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Yoshinaga-Itano C, Carr G, Davis A, Ching TYC, Chung K, Clark J, Harkus S, Kuan ML, Garg S, Balen SA, O’Leary S. Coalition for Global Hearing Health Hearing Care Pathways Working Group: Guidelines for Clinical Guidance for Readiness and Development of Evidence-Based Early Hearing Detection and Intervention Programs. Ear Hear 2024; 45:1071-1088. [PMID: 38783422 PMCID: PMC11325981 DOI: 10.1097/aud.0000000000001501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/02/2024] [Indexed: 05/25/2024]
Abstract
Editor's Note: The following article discusses the timely topic Clinical Guidance in the areas of Evidence-Based Early Hearing Detection and Intervention Programs. This article aims to discuss areas of services needed, guidance to countries/organizations attempting to initiate early hearing detection and intervention systems. Expert consensus and systematic/scoping reviews were combined to produce recommendations for evidence-based clinical practice. In Ear and Hearing, our long-term goal for the Point of View article is to stimulate the field's interest in and to enhance the appreciation of the author's area of expertise. Hearing is an important sense for children to develop cognitive, speech, language, and psychosocial skills. The goal of universal newborn hearing screening is to enable the detection of hearing loss in infants so that timely health and educational/therapeutic intervention can be provided as early as possible to improve outcomes. While many countries have implemented universal newborn hearing screening programs, many others are yet to start. As hearing screening is only the first step to identify children with hearing loss, many follow-up services are needed to help them thrive. However, not all of these services are universally available, even in high-income countries. The purposes of this article are (1) to discuss the areas of services needed in an integrated care system to support children with hearing loss and their families; (2) to provide guidance to countries/organizations attempting to initiate early hearing detection and intervention systems with the goal of meeting measurable benchmarks to assure quality; and (3) to help established programs expand and improve their services to support children with hearing loss to develop their full potential. Multiple databases were interrogated including PubMed, Medline (OVIDSP), Cochrane library, Google Scholar, Web of Science and One Search, ERIC, PsychInfo. Expert consensus and systematic/scoping reviews were combined to produce recommendations for evidence-based clinical practice. Eight essential areas were identified to be central to the integrated care: (1) hearing screening, (2) audiologic diagnosis and management, (3) amplification, (4) medical evaluation and management, (5) early intervention services, (6) family-to-family support, (7) D/deaf/hard of hearing leadership, and (8) data management. Checklists are provided to support the assessment of a country/organization's readiness and development in each area as well as to suggest alternative strategies for situations with limited resources. A three-tiered system (i.e., Basic, Intermediate, and Advanced) is proposed to help countries/organizations at all resource levels assess their readiness to provide the needed services and to improve their integrated care system. Future directions and policy implications are also discussed.
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Affiliation(s)
- Christine Yoshinaga-Itano
- University of Colorado, Boulder, Colorado, USA
- University of Witwatersrand, Johannesburg, South Africa
| | - Gwen Carr
- UCL Ear Institute London, London, United Kingdom
| | - Adrian Davis
- UCL Ear Institute London, London, United Kingdom
- London School of Economics, London, United Kingdom
- Imperial College London, London, United Kingdom
- Anglia Ruskin University, Cambridge, United Kingdom
| | - Teresa Y. C. Ching
- Macquarie University, Sydney, New South Wales, Australia
- NextSense Institute, Sydney, New South Wales, Australia
- University of Queensland, Brisbane, Queensland, Australia
| | - King Chung
- MGH Institute of Health Professions, Department of Communication Sciences and Disorders, Charlestown, Massachusetts, United States
| | | | | | - Meei-ling Kuan
- National Women’s League Hearing Health Foundation, Taipei, Taiwan
| | | | - Sheila Andreoli Balen
- Speech, Language and Hearing Department, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Sahoo KC, Dwivedi R, Athe R, Chauhan A, Jain S, Sahoo RK, Bhattacharya D, Rajsekhar K, Pati S. Cost-effectiveness of portable-automated ABR for universal neonatal hearing screening in India. Front Public Health 2024; 12:1364226. [PMID: 39188791 PMCID: PMC11345169 DOI: 10.3389/fpubh.2024.1364226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 07/29/2024] [Indexed: 08/28/2024] Open
Abstract
The World Health Organization considers Universal Neonatal Hearing Screening (UNHS) essential to global public health. Rashtriya Bal Swasthya Karyakram has included newborn hearing screening in India since 2013. The program faces human, infrastructure, and equipment shortages. First-line hearing screening with improved diagnostic accuracy is needed. The Portable Automated Auditory Brainstem Responses (P-AABR) can be used in remote areas for UNHS due to its low infrastructure needs and diagnostic accuracy. This study evaluated the cost-effectiveness of P-AABR in UNHS. We employed an analytical model based on decision trees to assess the cost-effectiveness of Otoacoustic Emission (OAE) and P-AABR. The total cost to the health system for P-AABR, regardless of true positive cases, is INR 10,535,915, while OAE costs INR 7,256,198. P-AABR detects 262 cases, whereas OAE detects 26 cases. Portable Automated ABR costs INR 97 per case detection, while OAE costs INR 67. The final ICER was 97407.69. The P-AABR device is cost-effective, safe and feasible for UNHS Rashtriya Bal Swasthya Karyakram (RBSK) programs. Beyond reducing false referrals and parent indirect costs, it detects more hearing-impaired infants. Even in shortages of skilled workers, existing staff can be trained. Thus, this study suggests integrating this device into community and primary health centers to expand UNHS coverage.
