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Huang EY, Suarez D, Holley A, Zhang E, McVicar SB, Black P, Sidesinger M, Park AH. Hearing Outcomes in Failed Newborn Hearing Screening Infants With and Without Chronic Serous Otitis. Otolaryngol Head Neck Surg 2023; 169:687-693. [PMID: 36821813 DOI: 10.1002/ohn.306] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 01/03/2023] [Accepted: 02/02/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVE To identify outcomes in hearing loss (HL) diagnosis and intervention in infants with a failed newborn hearing screen (NBHS) and otitis media with effusion (OME) compared to those with failed NBHS and without OME. STUDY DESIGN Retrospective review. SETTING Tertiary medical center. METHODS A chart review was performed on infants referred to Primary Children's Hospital for failed NBHS from 2012 to 2018. Eighty infants with failed NBHS and OME and 55 with failed NBHS and no OME were included. Incidence of permanent HL along with the age of HL confirmation and early intervention (EI) enrollment were compared. RESULTS The incidence of OME in infants with failed NBHS was 59.3%. Fifty-six percent of infants with OME and 12.5% of those without OME did not receive definitive hearing confirmation in either ear due to loss to follow-up or insufficient audiometric assessment. Permanent HL was identified in 11.3% (n = 9) of infants with OME and in 20.0% (n = 11) of those without OME. Infants with OME were significantly older at the time of HL confirmation (4.2 ± 2.1 months) and EI enrollment (5.4 ± 2.5 months) compared to those without OME at the time of HL confirmation (1.0 ± 1.0 months; p < .001) and EI enrollment (2.6 ± 1.8 months; p = .04). CONCLUSION Infants with failed NBHS and OME are highly susceptible to a significant delay in HL confirmation or lack of confirmatory hearing tests. Timely OME resolution with earlier ventilation tube insertion by 3 months of age and follow-up audiologic assessment is recommended.
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Affiliation(s)
- Emily Y Huang
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Daniel Suarez
- Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Anna Holley
- Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Emily Zhang
- Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | | | - Pamella Black
- Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | | | - Albert H Park
- Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA
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Nicholson N, Rhoades EA, Glade RE. Analysis of Health Disparities in the Screening and Diagnosis of Hearing Loss: Early Hearing Detection and Intervention Hearing Screening Follow-Up Survey. Am J Audiol 2022; 31:764-788. [PMID: 35613624 DOI: 10.1044/2022_aja-21-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to (a) provide introductory literature regarding cultural constructs, health disparities, and social determinants of health (SDoH); (b) summarize the literature regarding the Centers for Disease Control and Prevention (CDC) Early Hearing Detection and Intervention (EHDI) Hearing Screening Follow-Up Survey (HSFS) data; (c) explore the CDC EHDI HSFS data regarding the contribution of maternal demographics to loss-to-follow-up/loss-to-documentation (LTF/D) between hearing screening and audiologic diagnosis for 2016, 2017, and 2018; and (d) examine these health disparities within the context of potential ethnoracial biases. METHOD This is a comprehensive narrative literature review of cultural constructs, hearing health disparities, and SDoH as they relate to the CDC EHDI HSFS data. We explore the maternal demographic data reported on the CDC EHDI website and report disparities for maternal age, education, ethnicity, and race for 2016, 2017, and 2018. We focus on LTF/D for screening and diagnosis within the context of racial and cultural bias. RESULTS A literature review demonstrates the increase in quality of the CDC EHDI HSFS data over the past 2 decades. LTF/D rates for hearing screening and audiologic diagnostic testing have improved from higher than 60% to current rates of less than 30%. Comparisons of diagnostic completion rates reported on the CDC website for the EHDI HSFS 2016, 2017, and 2018 data show trends for maternal age, education, and race, but not for ethnicity. Trends were defined as changes more than 10% for variables averaged over a 3-year period (2016-2018). CONCLUSIONS Although there have been significant improvements in LTF/D over the past 2 decades, there continue to be opportunities for further improvement. Beyond neonatal screening, delays continue to be reported in the diagnosis of young children with hearing loss. Notwithstanding the extraordinarily diverse families within the United States, the imperative is to minimize such delays so that all children with hearing loss can, at the very least, have auditory accessibility to spoken language by 3 months of age. Conscious awareness is essential before developing a potentially effective plan of action that might remediate the problem.
