Can jaundice cause hearing impairment?

Q: My nine months old son is a premature baby, and had severe jaundice. He still cannot sit without support. He is unable to respond to sounds. Is this due to jaundice?

A:Jaundice is one of the known risk factors for hearing impairment. However,you / your doctor have thoughtfully done a hearing assessment. Mostprobably, your child would have had a screening test like BERA. By doing it,you have already done taken the first step. Kindly follow this up with thesame zeal. By age nine months, play audiometry / behavioural audiometrycan be done (by an experienced audiologist) to ascertain the hearingthresholds. Depending on the threshold level, further assistance to thechild can be planned. If the hearing impairment is significant, hearing aidswill have to be fitted. Yes, even at nine months hearing aids can be fitted.Good hearing is absolutely essential for the over all development of thechild. Hence, do not hesitate. After fitting the aid, start conversing withthe child. Stimulate him to speak. Always remember to avoid gestures.In the last one-decade, two new devices have been added to the armamentariumof the ENT surgeon. They are bone anchored hearing aid (BAHA) and cochlearimplant. The mechanisms of delivery of sound information by these two devicesare a little different. These two new devices are expensive and also carrysome operative and post operative risks. But, you have to realise that allthe devices including the hearing aid can deliver only sounds. Understandingthe sounds, interpreting the meanings of the sounds, formulation of speechand actual delivery of speech by the child depends on your efforts atteaching the child. These teaching efforts have to be prolonged over years.Hence, 'latest' does not mean the best. Provided a hearing aid does succeedin reaching the sounds into an impaired ear, the benefits will be equal orbetter than a cochlear implant. This is why it is mandated that a hearingaid will have to be tried in every hearing impaired child, for a few months.Only if this strategy fails, the option of cochlear implant will have to beentertained. In any child, some islands of hearing might be present. Thisstrategy of 'hearing aid first' tries to maximises the benefits of theseislands of hearing.In bringing back the child from the world of silence, the role of theparents, grand parents, siblings, teachers and neighbours is great. Specialteachers are available to guide you in this issue. In some regions in ourcountry, special schools are also available. Some such schools admit thechildren at a very tender age. Recently, one special school in Chennaiadmitted a child aged nine months. This school mandates that the mother alsoshould accompany the baby to the school every day. The principle is that theparents also need to be trained in rearing such children. If we start early,hearing impaired children can quickly be transferred to the regular schoolsin two years, three years or even earlier. Unfortunately, such services arevery few. Ask a second time; ask a second person. Please ask yourpaediatrician / ENT surgeon / audiologist to guide you.