Introduction
Congenital hearing loss means hearing loss that is present at birth. This causes difficulties in speaking and in understanding speech. If not treated adequately, children with congenital hearing loss often have inadequate speech and language skills which might persist into adulthood.
Types of congenital hearing loss
There are 3 types of congenital hearing loss which are:
Sensorineural hearing loss
This type of hearing loss is caused due to abnormalities or damage in the inner part of the ear and auditory nerve, which is the nerve responsible for connecting sounds from the ear to the brain to perceive it. This is the most common type of hearing loss. It is usually permanent.
Conductive hearing loss
Conductive hearing loss is caused due to abnormalities or damage in the outer and middle part of the ear. There is a dampening of the sound that reaches the inner ear which often results in hearing the sound as clear but of very low volume. It is usually reversible but can also be permanent depending on the cause.
Mixed hearing loss
This type of hearing loss is caused due to abnormalities or damage in the outer and/or middle ear and the inner ear. Here, the sound clarity and well as loudness is affected.
Causes of congenital hearing loss
There are various factors that can cause hearing loss at birth. These are:
- Genetic factors – Genetic factors are the most common cause for congenital hearing impairment. It can be syndromic (there are multiple issues present along with hearing loss) or non-syndromic (there is only hearing loss with no other issues). Some examples of syndromic hearing loss are Waardenburg syndrome, Usher syndrome and Alport syndrome. Common examples of non-syndromic hearing loss are Connexin 30 mutation, Otoferlin mutation and Pendrin mutation.
- Infections – Infections can be bacterial, viral, fungal or parasitic. The most common infections are Rubella, Cytomegalovirus, Syphilis, Toxoplasmosis (a parasitic infection) and Herpes Simplex Virus.
- Gestational diabetes
- Maternal high blood pressure during pregnancy
- Low birth weight
- Lack of oxygen during birth (Hypoxia)
- Jaundice during birth
- Medications that can damage inner part of the ear (ototoxic medications)
Challenges in Verbal Communication
Communication issues include comprehension and expression.
COMPREHENSION
Comprehension includes understanding of speech and language. People with congenital hearing loss can face different issues in comprehension which are:
- Reduced ability to understand speech sounds – Hearing loss can cause issues with clarity of speech. Certain words may not be heard as it is and might cause confusion and misunderstandings. For example, a person might hear the word “mat” as “bat”.
- Limited vocabulary which might cause confusion – A person who is less exposed to different words due to congenital hearing loss, might get confused with new words that they have not heard before.
- Issues in understanding complex sentence structures – There might be difficulties in understanding long or complex sentences and following verbal instructions.
- Difficulties in understanding abstract concepts when described verbally – Since abstract concepts are explained using complex language, a person with congenital hearing loss might find it difficult to grasp these descriptions.
- Having greater difficulties in understanding social conversations especially when there are multiple people speaking – People with hearing loss have to focus more on listening than people without hearing loss, making group conversations challenging.
- Extreme difficulties in understanding when there is background noise – Background noise worsens speech perception for people with hearing loss, especially those with sensorineural hearing loss.
- Issues in listening to audio calls or when the speaker’s mouth cannot be seen – Visual cues like mouth movements are crucial for understanding speech; if obscured, communication becomes more difficult.
EXPRESSION
Expression includes speech. The different factors that might get affected in speech are:
- Reduced expressive vocabulary – People with congenital hearing loss might use limited vocabulary if they are not exposed to a wide range of words.
- Articulation errors – These occur due to difficulties hearing certain sounds. Examples include:
- Sound omissions – “Paper” pronounced as “papuh” (omitting the “r”).
- Sound substitutions – “Pag” instead of “bag”.
- Distortions – Sounds unclear due to incomplete auditory input.
- Additions – Extra sounds added due to overcompensation (e.g., “pluh lay” for “play”).
- Lack of intonation or inappropriate intonation – Speech may be monotone or have abrupt pitch changes.
- Lack of voicing or faulty voicing – Difficulty distinguishing voiced and voiceless sounds (e.g., saying “Pie” for “Bye”).
- Errors in nasality – Confusion between nasal and oral sounds can cause hypernasality or hyponasality.
- Changes in stress patterns – Stress may be misplaced within words (e.g., “computer”).
- Errors with fricative and affricate sounds – Confusing similar mouth movements (e.g., “chirt” instead of “shirt”).
Treatment
Most adults with congenital hearing loss would have already received some form of treatment. They can be open to other treatment options or can include other treatment along with the ongoing treatment if they face difficulties in communication. There are different treatment methods depending on the type and severity of the loss and the communication issues the person is facing. Some of the most common treatment options are:
- Hearing aids – With greater advancements in technology, there are different types of hearing aids available depending on the type and severity of the hearing loss, and the lifestyle and comfort of the person.
- Cochlear implants – These are an alternative to hearing aids and are often opted for severe to profound levels of hearing loss.
- Assistive listening devices – These devices help in hearing better in certain situations like attending conferences or talking through the phone.
- Speech therapy – Speech therapy can help in improving enunciation, intonation, social communication and word stress.
Conclusion
Congenital hearing loss is hearing loss that is present at birth. People with congenital hearing loss face greater communication issues than people who develop hearing loss at a later period of their life. There are different issues that could arise in communication. It is important to understand these challenges and get the proper treatment in order to have good communication skills.
