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Abstract
This paper deals with congenital hearing loss (genetic, intrauterine and unfavourable perinatal influences). Data on prevalence vary. Confusion concerning terminology and inadequate facilities for diagnosis makes comparisons difficult.
The prevalence of profound deafness in most European and North American countries is about 1:2 000. When partial deafness is included, the prevalence is considerably higher. Few dependable data are available regarding the distribution of types and degrees of hearing loss and these vary from country to country. Information is better known within the congenitally hearing impaired population. The relation between aetiology and the type of hearing loss helps this knowledge. Sex distribution has been studied recently by the author and data are given. The relative distribution of causes is fairly well known and described in the paper.
The natural history of many types of congenital hearing loss has been inadequately studied. The pathology has been described but the processes leading to hearing loss are little understood. Progress has been made which will enable us to prevent several types of congenital hearing loss.
Certain rehabilitative measures enhance the propagation of the genetic type. Integration into the normal society should decrease this. Genetic counselling should help prevention. Probably unsuspected mutagenic agencies anhance the propagation of genetic hearing loss.
Social conditions influence many aspects of the condition. Movements of populations expose to infection those unprotected immunologically. They change the genetic composition of populations. Migrant populations create difficulties in rehabilitation because of different language backgrouds.
A disabled child always means a disabled family. The basic sociopolitical aspects of rehabilitation depend largely on the attitudes of society to the disability. Deafness still rates low in the hierarchy of disabilities in the estimation of society.
Population studies conducted at an acceptable standard are long overdue. International agreement on terminology and on identification is called for.