The Little Ears We Overlook

The Little Ears We Overlook

Why early hearing screening matters and why it’s time to act

When Nosipho brought her newborn home, everything seemed perfect. Her baby slept, cooed and cuddled just like any other. But something wasn’t right, there was no response to sound. It took months before Nosipho discovered that her daughter had been born with hearing loss, and even longer to find the help they needed.

She’s not alone. Around 17 babies are born in South Africa each day with permanent hearing loss, more than 6,000 each year. Most aren’t tested at birth. A 2009 survey found only 1 in 4 hospitals offered screening, and with many births happening outside hospitals, even fewer babies are checked early on.

Neurobiology shows there’s a “critical window” in the first 6 months of life for developing the auditory system. If babies with hearing loss don’t receive sound during this time, the brain’s hearing centres are taken over by other senses, making language development much harder later on (HPCSA, 2018).

But here’s the good news: early hearing screening can change everything. In Cape Town, audiologist Sarah Lange and her team at the Carel du Toit Centre show what’s possible. They help babies get diagnosed as early as a few days old, to learn to listen and speak like their hearing peers. In her words: “Children who are born deaf, but diagnosed early and fitted with hearing technology can develop speech and language equivalent to their typically hearing peers. The earlier the support, the better the outcomes, for the child and their family”she adds “The listening and spoken language approach for children who are deaf, allows them to integrate into the family, into the workplace, into a hearing society and into the world.”

Why this matters

In the first six months of life, a baby’s brain is wired for language. If they can’t hear, those pathways don’t form properly. But with early intervention such as hearing aids or cochlear implants, and support for families, deaf and hard-of-hearing children can thrive.

Quick, painless tests, done while a newborn sleeps, can flag issues before the family even leaves the hospital. That’s the approach used by Tersia de Kock and her team at the hearX Foundation. Using smartphones, they’ve trained nurses to run hearing screens during the six-week immunisation clinic visit. “This should be a right, not a privilege,” Tersia says. “By harnessing community-led screening and digital innovation, we can break barriers to access and give every child the opportunity to learn, connect, and thrive.”

The Health Professions Council of South Africa recommends every baby be screened by six weeks, diagnosed by four months and supported by eight. But we’re far from that goal.

It’s a matter of equity

Delayed diagnosis doesn’t just affect health, it deepens inequality. When we don’t screen early, we widen the gap between children who can access opportunity and those who can’t.

That’s why champions across the country are stepping up. Prof. Claudine Storbeck’s HI HOPES programme offers family-centred, home-based support with Deaf mentors and interventionists after diagnosis. This helps parents embrace the journey and learn how to support their child from the start. In the Eastern Cape, Dr Paul Cromhout’s Small Projects Foundation team has worked with #Keready mobile clinics to bring hearing tests to communities where they’re needed most.

Prof. Katijah Khoza-Shangase is advocating for hearing screening to become routine, not a luxury and highlights the need to develop a culturally relevant workforce to support families in their language. And behind the scenes, Tucker Bbosa from the Clinton Health Access Initiative is pushing to make screening part of national health planning. He says: “For a child to thrive, they need to be able to communicate and it starts with hearing. Early screening allows for timely interventions, giving children with hearing loss the chance to develop language skills on par with their hearing peers by age five.”

Hold my hand helping children to reach their full potential

Campaigns like Hold My Hand support South Africa’s National Strategy to Accelerate Action for Children, helping ensure every child reaches their full potential, including those with hearing and vision loss. Early screening is one of the most impactful ways to do that. It’s cost-effective, supports families, and changes lives.

What you can do

Even if you’re not an audiologist or policymaker, you can still be part of the change:

·       Ask about newborn hearing screening when giving birth in a private hospital or clinic. It’s not yet routine, but awareness matters.

·       Support task-shifting, where trained community workers carry out basic hearing screens, a proven approach in under-resourced areas.

·       Advocate for a national EHDI programme so screening becomes standard, with clear policy, funding, equipment and follow-up care.

South Africa has the tools, the champions and the momentum. Now we need the will and a whole-of-society push to make early screening the norm.

Let’s not wait until children fall behind. Let’s listen sooner. Let’s act earlier and hold their hands from the start.

Want to get involved? Email info@holdmyhand.org.za