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Affiliation(s)
- Krushna Chandra Sahoo
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Rinshu Dwivedi
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Ramesh Athe
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Akshay Chauhan
- Department of Health Research, Ministry of Health & Family Welfare, Health Technology Assessment in India (HTAIn), New Delhi, India
| | - Shalu Jain
- Department of Health Research, Ministry of Health & Family Welfare, Health Technology Assessment in India (HTAIn), New Delhi, India
| | - Rakesh Kumar Sahoo
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Debdutta Bhattacharya
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Kavitha Rajsekhar
- Department of Health Research, Ministry of Health & Family Welfare, Health Technology Assessment in India (HTAIn), New Delhi, India
| | - Sanghamitra Pati
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
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Obeidat FS, Alothman N, Alkahtani R, Al-Najjar S, Obeidat M, Ali AY, Ahmad E, Alghwiri AA. Evaluation of newborn hearing screening program in Jordan. Front Pediatr 2024; 12:1420678. [PMID: 39055617 PMCID: PMC11269245 DOI: 10.3389/fped.2024.1420678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 06/28/2024] [Indexed: 07/27/2024] Open
Abstract
Introduction The Newborn Hearing Screening (NHS) program was officially launched in Jordan in 2021. Since its inception, no studies have examined the effectiveness of the program. This study seeks to assess the effectiveness and outcomes of the NHS program in Jordan. Methods A retrospective cross-sectional study was conducted to investigate the program coverage rate, referral rate, loss to follow-up rate and the hearing status of newborns who successfully completed the necessary diagnostic assessment. Live births in all hospitals administered by the Ministry of Health (MoH) in Jordan from July 2021 to November 2023 were included. Results Out of 25,825 newborns delivered, 99.4% (25,682) were screened. A referral rate of 0.7% (189) was recorded. Approximately 61.9% of those referred (n = 117) had normal hearing, while 31.7% (60 infants) were diagnosed with hearing loss. The prevalence of congenital hearing loss was 0.14%, and the mean age for identifying hearing loss was 11 months. Discussion The current status of the NHS program in Jordan is promising. The program has achieved most benchmarks recommended by the Joint Committee on Infant Hearing (JCIH), demonstrating encouraging outcomes. There is a need to investigate and address the factors causing delays in the identification of hearing loss in Jordan.
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Affiliation(s)
- Faten S. Obeidat
- Department of Hearing and Speech Sciences, School of Rehabilitation Sciences, University of Jordan, Amman, Jordan
| | - Noura Alothman
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Rania Alkahtani
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Sameer Al-Najjar
- Department of Genetic & Congenital Disorders Prevention, Non-Communicable Diseases Directorate, Ministry of Health, Amman, Jordan
| | - Mohammad Obeidat
- Department of Hearing and Speech Sciences, School of Rehabilitation Sciences, University of Jordan, Amman, Jordan
| | - Asia Y. Ali
- Department of Audiology, Al-Bashir Hospital, Amman, Jordan
| | - Elham Ahmad
- Department of Information System and Program, Ministry of Health, Amman, Jordan
| | - Alia A. Alghwiri
- Department of Physiotherapy, School of Rehabilitation Sciences, University of Jordan, Amman, Jordan
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, Pittsburgh, PA, United States
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Alothman N, Elbeltagy R, Mulla R. Universal newborn hearing screening program in Saudi Arabia: Current insight. J Otol 2024; 19:35-39. [PMID: 38313764 PMCID: PMC10837551 DOI: 10.1016/j.joto.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/25/2023] [Accepted: 01/01/2024] [Indexed: 02/06/2024] Open
Abstract
Newborn hearing screening (NHS) programs are essential to identify hearing loss early in life and to improve outcomes in children. In Saudi Arabia, the national NHS program has been operational since 2016; however, few studies have evaluated its status, and none have covered all provinces across the country. This cross-sectional retrospective study provides an overview of the program's status across all provinces, focusing on screening coverage rates, referral/fail rates, and follow-up procedures. In 2021, 199,034 newborns were screened, with a coverage rate of 92.6% and an overall referral/fail rate of 1.87%. These performance measures provide a foundation for future progress and improvements. This study highlights the importance of ongoing efforts to enhance the program's effectiveness and sustainability.