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Affiliation(s)
| | | | - Rachel E. Glade
- Communication Science and Disorders, University of Arkansas, Fayetteville
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Graham C, Seeley J, Gina A, Saman Y. Mapping the content of mothers' knowledge, attitude and practice towards universal newborn hearing screening for development of a KAP survey tool. PLoS One 2019; 14:e0210764. [PMID: 30785897 PMCID: PMC6382093 DOI: 10.1371/journal.pone.0210764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/01/2019] [Indexed: 12/01/2022] Open
Abstract
Understanding mother’s knowledge, attitude and practice (KAP) of permanent childhood hearing impairment (PCHI) is essential for the success of universal newborn hearing screening (UNHS) as poor compliance and follow-up remains a global challenge. To determine content area for a questionnaire that measures PCHI-related KAP in rural mothers, we trained moderators who interviewed 145 pregnant women (17 groups) from 5 ante-natal clinics. Interviews were recorded, transcribed, summarised and analysed using thematic framework analysis. Four knowledge themes were identified: 1) PCHI was perceived as the malfunction of hearing leading to disability; 2) a poorly-responsive/communicative child may have PCHI; 3) lifestyle, hereditary and environmental factors are significant causes of PCHI; 4) medical management of PCHI was doubted, with some advocating birth and ancestral rituals. Two themes were identified for attitude: 1) beliefs that PCHI was emotionalised due to the negative lifelong impact on the child and family; 2) UNHS processes were favourable though some preferred other belief systems. Three themes were identified for practice: 1) doctors were the first choice followed by traditional healers; 2) willingness to continue follow-up although challenges exist; 3) minimal family support during consultation. The contextualised KAP of women regarding UNHS processes and PCHI provided content area for the design of a KAP tool.
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Affiliation(s)
- Christine Graham
- Nelson Mandela School of Clinical Medicine, University of KwaZulu Natal, Durban, South Africa
- * E-mail:
| | - Janet Seeley
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ayanda Gina
- Department of Audiology, University of KwaZulu Natal, Durban, South Africa
| | - Yougan Saman
- Nelson Mandela School of Clinical Medicine, University of KwaZulu Natal, Durban, South Africa
- Ear Nose and Throat Department, University Hospitals of Leicester, Leicester, United Kingdom
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Abstract
Hearing loss is the most common congenital defect. With early diagnosis and intervention, we are able to improve speech and language outcomes in this population. In this article, we discuss the implications of the newborn hearing screen, as well as diagnostic interventions, management, and intervention, and the increasing role of congenital cytomegalovirus screening.
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Affiliation(s)
- Kavita Dedhia
- Department of Pediatric Otolaryngology, Emory University, 2015 Uppergate Drive, Atlanta, GA 30324, USA.
| | - Elise Graham
- Department of Pediatric Otolaryngology, University of Utah, 100 North Mario Capercchi Drive, Salt Lake City, UT 84113, USA
| | - Albert Park
- Department of Pediatric Otolaryngology, University of Utah, 100 North Mario Capercchi Drive, Salt Lake City, UT 84113, USA
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Hawley KA, Goldberg DM, Anne S. Utility of a multidisciplinary approach to pediatric hearing loss. Am J Otolaryngol 2017; 38:547-550. [PMID: 28535875 DOI: 10.1016/j.amjoto.2017.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/08/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Because management of hearing loss (HL) often requires multiple specialists, a multidisciplinary clinic, Pediatric Hearing Management Clinic, (PHMC) was established to coordinate care for children with newly diagnosed HL. METHODS Retrospective review of patients seen in PHMC from February 2009 to April 2010. RESULTS Clinic information was available for 40/41 of the patients and was included in the study. 37/41 had confirmed HL. HL was categorized into bilateral/symmetric [15], bilateral/asymmetric [12] and unilateral [10]. Sixteen patients subsequently received hearing amplification after PHMC visit. Follow up was successfully established with otolaryngology in 23/32 (72%) patients, audiology in 29/40 (73%) patients, speech pathology in 11/12 (92%) patients, and ophthalmology in 15/30 (50%) patients. Twenty-nine patients completed evaluations of PHMC. The mean score in six total categories was 3.8/4.0 (4.0 as the highest satisfaction). CONCLUSION A multidisciplinary clinic approach provides a convenient and effective way to coordinate care for children with HL.
