Hearing impairment and development — formative SAQs

SAQ 1 (10 marks)

Parents of an 8-month-old receive diagnostic confirmation of bilateral severe sensorineural hearing loss after a newborn refer. They ask you to “finish all the blood tests first” before hearing aids. [3]

1. Why is delaying amplification until aetiology testing is complete the wrong priority? (3) [3] [1]
2. List five components of the first-month management plan. (5) [3] [4]
3. What outcome message is evidence-aligned without false certainty? (2) [4] [1]

Model answer

Language access is time-critical in early life; earlier identification/intervention programmes improve communication outcomes on average. Aetiology tests should run in parallel, not block devices. [1] [3]

Plan: fit hearing aids promptly; enrol family-centred early intervention; ENT/audiology coordination; discuss implant pathway candidacy where appropriate; start indicated aetiology evaluation; support family coping and teach device use; schedule close review of hours-of-use and communication. [3] [4]

Message: earlier access supports better spoken language trajectories for many children (including CI candidates in cohort data), but individual outcomes vary and need ongoing team care — no guarantee of “normal speech,” no nihilism either. [1] [4]

SAQ 2 (10 marks)

A 7-year-old has slight-to-mild bilateral loss on audiology after school concerns. Another child on the ward is recovering from bacterial meningitis. [8]

1. Why must mild loss still trigger educational planning? (3) [8]
2. What audiology action is required after bacterial meningitis and why is it urgent? (4) [3] [4]
3. When might tympanostomy tubes be considered for OME rather than endless observation? (3) [9]

Model answer

Population evidence links slight-to-mild childhood hearing loss with academic, behavioural and quality-of-life impacts; noise-filled classrooms worsen functional hearing. Plan seating, remote microphone options and review. [8]

Post-meningitis: arrange urgent diagnostic audiology because hearing can deteriorate rapidly and implant windows may close with cochlear fibrosis/ossification; escalate ENT/implant services if severe loss appears. [3] [4]

Tubes: persistent/recurrent OME with documented hearing impact and developmental or educational concern per guideline criteria — not automatic tubes for every effusion. [9]