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Affiliation(s)
- Noura Alothman
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Reem Elbeltagy
- Audiovestibular Medicine, Ear-Nose-Throat Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Reem Mulla
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
- Department of Hearing, Speech and Language Sciences, Gallaudet University, Washington, DC, USA
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Octavius GS, Daleni VA, Sagala YDS. An Insight into Indonesia's Challenges in Implementing Newborn Screening Programs and Their Future Implications. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1216. [PMID: 37508713 PMCID: PMC10378005 DOI: 10.3390/children10071216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/04/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023]
Abstract
Due to high entry barriers, countries might find it daunting to implement the NBS program, especially those just trying to start it. This review aims to discuss Indonesia's barriers that hinder newborn screening (NBS) implementation while discussing the future implications. Literature in Pubmed and Google Scholar was scoured with keywords such as "Newborn Screening", "Neonatal Screening", "Indonesia", "Asia Pacific", "Barriers", and "Challenges". We also searched for relevant references in those published articles. Grey literature, such as state regulations, informative webinars on the topics by experts regarding current situations, and press releases by the Indonesian Minister of Health (MoH), was also searched. Newborn screening is no longer considered just a laboratory test but an array of well-harmonized systems that must be orchestrated well. Some of the barriers Indonesia faces in implementing NBS are a lack of prevalence data, ethical issues, infrastructure, cost-benefit analysis, logistical issues, government support, patient issues, a lack of commitments, and a lack of healthcare workers, specialization, and training. Government support with professional advocates and support groups, proper infrastructure, and a single-payer system for NBS programs are necessary to accelerate NBS programs in Indonesia.
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Affiliation(s)
- Gilbert Sterling Octavius
- Department of Pediatrics, Universitas Pelita Harapan, Tangerang 15811, Indonesia
- St. Theresia Hospital, Jambi 36123, Indonesia
| | - Vamela Adman Daleni
- Department of Pediatrics, Universitas Pelita Harapan, Tangerang 15811, Indonesia
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Exploring the Stories of Parents' Experiences With Infant Hearing-Loss Screening and Diagnosis in the United States. Ear Hear 2022; 44:518-529. [PMID: 36534640 DOI: 10.1097/aud.0000000000001294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES For the past 20 years, birthing hospitals in the United States have required newborns to undergo a hearing-loss screening before leaving the hospital. Since the initial newborn hearing screening mandates, there has been much outcome research documenting the successes and barriers of the programs. However, we know little about the experiences of their parents during the time between screening and diagnosis. We propose that elucidating the parents' experiences with newborn hearing-loss screening and diagnosis-via their own stories-is a first step toward understanding their varied experiences and has the potential to ultimately improve hearing healthcare for both children and their families. Thus, to better understand the early hearing screening and detection experience from hearing parents' perspectives, we asked the following research question: what are parents' experiences with their newborns' hearing-loss screening and diagnosis in the United States? DESIGN The present study employed a prospective, cross-sectional qualitative design. Specifically, we gathered stories from 13 hearing parents who each have a child born in the United States and diagnosed with hearing loss no later than 14 mo of age between the years of 2016 and 2020. We used thematic analysis to uncover common themes across parent narratives. Saturation was reached at interview no. 4; thus no further sampling was needed. FINDINGS Two major themes emerged from the data: (1) hearing healthcare experiences and (2) parents' early experiences during the period between their child's newborn hearing-loss screening and diagnosis. Subthemes were also uncovered. Three emergent subthemes related to health-care experiences included: (1) downplayed newborn hearing screening referrals, (2) clinician-centered care, and (3) medical expenses and health coverage. The three subthemes of the second theme were as follows: (1) parent-to-parent support, (2) "mom guilt," and (3) a new reality. CONCLUSION The present study's narrative accounts from parents about their infants' early hearing detection experiences revealed several, different subthemes that emerged from the same, mandated newborn experience in US families. These findings highlight important moments throughout the hearing-loss screening and detection process, which could benefit from more effective, family-centered hearing healthcare. This knowledge also facilitates the field's move toward improved education of future and current providers and regarding family-centered approach, which could address concerns and expectations of new parents at the very start of their newborns' hearing-loss journeys.
