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Introduction
Children with different genetic, neurodevelopmental and neurological conditions suffer from a variety of symptoms affecting different aspects of their growth. Hearing impairment could be identified as a part of the medical condition or as one of its common symptoms as in cases of mucopolysaccharidoses (MPS), where the prevalence of hearing impairment ranging from 67.3 to 94% [18] and [24], cerebral palsy,with a prevalence of hearing loss of 2–13% [9, 19], and neonatal hyperbilirubinemia, with prevalence of hearing loss of 4–39% [4]. Or it could an associated comorbidity as in cases of Down syndrome with a prevalence rate of 4.5–78% [2] or autism spectrum disorder, prevalent in 0.9–6% among this population [3]. In general, it has been estimated that hearing impairment could range from 0.9 to 78% in children with developmental disorders [23]. Hearing impairment among these children especially when presented with other challenging manifestations, as cognitive and language delay, could be masked or misdiagnosed leading to compounded adverse effects and poorer outcomes in their intellectual and linguistic development [15]. Hearing loss has a serious impact on speech and language development with subsequent behavioral and cognitive problems,children with hearing impairment showed lower scores in receptive language, literacy and numeracy skills, higher levels of hyperactivity and attention deficits, abnormal emotional responses, and conduct disorders. All these outcomes increase symptoms severity of the already challenging demands of children with special needs [8].
Hearing loss can arise from anywhere throughout the auditory system, from the external auditory canal, sound conduction mechanism, cochlea, cochlear nerve, up to the central auditory pathways. Rehabilitation options exist for all types of hearing loss, regardless of cause or location [12]. Hearing impairments could be conductive, sensorineural, or mixed,it could be unilateral or bilateral with various causes whether prenatal, perinatal, or postnatal. It could also arise in early or late childhood or even adulthood. Therefore, assessment and follow up of hearing is crucial in cases of language and cognitive impairment even after passing neonatal screening [6]. Hearing difficulties further cause poorer social, communication, and educational functions in special needs population. Health care services for children with special needs and developmental delays should be aware of early identification and management of hearing difficulties along with other developmental comorbidities to improve cognitive and language functioning as...