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Link Between Childhood Hearing Impairment and Injuries Investigated

Having children with hearing impairments is a challenge on many fronts, such as difficulties with learning vocabulary, acquiring language skills, and mastering other aspects of verbal communication.

But there are also other risks associated with a hearing impairment for example, not hearing well can lead to various physical injuries which require medical attention.

Until recently, few studies have tested the hypothesis that children with sensory impairments such as deafness may be at increased risk of injuries. But now a study conducted at the University of South Carolina School of Medicine shows that the hearing impaired children are much more likely than other kids to end up in an emergency room with a wide variety of injuries

Thousands of Children Affected

According to American Speech-Language-Hearing Association (ASHA), approximately 740,000 individuals in the U.S. have severe to profound hearing loss. Of these, almost 8 percent are under the age of 18. Among African-American, Cuban-American, Mexican-American, Puerto Rican, and non-Hispanic white children, it is estimated that some 391,000 school-aged youngsters suffer from unilateral hearing loss, that is, impairment affecting only one ear. Approximately 15 percent have low- or high-frequency hearing loss of at least 16 decibels hearing level in one or both ears. And profound, early-onset deafness is present in between four and 11 children per 10,000; in at least 50 percent of cases, it is attributed to genetic causes.

Other causes of childhood hearing loss, ASHA says, include otitis media (an inflammation in the middle ear usually associated with the buildup of fluid,) as well as acquired hearing loss, which may be a result of a disease or an injury.

Less Hearing, More Injuries

The South Carolina study, released at the end of 2007, investigated injuries treated in 2002 and 2003. It compared rates of emergency department or hospital treatment for injury among the states Medicaid-insured children with and without a diagnosis of hearing loss. They investigated more than 138,000 injuries that included fractures, sprains, strains, burns and cuts. About 90,000 children had normal hearing, and approximately 1,000 suffered from hearing loss.

The study could not determine whether hearing-impaired children were at an increased risk of injury or whether the parents of these kids are more likely to seek treatment. Another possibility might be that children with hearing problems often have additional medical issues that make them more prone to injuries.

Still, based on the studys findings, it is likely that impaired hearing may put children at higher risk of injury because they may not hear warning signs and noises of impending danger.

Children with hearing loss had significantly higher treatment rates for every injury type, bodily location and external cause, says researcher Joshua R. Mann, MD, MPH, of Department of Family and Preventive Medicine at University of South Carolina School of Medicine. We classified injuries three ways: body site, nature of the injury, and external cause. Among children with hearing loss, the most common body site was upper extremity. The most common injury type was contusion. The most common external cause was falls.

An Ounce of Prevention

A challenge many parents of hearing impaired children are facing is how do to prevent injuries. Unfortunately, the study has not provided any clear answers to this dilemma.

The study wasnt focused on ways of prevention, Dr. Mann says, and I dont know whether there are any evidence based guidelines out there specifically directed toward children with hearing loss and their families.
General guidelines borne out of the study, however, suggest that efforts to develop injury prevention interventions designed specifically for these children and their families would seem to be warranted. Dr.Mann concludes, Meanwhile, clinicians should consider discussing injury prevention strategies with parents of children with hearing loss. A discussion of the implications of a childs diminished ability to hear verbal or nonverbal warnings could be a central aspect of this counseling.

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