Because hearing impairment is an invisible disability, it is easily ignored, especially if other, more dominant, health issues are also present. If hearing impairment, whether mild or unilateral, is not identi¢ed early enougheither at birth or within the ¢rst 2 years of lifeit may have serious consequences for the child’s speech, language, and cognitive skills development. The child’s educational process and achievement may also be compromised if a hearing loss is unidenti¢ed and rehabilitation is not instituted. In the United States, as noted earlier, neonatal hearing screening is now common in many states. Neonates usually receive routine screening to rule out the presence of a hearing loss before their discharge from the hospital after delivery. An infant with suspected hearing loss is followed, and appropriate diagnostic and rehabilitative measures are put in place. However, for children with multiple disabilities, the presence of a hearing loss, its evaluation, andrehabilitation constitute additional challenges
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