There are numerous risk factors that may have a causal association with neonatal deafness. It is well established that hearing loss in children leads to inadequate social, intellectual and emotional growth. Also, due to this, the optimal capacity or intellectual functionality of an individual is not attained due to this. Social acceptance of the individual also becomes difficult with hearing impairment. As a strict protocol, hearing screening is mandatory in the western world from 1999. The screening programs can detect hearing loss prior to 6 months of age and initiation of treatment before 1 year can limit the disability and improve social acceptance leading to normal life for the child. One must be wary that the screening programs in place are not able to prevent the development of disability. There are identifiable established risks to the fetus in literature. They are from ante-nate infections like maternal rubella, herpes zoster, cytomegalovirus infections (these being the major ones). Syndromes like Penred, Alport’s, Hurler and Kippel fiel are proven syndromes with hearing loss. Gene mutations like GJB2, ECHOS1, PDS gene mutations are currently established causes for congenital and childhood-onset of hearing loss. As the incidence of congenital hearing loss is between 1 to 5 per 1000 live births, there should be continuous vigil and scrutiny of data for the benefit of future generations to come. So it is our social responsibility to carry forward this research.In India, majority of hospitals do not conduct universal or high-risk screening. In such a situation, a centralized facility catering to all hospitals in a city is a practical option. A two-stage screening protocol can be made, in which infants are screened first with otoacoustic emissions (OAE). Infants who fail the OAE are screened with auditory brainstem response (ABR). 
In this two tier screening program, the second tier being ABR (which is more expensive) is required only for a select few, making the program more practical and viable. The Child Health Screening and Early Intervention Services Program (Rashtriya Bal Swasthya Karyakram) under National Rural Health Mission initiated by the Ministry of Health and Family Welfare of Government of India has included congenital deafness as one of the conditions to be included for early identification and remediation. It involves screening of infants and children under age 18 years by a mobile team and provision of appropriate treatment at District Early Intervention Centers (DEICs). This ambitious scheme is likely to streamline the management of hearing disabilities. Prathama foundation is in association with many hospitals and other delivery centers to screen new born children at the earliest. Collecting history, Administering HRR, Hearing testing, Neurological examination and counseling the results as well the normal developmental milestones are the main parts of the screening program.
Program Glimpses
