Abstract
The Republic of Ireland has a total population of 3.5 million people, mainly rural or in small towns, a rapidly declining birthrate during 1984 to 1991, and a geographically stable children's population. A unified Audiology Service is provided by the National Rehabilitation Board for the fitting of heaing aids to all children deemed to require them. The current study outlines a database analysis of all children fitted with hearing aids for the first time in 1984 or 1991. Follow-up information on the status (in 1991–1992) of those fitted in 1984 was obtained, with regard to hearing loss, schooling and changes in aiding. Data on severe/profound losses in particular, and the trends in service provision are examined. Similar numbers of children were fitted with hearing aids in the two years sampled, even though the overall degree of hearing loss amongst this population had fallen.
Data on 1984 and 1991 hearing-aid fittings give some insight into changing patterns of identification and management of childhood hearing loss in Ireland. More data are needed to provide birthrate statistics, and this is now underway. The main conclusions are:
1. Numbers of children fitted with hearing aids in 1984 and 1991 were similar, but overall degree of hearing loss fitted fell in 1991. Falls in rates of severe/profound loss, both congenital and acquired, resulted mainly from a falling birthrate and ‘MMR’ vaccination. More referrals and greater acceptability of hearing aids led to more mild losses being fitted in 1991.
2. Changes in causes of loss fitted with hearing aids included the elimination of maternal rubella as a cause, reduction in meningitis and increase in perinatal cases fitted in 1991 com pared with 1984.
3. Median ages of fitting hearing aids to those with congenital loss fell from 1984 to 1991, but more exact data are needed. Acquired conductive loss was typically not fitted earlier.
4. Hearing deterioration 7 years after fitting of a hearing aid in 1984 occurred in <6% of cases, except for severe sensorineural/mixed loss, where the risk was 12%. For acquired conductive losses, chances of improvement were well over 50%.
5. Schooling for those with severe/profound loss was still based on Special Schools for the Deaf, not Units, in 1991, but almost half of those fitted in 1984 with severe hearing loss were in mainstream schools in 1991, with Visiting Teacher support.
6. Useful life for a child's hearing aid was between 4 and 5.5 years, regardless of age at initial fitting or aid fitted.