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Lam-Cassettari C, Wadnerkar-Kamble MB, James DM. Enhancing Parent-Child Communication and Parental Self-Esteem With a Video-Feedback Intervention: Outcomes With Prelingual Deaf and Hard-of-Hearing Children. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2015; 20:266-74. [PMID: 25819293 PMCID: PMC4450156 DOI: 10.1093/deafed/env008] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 02/23/2015] [Indexed: 05/08/2023]
Abstract
Evidence on best practice for optimizing communication with prelingual deaf and hard-of-hearing (DHH) children is lacking. This study examined the effect of a family-focused psychosocial video intervention program on parent-child communication in the context of childhood hearing loss. Fourteen hearing parents with a prelingual DHH child (Mage = 2 years 8 months) completed three sessions of video interaction guidance intervention. Families were assessed in spontaneous free play interactions at pre and postintervention using the Emotional Availability (EA) Scales. The Rosenberg Self-esteem Scale was also used to assess parental report of self-esteem. Compared with nontreatment baselines, increases were shown in the EA subscales: parental sensitivity, parental structuring, parental nonhostility, child responsiveness, and child involvement, and in reported self-esteem at postintervention. Video-feedback enhances communication in families with prelingual DHH children and encourages more connected parent-child interaction. The results raise implications regarding the focus of early intervention strategies for prelingual DHH children.
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The Otolaryngologist's Role in Newborn Hearing Screening and Early Intervention. Otolaryngol Clin North Am 2014; 47:631-49. [DOI: 10.1016/j.otc.2014.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Clark JH, Wang NY, Riley AW, Carson CM, Meserole RL, Lin FR, Eisenberg LS, Tobey EA, Quittner AL, Francis HW, Niparko JK. Timing of cochlear implantation and parents' global ratings of children's health and development. Otol Neurotol 2012; 33:545-52. [PMID: 22588232 DOI: 10.1097/mao.0b013e3182522906] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess children's health-related quality of life (HRQL) and development after cochlear implant (CI) surgery and compare improvements between different age of implantation categories. STUDY DESIGN Prospective, longitudinal study comparing outcomes of deaf children post-CI with hearing controls. SETTING Six US CI centers. PATIENTS Deaf children who received CI (n = 188) and hearing children of comparable ages (n = 97). INTERVENTION CI before 5 years of age. MAIN OUTCOME MEASURE Parental ratings of global HRQL and development, as assessed over the first 4 years of follow-up using visual analog scales. Development scores assess parental views of children's growth and development, motor skills, ability to express themselves and communicate with others, and learning abilities. Associations of baseline child and family characteristics with post-CI HRQL and development were investigated using multivariable analysis, controlling for factors that influence post-CI language learning. RESULTS Baseline deficits of CI candidates relative to hearing controls were larger in development than HRQL. Development scores improved significantly by 4 years after CI, particularly in the youngest CI recipients. Developmental deficits of older CI recipients with early, extended hearing aid use were only partially remediated by CI. Overall, no significant health deficits were observed in CI children after 4 years. Cognition and speech recognition were positively associated with both HRQL and development. CONCLUSION Parental perspectives on quality of their child's life and development provide practical insight into the optimal timing of interventions for early-onset deafness. Validity of parental global assessments is supported by clinical measures of speech perception and language learning and comparison with a well-validated health status instrument.
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Affiliation(s)
- James H Clark
- Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Maia RM, Silva MAMD, Tavares PMB. Saúde auditiva dos recém-nascidos: atuação da fonoaudiologia na Estratégia Saúde da Família. REVISTA CEFAC 2011. [DOI: 10.1590/s1516-18462011005000114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: analisar o acompanhamento dos recém-nascidos quanto à promoção da saúde auditiva após a inserção da fonoaudiologia na Estratégia Saúde da Família. MÉTODO: estudo retrospectivo e documental com abordagem quantitativa com 88 recém-nascidos que realizaram o teste da orelhinha, no período de fevereiro a maio de 2010, a partir dos relatórios mensais de devolutiva do Serviço de Atenção a Saúde Auditiva do município, consolidados mensais e prontuários de um Centro de Saúde da Família em Sobral-Ce. RESULTADOS: dos recém-nascidos avaliados, 35 (39,77%) falharam no teste, entre estes, 7 (20%) apresentam indicador de risco para deficiência auditiva e 28 (80%) não apresentavam nenhum risco. Verificou-se também divergências entre os dados do Serviço de Atenção a Saúde Auditiva e os prontuários do Centro de Saúde da Família quanto a classificação dos indicadores de risco para a perda auditiva. Observou-se ainda que, o número de encaminhamentos para o teste da orelhinha aumentou 8,33%. Em relação ao reteste, 1 (7,69%) criança retornou nos meses de março a agosto de 2009 e entre os meses de setembro/2009 a fevereiro/2010 após a atuação da fonoaudiologia no CSF do Sumaré 17 (65,38%) crianças realizaram o reteste. CONCLUSÃO: os dados sugerem a importância da presença do fonoaudiólogo na atenção primária, sendo fundamental no acompanhamento e monitoramento do diagnóstico precoce das alterações auditivas.