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Parker A, Skoe E, Tecoulesco L, Naigles L. A Home-Based Approach to Auditory Brainstem Response Measurement: Proof-of-Concept and Practical Guidelines. Semin Hear 2022; 43:177-196. [PMID: 36313050 PMCID: PMC9605808 DOI: 10.1055/s-0042-1756163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
Broad-scale neuroscientific investigations of diverse human populations are difficult to implement. This is because the primary neuroimaging methods (magnetic resonance imaging, electroencephalography [EEG]) historically have not been portable, and participants may be unable or unwilling to travel to test sites. Miniaturization of EEG technologies has now opened the door to neuroscientific fieldwork, allowing for easier access to under-represented populations. Recent efforts to conduct auditory neuroscience outside a laboratory setting are reviewed and then an in-home technique for recording auditory brainstem responses (ABRs) and frequency-following responses (FFRs) in a home setting is introduced. As a proof of concept, we have conducted two in-home electrophysiological studies: one in 27 children aged 6 to 16 years (13 with autism spectrum disorder) and another in 12 young adults aged 18 to 27 years, using portable electrophysiological equipment to record ABRs and FFRs to click and speech stimuli, spanning rural and urban and multiple homes and testers. We validate our fieldwork approach by presenting waveforms and data on latencies and signal-to-noise ratio. Our findings demonstrate the feasibility and utility of home-based ABR/FFR techniques, paving the course for larger fieldwork investigations of populations that are difficult to test or recruit. We conclude this tutorial with practical tips and guidelines for recording ABRs and FFRs in the field and discuss possible clinical and research applications of this approach.
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Affiliation(s)
- Ashley Parker
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, Storrs, Connecticut
- Connecticut Institute for Brain and Cognitive Sciences, University of Connecticut, Storrs, Connecticut
- Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Erika Skoe
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, Storrs, Connecticut
- Connecticut Institute for Brain and Cognitive Sciences, University of Connecticut, Storrs, Connecticut
- Cognitive Sciences Program, University of Connecticut, Storrs, Connecticut
| | - Lee Tecoulesco
- Cognitive Sciences Program, University of Connecticut, Storrs, Connecticut
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut
| | - Letitia Naigles
- Connecticut Institute for Brain and Cognitive Sciences, University of Connecticut, Storrs, Connecticut
- Cognitive Sciences Program, University of Connecticut, Storrs, Connecticut
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut
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Kingsbury S, Khvalabov N, Stirn J, Held C, Fleckenstein SM, Hendrickson K, Walker EA. Barriers to Equity in Pediatric Hearing Health Care: A Review of the Evidence. PERSPECTIVES OF THE ASHA SPECIAL INTEREST GROUPS 2022; 7:1060-1071. [PMID: 36275486 PMCID: PMC9585532 DOI: 10.1044/2021_persp-21-00188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE We review the evidence regarding barriers to hearing health care for children who are deaf or hard of hearing. BACKGROUND There are considerable data to suggest that hearing health care disparities constitute a major factor in loss to follow-up or documentation for children going through the Early Hearing Detection and Intervention process. Families are affected by a combination of factors underlying these disparities, resulting in delayed care and suboptimal developmental outcomes for children who are deaf or hard of hearing. CONCLUSIONS To address the socioeconomic, cultural, and linguistic inequities seen in the diagnosis and management of childhood hearing loss, pediatric audiologists and speech-language pathologists have a responsibility to provide culturally responsive practice to their individual clients and their families, as well as advocate for substantive changes at the policy level that impact their clients' daily lives.
