An overview of motor skill performance and balance in hearing impaired children

Childhood hearing impairment is a significant public health problem, which is associated with long-term academic and communicative difficulties [1,2]. The prevalence of moderate to profound hearing loss in children, including sensorineural hearing loss and conductive hearing loss is 1 to 6 of 1000, of which, 10% have hearing levels that fall in the profound range [3-6]. Moreover, it is estimated that about 440 million children worldwide have hearing loss above 85 decibels, and this increases to about 800 million when the threshold is reduced to 50 dB [7,8]. Although many children have hearing impairments, each child is unique.Newborn hearing screening has led to earlier identification and treatment of infants with hearing loss [7,8]. However, the earlier identification of childhood hearing impairment is considered critical for normal speech, language, cognitive and social development [4].As routine screening does not include assessment of balance and motor deficits, physical therapy services are not included in the educational programme, unless obvious neurological or orthopedic disorders are diagnosed. However teachers and parents of these children often report inco-ordination, clumsiness and balance deficits which may hinder the child's optimal performance [9]. Moreover, many pediatric health care providers are often too busy or inadequately trained in conducting elaborate developmental screening tests during the regular clinics. These tests are performed only when the child present with an obvious deficit [10]. Hence, we aim to provide a concise description on balance and motor performance in hearing impaired children.The degree of hearing loss explains the severity of hearing impairment. Table 1 shows the degrees of hearing loss according to American Speech-Language Hearing Association [11].American speech-language hearing association has categorized hearing loss based on the part of the auditory system damaged. Accordingly there are three basic types of hearing