title: Asymmetric Hearing During Development: The Aural Preference Syndrome and Treatment Options.
abstract: Deafness affects ∼2 in 1000 children and is one of the most common congenital impairments. Permanent hearing loss can be treated by fitting hearing aids. More severe to profound deafness is an indication for cochlear implantation. Although newborn hearing screening programs have increased the identification of asymmetric hearing loss, parents and caregivers of children with single-sided deafness are often hesitant to pursue therapy for the deaf ear. Delayed intervention has consequences for recovery of hearing. It has long been reported that asymmetric hearing loss/single-sided deafness compromises speech and language development and educational outcomes in children. Recent studies in animal models of deafness and in children consistently show evidence of an "aural preference syndrome" in which single-sided deafness in early childhood reorganizes the developing auditory pathways toward the hearing ear, with weaker central representation of the deaf ear. Delayed therapy consequently compromises benefit for the deaf ear, with slow rates of improvement measured over time. Therefore, asymmetric hearing needs early identification and intervention. Providing early effective stimulation in both ears through appropriate fitting of auditory prostheses, including hearing aids and cochlear implants, within a sensitive period in development has a cardinal role for securing the function of the impaired ear and for restoring binaural/spatial hearing. The impacts of asymmetric hearing loss on the developing auditory system and on spoken language development have often been underestimated. Thus, the traditional minimalist approach to clinical management aimed at 1 functional ear should be modified on the basis of current evidence.
authors.affiliation: Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada; karen.gordon@utoronto.ca.
authors.forename: Karen
authors.initials: K
authors.lastname: Gordon
authors.affiliation: Hearing, Speech, and Language Center, Sheba Medical Center, Tel Hashomer, Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and.
authors.forename: Yael
authors.initials: Y
authors.lastname: Henkin
authors.affiliation: Cluster of Excellence Hearing4all, Institute of AudioNeuroTechnology, Hannover, Germany; Department of Experimental Otology, ENT Clinics, School of Medicine, Hannover Medical University, Hannover, Germany; and School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas.
authors.forename: Andrej
authors.initials: A
authors.lastname: Kral
mesh_terms: D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003638:Deafness / Q000503:physiopathology* / Q000628:therapy; D006310:Hearing Aids; D006320:Hearing Tests; D006801:Humans; D007804:Language Development; D019986:Persons with Hearing Disabilities