State of deaf children in West Bengal, India: What can be done to improve outcome.

OBJECTIVE: Prelingual deafness in children demands urgent action as best outcome is dependent on earliest possible diagnosis and intervention. Objective of this study was to determine age of suspicion, diagnosis, intervention, and outcome in a representative group of deaf children in West Bengal, India, and suggest ways of improving these parameters.

METHODS: In this cross-sectional study, ages of suspicion, diagnosis, intervention and outcome of 303 randomly selected deaf children were elicited from a cohort of 1316 children with deafness identified in an earlier study.

RESULTS: Median ages of suspicion, diagnosis and amplification were 18, 72 and 84 months respectively. Age of suspicion was significantly related to parental education (p < 0.05); age of diagnosis to parental education and socio-economic status (p < 0.001) and children's geographic location (p < 0.01). Following diagnosis, 86% of children received hearing aids but only 6% used their aids consistently; 86% were non-verbal, 12% could communicate with a mixture of speech and gesture and only 2% with speech alone.

CONCLUSION: Current situation of deaf children in West Bengal, and evidence indicates, in much of India, is insupportable. However, widely diverse socio-economic conditions and scarcity of public health infrastructure preclude one solution of the problem for the whole country. In absence of the ideal universal newborn hearing screening, rigorously monitored and costed pilot programs of different models of early detection and intervention using newborn hearing screening, targeted screening and trial of calibrated noisemakers by primary care workers should be tried to see which works best where, so that successful programs can be scaled up over time.