Support for school-age children with hearing impairments during their schooling period requires addressing diverse individual needs, including academic success, psychological growth, and experiences of social participation. Therefore, effective support necessitates multidisciplinary collaboration across medical, educational, and welfare fields. However, support plans within each field may tend to operate independently, leading to fragmented collaboration and “siloed” practices.

　　In this context, the “Consultation Support Office” serves as a hub integrating these various fields.

　　This office unifies the goals of various agencies by formulating a “Plan for Utilization of Support for Children with Disabilities (PUSCD)” and convening meetings the among members from the respective fields, acting as an integrator standing alongside the families. However, structural problems exist, including a lack of expertise regarding hearing loss among consultation support specialists, insufficient awareness about the system, and a lack of institutional safeguards for collaboration among relevant agencies.

　　Going forward, to achieve a smooth social transition of children with hearing impairments, it is an urgent need to build an effective collaborative framework centered on the consultation support system. Towards this end, it is important to train specialists, improve their compensation system, and mandate coordination at key life stages of the support recipients.

　　Although early intervention for hearing loss is expected to improve or maintain cognitive function, few reports have addressed the appropriate target frequencies for auditory assessment. We conducted pure-tone audiometry, adding the frequencies of 3kHz and 6kHz to the conventional seven-frequency test, in participants of the Iwaki Health Promotion Project. Subsequently, we examined the proportion of individuals with hearing loss by age group and the frequency of unrecognized hearing loss from the gender and age perspectives.

　　The results showed that in the high-frequency range of 3kHz and above, the increase in hearing threshold was greater in men aged 50 years old or over and women aged 60 years old or over. Furthermore, approximately 80% of participants reported no awareness of hearing loss. Among these, 18.0% showed an average threshold increase of 25 dB or more across three high-frequency frequencies in their better ear. This suggests a significant number of “unaware hearing-impaired individuals”. Therefore, regardless of self-reported hearing loss, it is considered important for men and women to undergo regular hearing evaluations starting in their 50s and 60s, respectively.

　　Auditory steady-state response (ASSR), an objective audiometry parameter, is used clinically for detailed audiometric evaluation after newborn hearing screening and for diagnosing functional hearing loss.

　　In recent years, ASSR using chirp sounds has become available, and there have been many reports on its usefulness. In this study, we evaluated 34 patients (13 with normal hearing and 21 with hearing loss) using the SENTIERO. We investigated the difference score (DS), correlations between ASSR thresholds and pure tone audiometric thresholds (PTA thresholds), as well as the testing time. Positive correlations were observed at all six frequencies measured, and the average value of the DS was within 10dB. The average testing time was 28 minutes. Hearing evaluation by ASSR using SENTIERO is considered as being clinically useful because it reflects the PTA threshold well, and the testing time is less than 30 minutes.

　　Clinical research into cochlear implantation for unilateral severe-to-profound hearing loss began in 2017, and its effectiveness was confirmed in a group that underwent the advanced medical care at our hospital in 2021.

　　Persons with unilateral hearing loss receiving cochlear implants can hear in their better ear, so that a different rehabilitation method is required from that for patients with bilateral hearing loss; however, no such method has been established yet in Japan. Therefore, in this study, auditory rehabilitation using direct audio input to a cochlear implant was performed in patients receiving the advanced medical care, and the results suggested the effectiveness of the rehabilitation method.

　　 Going forward, it is thought that efforts will be needed to maintain motivation in the patients to continue wearing the implant, to customize the rehabilitation content for everyone, and to ensure support from family and key people, as connecting and operating the device for direct input can be cumbersome.