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Park AH, Wilson MA, Stevens PT, Harward R, Hohler N. Identification of Hearing Loss in Pediatric Patients with Down Syndrome. Otolaryngol Head Neck Surg 2011; 146:135-40. [DOI: 10.1177/0194599811425156] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective. To determine the type of hearing loss, incidence of the lost to follow-up rate, and the time to diagnose sensorineural hearing loss (SNHL) in children with Down syndrome (DS) identified from a statewide database. Study Design. Case series with chart review. Setting. Pediatric referral center. Subjects and Methods. Three hundred forty-four patients with DS born in Utah between January 2002 and December 2006 were identified using the Utah Department of Health’s Newborn Hearing Screening database and birth defects registry. Results. Three hundred thirty-two patients were included in the study. Eighty-seven infants (26.2%) did not pass their newborn hearing screening (NBS). Thirty-three of these children (37.9%) had a conductive hearing loss attributed to serous otitis media. Five infants had SNHL; 3 children were diagnosed with a mixed hearing loss (MHL). The average time to diagnose a sensorineural hearing loss was 485 ± 601 days. One child who passed his NBS was subsequently found to have an SNHL. More than 43% of the newborns with DS who passed their NBS developed a conductive hearing loss requiring insertion of ventilation tubes. Eighty-four percent of newborns with DS who did not undergo NBS did not have any apparent subsequent audiologic testing. Conclusion. Patients with DS present with a relatively high incidence of conductive hearing loss, MHL, and SNHL and a higher lost to follow-up rate compared to patients without DS. The authors were not able to diagnose SNHL within the 90-day period recommended by the Joint Committee on Infant Hearing.
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Affiliation(s)
- Albert H. Park
- Division of Otolaryngology–Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Matt A. Wilson
- Division of Otolaryngology–Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Paul T. Stevens
- University of Utah School of Medicine, Salt Lake City, Utah, USA
| | | | - Nancy Hohler
- Audiology, Primary Children’s Medical Center, Salt Lake City, Utah, USA
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Shulman S, Besculides M, Saltzman A, Ireys H, White KR, Forsman I. Evaluation of the universal newborn hearing screening and intervention program. Pediatrics 2010; 126 Suppl 1:S19-27. [PMID: 20679316 DOI: 10.1542/peds.2010-0354f] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
During the last 20 years, the number of infants evaluated for permanent hearing loss at birth has increased dramatically with universal newborn hearing screening and intervention (UNHSI) programs operating in all US states and many territories. One of the most urgent challenges of UNHSI programs involves loss to follow-up among families whose infants screen positive for hearing loss. We surveyed 55 state and territorial UNHSI programs and conducted site visits with 8 state programs to evaluate progress in reaching program goals and to identify barriers to successful follow-up. We conclude that programs have made great strides in screening infants for hearing loss, but barriers to linking families of infants who do not pass the screening to further follow-up remain. We identified 4 areas in which there were barriers to follow-up (lack of service-system capacity, lack of provider knowledge, challenges to families in obtaining services, and information gaps), as well as successful strategies used by some states to address barriers within each of these areas. We also identified 5 key areas for future program improvements: (1) improving data systems to support surveillance and follow-up activities; (2) ensuring that all infants have a medical home; (3) building capacity beyond identified providers; (4) developing family support services; and (5) promoting the importance of early detection.
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Affiliation(s)
- Shanna Shulman
- Blue Cross Blue Shield of Massachusetts Foundation, Boston, Massachusetts, USA
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