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Affiliation(s)
- Sarah Kingsbury
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
| | - Nicole Khvalabov
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
| | - Jonathan Stirn
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
| | - Cara Held
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
| | | | - Kristi Hendrickson
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
| | - Elizabeth A. Walker
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
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Xiang J, Zhang H, Sun X, Zhang J, Xu Z, Sun J, Peng Z. Utility of Whole Genome Sequencing for Population Screening of Deafness-Related Genetic Variants and Cytomegalovirus Infection in Newborns. Front Genet 2022; 13:883617. [PMID: 35571039 PMCID: PMC9099144 DOI: 10.3389/fgene.2022.883617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Hearing loss affects approximately two out of every 1,000 newborns. Genetic factors and congenital cytomegalovirus (CMV) infections account for around 90% of the etiology. The purpose of this study was to develop and test a whole genome sequencing (WGS) approach to detect deafness-related genetic variants and CMV infections simultaneously in newborns.Method: Deafness-related genes causing congenital or childhood hearing loss were curated and selected for newborn screening. Nine dried blood spots from newborns with known genetic variants (n = 6) or CMV infections (n = 3) were employed to develop and validate the WGS testing and analytic pipeline. We then pilot tested the WGS analysis on 51 de-identified clinical samples.Results: 92 gene-disease pairs were selected for screening hearing loss in newborns. In the validation test, WGS accurately detected all types of genetic variants, including single nucleotide variations, insertions/deletions, and copy number variations in the nuclear or mitochondrial genome. Sequence reads mapping to the CMV reference genome were discovered in CMV infected samples. In the pilot test, WGS identified nine out of 51 (18%) newborns carrying pathogenic variants associated with deafness.Conclusion: WGS can simultaneously detect genetic variants and CMV infections in dried blood spot specimens from newborns. Our study provides proof of principle that genome sequencing can be a promising alternative for newborn screening of hearing loss.
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Affiliation(s)
- Jiale Xiang
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
| | | | | | - Junqing Zhang
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | - Zhenpeng Xu
- BGI-Wuhan Clinical Laboratories, BGI-Shenzhen, Wuhan, China
| | - Jun Sun
- Tianjin Medical Laboratory, BGI-Tianjin, BGI-Shenzhen, Tianjin, China
| | - Zhiyu Peng
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing, China
- BGI Genomics, BGI-Shenzhen, Shenzhen, China
- *Correspondence: Zhiyu Peng,
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Almuqbil A, Almutairi A, Altuaysi A, Alwhaid M, Alhasson M, Alharbi M, Alsalam H, Almazyadi H. Knowledge and attitude of the general population regarding infant hearing loss in Saudi Arabia. J Family Med Prim Care 2022; 11:644-652. [PMID: 35360802 PMCID: PMC8963623 DOI: 10.4103/jfmpc.jfmpc_1399_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/10/2021] [Accepted: 11/10/2021] [Indexed: 11/04/2022] Open
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Sapp C, Stirn J, O'Hollearn T, Walker EA. Expanding the Role of Educational Audiologists After a Failed Newborn Hearing Screening: A Quality Improvement Study. Am J Audiol 2021; 30:631-641. [PMID: 34269595 PMCID: PMC8642079 DOI: 10.1044/2021_aja-21-00003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/23/2021] [Accepted: 04/11/2021] [Indexed: 12/16/2022] Open
Abstract
Purpose Lack of timely and proximal access to diagnostic hearing evaluation using auditory brainstem response (ABR) testing hampers the effectiveness of Early Hearing Detection and Intervention (EHDI) programs in the United States. This study measured the impact of a state-based quality-improvement (QI) project that provided diagnostic ABR equipment and training to educational audiologists distributed throughout Iowa in regional special education centers. Method We used de-identified administrative data generated by the state EHDI program to analyze markers of access to early hearing health care for infants in a preproject condition ("Baseline") compared to the implementation of diagnostic ABRs at the regional special education centers ("QI Project"). Results Our findings revealed that the QI Project was associated with improvements in timeliness of first hearing evaluation, distance traveled for first hearing evaluation, and likelihood of receiving on-guideline audiology care during the first hearing evaluation. Conclusions Following the onset of the QI Project, infants and their families had greater access to initial hearing evaluation after failed newborn hearing screening. This improvement could have cascading effects on timeliness of later intervention among those with confirmed permanent childhood hearing loss.
