Are you one of those parents who often get the feeling that your child is slow in learning language than others in their own age peers? Sure as parents most of us can assess some point of development activities. When the child took his first steps at the age of 12 months, we expect the child to produce their first words also. And when we found out that the child at the age of even 2yrs., no language skill is enhanced, we are sure that the child would turn out to be a handicapped as if by some black magic power. Many parents might over blow the extent of their children's problems and it can complicate the further treatment/rehabilitation plans. Deafness is an invisible impairment, which makes the problem identification still more difficult to diagnose at an appropriate time i.e. before 2yrs. Critical period of language learning.

What is Hearing impaired?
Over the years the term has been given different definitions, but most are not accurate enough to cover the broad range of difficulties the hearing impaired individuals suffered. The word actually refers to those exceptional children who are atleast some degree of acquiring language skills is affected due to hearing defects. But though a hearing level of 70dB and above does indicate severe to profound problems, it doesn't always define the term. In general hearing impaired children are less vocabulary, and communication difficulties who are unable to envision multiple approaches to a problem and develop social isolation to deal with it.

To determine whether your child fits into this category, you have to look for certain characteristics such as response to loud/soft sounds, Imitation/repetition, motivation, curiosity, ability to communicate, use of signs and less attention span. Of course, some normal children do have at least one of those characteristics, but you can only assume they are hearing impaired if these traits are more intense than children their own age. If you happened to sing to your toddler a nursery rhyme sufficiently more nos. of time and no imitation respond is coming from your kid, then you definitely have reason to suspect he may be hearing impaired. Also the intellectual traits such as like mental problems could also hamper your judgment. Try to watch your child as he plays, whether alone or in group. Any suspicion from your observation warrants an immediate attention of ENT referral.

Early Detection
What most parents don't seem to realize is that they can tell whether a child is hearing impaired long before at the time of birth or at the later stage.

If your child doesn't birth cry, head/neck defect, and infections history or heredity problems, then child need assessment. But what do you do when you have a hunch that you are dealing with some sort of problems like hearing impairment? The first advice is don't ignore the fact. Do something about it. Help your child develop to his/her full potential to achieve as an self independent individual.

You need to make an arrangement for an array of neo-natal hearing testing services including sound screening test, free field test, conditioning, Electro galvanic response audiometry, crib-o-gram, play/visual reinforced audiometry, Oto acoustic emission (OAE), Auditory brain response (ABR), Impedance, Reflex decay etc. Then it is all up to the specialist's advice. If you don't do anything to nurture that advice, chances are your child will never be able to reach his full potential to learn language.

Contrary to old beliefs that a child's language learning abilities in hearing impaired child is nil. It has now been confirmed that nurture plays a significant role in rehabilitation of hearing impaired children. You can either kill those chances of acquiring language and make them sign language communicator of silent world, ensuring a life of frustration and depression (they know they are different, but cannot express themselves), or you as a parent can transform their capabilities to fruitful, help them develop their auditory skills, language vocabulary, speech stimulation and above of all to satisfy their curiosity and foster their analytical skills.

Sometimes, unintentionally of course, we as parents tend to suppress\certain potentialities in our hearing impaired children, presuming that they cannot hear it. We simply stopped talking to them. A hearing impaired child may pose a serious challenge to reach the goal of self dependency, we as parents must learn that hearing impairment doesn't mean mute it is rather man made. We have to identify the problems early and an immediate intervention must begin as early as possible.

Looking to the future
We have a real problem in our homes when parents are unable to detect and deal with hearing impairment, unfortunately many parent are negligent to do neither. I have strong advocacy of neonatal screening program for all High-risk register children (HRR). It is the only way we can help the early detection and intervention. They have a right, like all other children, to be rehabilitated and placed in a proper intervention centre. They also need to be able to communicate with peers of their same level of language skills.

We should be optimistic about the future in this area. Realizing the implications of such problems, one hope that our state Govt. will have some future planning for the early detection programme for such invisible problems. Therefore, the Manipur Govt. must start a project for the early identification of hearing impairment. RIMS can be a part of this project where medical facilities can be upgraded further with available manpower expertise. Money will have to be invested to ensure programs, which will detect and make use of hearing impaired individuals. All the district hospitals must also have a pilot team to run such a project.

But despite such dreams, the fact still remains that there isn't enough awareness of the importance of detecting and nurturing hearing impairment-and many parents and even Doctors are just not giving these hearing impaired children the environment needed to provide both the physical and psychological stimulation that they need.

TIPS FOR THE PARENTS:-

• Give them the same amount of both love and discipline you would to any child. Being hearing impaired doesn't mean they need sympathy.
  
  

• Create a stimulating learning environment in your home. Hearing impaired child need a lot of speech and language stimulation to acquire language skills. One suggestion is to hang up charts on different walls giving them the opportunity to explore and ask.
  
  

• Provide opportunities for question and story telling moments.
  
  

• Don't be disheartened with no answer or no repetition from your child. Keep continue stimulation. You need to be patient and to provide different clues for the stimulation is needed.
  
  

• Use your ability to dramatize the situation. All children love to hear story and hearing impaired child can get more fun and benefit from the creative /direct activities.
  
  

• Enjoy and respect your child's individuality, they can!