It has long been recognized that children with persistent moderate to profound hearing impairment of early onset experience a variety of communicative, academic, psychosocial, and emotional difficulties.<sup>7 Audiology, Education and the Hearing Impaired Child St. Louis, MO: CV Mosby (1981). 

Cliccare qui per andare alla sezione Riferimenti, 21 Davis J.M., Shepherd N.T., Stelmachowicz P.G. , e al. Characteristics of hearing-impaired children in the public schools: Part II. Psychoeducational data J Speech Hear Dis 1981 ;  46 : 130-137

Cliccare qui per andare alla sezione Riferimenti, 25 de Villiers P.A. Educational implications of deafness: Language and literacy Hearing Loss in Childhood: A Primer Report of the 102nd Ross Conference on Pediatric Research Columbus, OH: Ross Laboratories (1992).  127-135

Cliccare qui per andare alla sezione Riferimenti</sup> Even some children with significant unilateral sensorineural hearing loss (SNHL) (> 40 dB) exhibit problems in learning and difficulties with speech understanding in noisy situations.<sup>9 Bess F.H., Tharpe A.M. Unilateral hearing impairment in children Pediatrics 1984 ;  74 : 206-216

Cliccare qui per andare alla sezione Riferimenti</sup> Also, significant costs are associated with early childhood hearing impairments. The estimated lifetime cost of childhood hearing loss exceeds $1 million for each affected child. Other less obvious costs include family tension, breakdowns in family communication, and social isolation.<sup>8 Bess F.H., Paradise J.L. Universal screening for infant hearing impairment: Not simple, not risk-free, not necessarily beneficial, and not presently justified Pediatrics 1994 ;  93 : 330-334

Cliccare qui per andare alla sezione Riferimenti, 20 Davis J.M. Management of the school age child: A psychosocial perspective Hearing Impairment in Children Parkton, MD: York Press (1988). 

Cliccare qui per andare alla sezione Riferimenti, 47 Maliszewski S.J. The impact of a child’s hearing impairment on the family: A parent’s perspective Hearing Impairment in Children Parkton, MD: York Press (1988). 

Cliccare qui per andare alla sezione Riferimenti</sup>

In contrast to the moderate to profound hearing losses, limited information exists on children with minimal, progressive, and fluctuating types of hearing impairments. In recent years, however, we have witnessed an increasing amount of published research on these rather unique populations of children. Because pediatricians are often the first to encounter children with hearing loss, it is important for them to develop some familiarity with the clinical characteristics of minimal, progressive, and fluctuating hearing losses in children. To this end, current clinical data on children with these types of hearing impairment are presented. For the purpose of this report, minimal hearing loss includes both conductive and sensorineural hearing losses; emphasis is placed on clinical characteristics, appropriate identification in pediatric practice settings, and recommended management.