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Affiliation(s)
- Caitlin Sapp
- University of North Carolina Medical Center, Chapel Hill
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Siefkes H, Kair LR, Saarinen A, Lakshminrusimha S. Inadequacies of hospital-level critical congenital heart disease screening data reports: implications for research and quality efforts. J Perinatol 2021; 41:1611-1620. [PMID: 32792631 PMCID: PMC7881046 DOI: 10.1038/s41372-020-00783-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/17/2020] [Accepted: 08/03/2020] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Assess the quality of critical congenital heart disease (CCHD) screening data reports in California, where CCHD screening is not mandatory but reporting is. STUDY DESIGN Retrospective review of California hospital-level CCHD screening data to evaluate data reliability and adherence to state screening and reporting recommendations. Data were evaluated for internal consistency and compared to two databases. RESULTS Over one-third of hospitals did not submit data. Only 70.7% of the Vital Records live births were reported in CCHD screening data. Only 46% of reporting hospitals submitted data with matching numbers of completed screens and results, and 22% matched their respective live births in a second database. CONCLUSION CCHD data reporting in California is incomplete, which may miss 359 CCHD cases/year from non-reporting. Data inconsistencies may miss additional cases. Mandatory screening, reporting, and improvements in data reliability are urgently needed to inform screening modifications and enhance timely detection and disease surveillance.
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Affiliation(s)
- Heather Siefkes
- Department of Pediatrics, University of California Davis, Sacramento, CA, USA.
| | - Laura R Kair
- Department of Pediatrics, University of California Davis, Sacramento, CA, USA
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Zimatore G, Skarzynski PH, Di Berardino F, Filipponi E, Hatzopoulos S. Differences between Pressurized and Non-Pressurized Transient-Evoked Otoacoustic Emissions in Neonatal Subjects. Audiol Neurootol 2021; 26:346-352. [PMID: 33691303 DOI: 10.1159/000512762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/02/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Recently, Interacoustics presented a new otoacoustic emission protocol where the probe pressurizes the ear cavity, thus eliminates the risk of non-assessment (REFER outcome) due to a negative middle ear pressure. This study evaluated the characteristics and the performance of this new protocol on a newborn well-baby population. METHODS One hundred sixty-three newborns (age 2.7 ± 1.1 days) for a total of 294 ears were assessed randomly. Transiently evoked otoacoustic responses were acquired by the Titan device (Interacoustics), using the default and a pressurized TEOAE protocol. The data were analyzed in terms of signal to noise ratios (S/Ns) at 5 frequencies, namely, 0.87, 1.94, 2.96, 3.97, and 4.97 kHz. To assess any possible gestational age (GE) effects on the TEOAE variables, the responses were subdivided in 4 different age subgroups. RESULTS There were no significant differences between the left and right ear TEOAE responses, for age (in days), GE (in weeks), weight (in grams), and S/N at all 5 frequencies. Considering the pooled 294 ears, paired t tests between the default and the pressurized TEOAE data showed significant differences across all 5 frequencies (p < 0.01). The pressurized protocol generated TEOAE responses presenting larger S/Ns, and a positive additive effect of approximately 2.31 dB was observed at all tested frequencies. There were no significant GE effects on the pressurized TEOAE responses. In terms of performance, both protocols performed equally (same number of PASSes). CONCLUSION The pressurized TEOAE protocol generates responses with higher S/Ns which might be useful in borderline cases where the middle ear status might cause a REFER screening outcome.
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Affiliation(s)
- Giovanna Zimatore
- Department of Theoretical and Applied Sciences Applied Physics, eCampus University, Novedrate, Italy
| | - Piotr Henryk Skarzynski
- World Hearing Center, Warsaw, Poland.,Department of Heart Failure and Cardiac Rehabilitation, Medical University of Warsaw, Warsaw, Poland.,Institute of Sensory Organs, Kajetany, Poland
| | - Federica Di Berardino
- Department of Clinical Sciences and Community Health and Department of Specialistic Surgical Sciences, Audiology Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Eliana Filipponi
- Department of Clinical Sciences and Community Health and Department of Specialistic Surgical Sciences, Audiology Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
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Woerner AC, Gallagher RC, Vockley J, Adhikari AN. The Use of Whole Genome and Exome Sequencing for Newborn Screening: Challenges and Opportunities for Population Health. Front Pediatr 2021; 9:663752. [PMID: 34350142 PMCID: PMC8326411 DOI: 10.3389/fped.2021.663752] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/07/2021] [Indexed: 01/01/2023] Open
Abstract
Newborn screening (NBS) is a population-based program with a goal of reducing the burden of disease for conditions with significant clinical impact on neonates. Screening tests were originally developed and implemented one at a time, but newer methods have allowed the use of multiplex technologies to expand additions more rapidly to standard panels. Recent improvements in next-generation sequencing are also evolving rapidly from first focusing on individual genes, then panels, and finally all genes as encompassed by whole exome and genome sequencing. The intersection of these two technologies brings the revolutionary possibility of identifying all genetic disorders in newborns, allowing implementation of therapies at the optimum time regardless of symptoms. This article reviews the history of newborn screening and early studies examining the use of whole genome and exome sequencing as a screening tool. Lessons learned from these studies are discussed, along with technical, ethical, and societal challenges to broad implementation.
