heavy engine noise can lead to noise-induced hearing loss.

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Even frequent headphone use at high volumes may cause gradual and irreversible damage. Preventive measures, including wearing ear protection in noisy settings and limiting volume levels, are essential safeguards. Certain medications may also affect hearing.

Some drugs are ototoxic, meaning they can damage the ear. Although many are necessary and life-saving, they must be used strictly under medical supervision. Selfmedication carries serious risks. Additionally, some medications taken during pregnancy may affect a child’s hearing, highlighting the importance of proper prenatal care.

Beyond medical considerations, stigma remains a significant barrier. Some parents hesitate to seek treatment or allow their children to use hearing aids because of fear of social judgment. Dr Rafeeque firmly rejects this mindset. Hearing aids, he notes, are medical devices designed to improve quality of life, much like eyeglasses improve vision or wheelchairs support mobility.

Eliminating stigma through counselling and public awareness is essential to ensuring that children receive timely and appropriate support. Genetics may also influence hearing later in life. After the age of fifty, many individuals experience gradual hearing deterioration, particularly in families with a history of agerelated hearing loss.

Early evaluation and protective measures remain important in such cases. Echoing these concerns, Ella Foundation founder Ms Esther Jaswant is urging stronger government commitment to early screening and teacher training. She argues that schools must provide interpreters, families must learn sign language, and communities must move away from labelling toward understanding