**2. Early identification of a hearing loss**

Hearing loss which occurs congenitally or early in life prevents language development in its normal discourse since hearing is our primary sense to acquire spoken language. Therefore some steps should be taken to help babies with hearing loss to achieve speech and language skills.

It has been widely acknowledged that children born with a hearing loss can acquire and develop spoken language if they are identified and fitted with appropriate hearing technology early in their lives and receive quality intervention services (Clark, 2007; Cole & Flexer, 2007; DesJardin, et. al., 2006; Estabrooks, 2006). Younger the age of diagnosis and intervention, better the development of spoken language (White, 2006; Yosinago-Itano & Apuzzo, 1998; Yosinago-Itano & Sedey, 2000). For this reason, it is aimed to identify and fit the hearing aids within the first 3 months of life and to start the intervention program no later than 6 months of age.

Technology for automated hearing screening with otoacoustic emissions (OAE) and with auditory brainstem responses (ABR) permits fast, accurate and cost-effective identification of hearing loss in infants within hours after their birth. During the last two decades universal newborn hearing screening (UNHS) were supported as official policy in most developed countries (Department of Public Health, 2009; NDCS; 2004). It is also steadily expanding in developing countries; giving way to early identification and management of any kind of a hearing loss in infants and young children throughout the world.

Early identification and fitting of hearing aids/cochlear implant provide opportunities to stimulate auditory pathways during the critical periods of language acquisition and enables normal development of language. Although it is flawed, sensory stimulation which is provided through the hearing aids or cochlear implants supports the development of the neural network within the auditory system (Ryugo, et.al., 2000). On the other hand, a language enhancing environment should also be created to make maximum use of the sensory stimulation since learning is required for language acquisition (Clark, 2007; Cole & Flexer, 2007; Lieven, 1994; Otto, 2006 ; Sokolov & Snow, 1994).

In course of language development the first two years of life are seen to be critical.