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Affiliation(s)
- Audrey C Woerner
- Department of Pediatrics, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Renata C Gallagher
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States
| | - Jerry Vockley
- Department of Pediatrics, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States
| | - Aashish N Adhikari
- Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, United States.,Artificial Intelligence Lab, Illumina Inc, Foster City, CA, United States
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15
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Sola AM, Vukkadala N, Giridhar S, Stephans J, Allen IE, Chan DK. Validation of a Hearing-Related Quality-of-Life Questionnaire for Parents and Deaf or Hard-of-Hearing Infants and Toddlers. Otolaryngol Head Neck Surg 2020; 165:360-369. [PMID: 33317400 DOI: 10.1177/0194599820976175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To design and validate a hearing-related quality-of-life questionnaire targeted toward parents and deaf or hard-of-hearing infants and toddlers: the Hearing-Related Infant/Toddler and Parent Quality of Life (HIP-QL) questionnaire. STUDY DESIGN Cross-sectional questionnaire and prospective instrument validation. SETTING Academic pediatric otolaryngology clinic. METHODS A 67-question questionnaire developed from constructs of a grounded theory analysis was administered to parents of 31 deaf or hard-of-hearing children and 14 typically hearing children. Questionnaire construct validity, reliability, and discriminant validity were tested. RESULTS Based on exploratory factor analysis, a 32-item construct composed of developmentally appropriate questions was reduced to a 17-item construct with 4 domains addressing quality of life for both child (auditory/communication behavior, temperament) and parent (management, parent-directed factors). Internal consistency measures were appropriate (Cronbach's alpha = 0.65), and test-retest reliability was high (intraclass correlation coefficient = 0.73). Total HIP-QL scores correlated significantly with related total PedsQL scores (r = 0.57, P < .001). As predicted, parents of children who are deaf or hard of hearing reported significantly lower mean HIP-QL scores but not mean PedsQL scores. HIP-QL was more sensitive than PedsQL for predicting case versus control membership (86.7% vs 76.9%). Multivariable regression confirmed a negative relationship between severity of hearing loss and HIP-QL score after controlling for age, sex, income, and maternal education. CONCLUSIONS This context-specific questionnaire is the first validated quality-of-life instrument for parents and deaf or hard-of-hearing infants and toddlers. Previously, parental stress and functional disability questionnaires were used as proxies; therefore, this questionnaire has the potential to serve as an important tool for patient- and caregiver-centered outcomes research.
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Affiliation(s)
- Ana Marija Sola
- School of Medicine, University of California-San Francisco, San Francisco, California, USA
| | - Neelaysh Vukkadala
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA
| | - Sonya Giridhar
- Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, USA
| | - Jihyun Stephans
- Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, USA
| | - Isabel Elaine Allen
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, USA
| | - Dylan K Chan
- Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, USA
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16
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Mahmood Z, Dogar MR, Waheed A, Ahmad AN, Anwar Z, Abbasi SZ, Anwar A, Hashmi AA. Screening Programs for Hearing Assessment in Newborns and Children. Cureus 2020; 12:e11284. [PMID: 33274158 PMCID: PMC7707914 DOI: 10.7759/cureus.11284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective In this study, we aimed to assess the incidence of hearing loss in the pediatric population through otoacoustic emission (OAE) and brainstem evoked response audiometry (BERA) and to analyze the possible etiological factors responsible for it. Material and methods A retrospective observational study was conducted in the Otolaryngology (ENT) and Gynecology and Obstetrics Departments at the Jinnah Postgraduate Medical Centre and National Institute of Child Health in Karachi, Pakistan between July 2019 and October 2019. The convenient sampling technique was used to select the patients. The final sample size consisting of newborns and children was 108. Initially, screening procedures were undertaken for newborns to detect permanent or fluctuating, bilateral or unilateral, and sensory or conductive hearing loss, averaging 30-40 dB or more in the frequency region, which indicated potential issues related to speech recognition (approximately 500-4,000 Hz). The screening of newborns involved the use of non-invasive, objective physiologic measures that included OAEs and/or auditory brainstem response (ABR). The children with hearing impairment then underwent BERA; thereafter, further investigations were performed to confirm the defects found on BERA testing. Results Of the 108 cases, 96 had normal hearing on OAE screening, and 12 were found to have hearing loss on the OAE test. Further testing was carried out on BERA for 12 cases that had been detected to have hearing loss on OAE, and BERA showed normal hearing for five cases whereas seven were found to have hearing loss. Of the seven patients with hearing loss on the BERA test, five were diagnosed with cochlear deafness, and two had retrocochlear deafness. Conclusion Our present study concludes that in order to avoid any hearing problems in infants, OAE hearing screening and diagnostic BERA screening programs should be carried out in all the hospitals of Pakistan to assess newborn hearing at an early age.
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Affiliation(s)
- Zafar Mahmood
- Otolaryngology, Liaquat College of Medicine and Dentistry, Darul Sehat Hospital, Karachi, PAK
| | | | - Abdul Waheed
- Otolaryngology, Sindh Employees Social Security Institution (SESSI) Landhi Hospital, Karachi, PAK
| | - Ahmad Nawaz Ahmad
- Otolaryngology, Liaquat National Hospital and Medical College, Karachi, PAK
| | - Zubair Anwar
- Otolaryngology, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | | | - Adnan Anwar
- Physiology, Al-Tibri Medical College, Karachi, PAK
| | - Atif A Hashmi
- Pathology, Liaquat National Hospital and Medical College, Karachi, PAK
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Haller T, Shoup A, Park A. Should hearing targeted screening for congenital cytomegalovirus infection Be implemented? Int J Pediatr Otorhinolaryngol 2020; 134:110055. [PMID: 32361556 PMCID: PMC7293539 DOI: 10.1016/j.ijporl.2020.110055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 12/18/2022]
Abstract
Since 2013, after Utah became the first state to implement hearing targeted early CMV screening, a national debate has been percolating about whether this approach should be introduced nationally. Currently Utah, Iowa, Connecticut, and New York have passed legislation mandating early CMV screening, and over 100 birth hospitals across the United States have voluntarily implemented early CMV screening programs as part of their standard of care. We reviewed the evidence related to this approach and used the Wilson and Jungner (1968) criteria to evaluate this method of screening. Based on these criteria, there is substantial rationale and evidence to support a hearing targeted approach to screen for congenital CMV. Given this evidence, we currently recommend that infants who fail newborn hearing screen should undergo CMV screening.
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Affiliation(s)
- Travis Haller
- Division of Otolaryngology- Head and Neck Surgery, University of Utah
| | - Angela Shoup
- Division of Communicative and Vestibular Disorders, Department of Otolaryngology University of Texas Southwestern Medical Center at Dallas
| | - Albert Park
- Division of Otolaryngology- Head and Neck Surgery, University of Utah
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18
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Deng X, Gaffney M, Grosse SD. Early Hearing Detection and Intervention in the United States: Achievements and Challenges in the 21 st Century. China CDC Wkly 2020; 2:378-382. [PMID: 32774988 PMCID: PMC7413595 DOI: 10.46234/ccdcw2020.097] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Xidong Deng
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Marcus Gaffney
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Scott D Grosse
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
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McInerney M, Scheperle R, Zeitlin W, Bodkin K, Uhl B. Adherence to follow-up recommendations for babies at risk for pediatric hearing loss. Int J Pediatr Otorhinolaryngol 2020; 132:109900. [PMID: 32006864 DOI: 10.1016/j.ijporl.2020.109900] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/20/2020] [Accepted: 01/20/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this retrospective study was to evaluate the families' compliance with recommendations for continued monitoring of babies with high-risk factors for hearing loss. METHODS Hearing screening and follow-up results from 604 babies were tracked across a five-year period. Bivariate analysis, including chi-square analysis, t-tests, and one-way analyses of variance were conducted to test whether various factors predicted likelihood of follow up. RESULTS Although 86% of the babies returned for the initial follow-up appointment, few completed the protocol or were diagnosed with hearing loss (10.3%). Excluding the babies who never returned, the average age for initial assessment was near the recommended 3-month target (3.5 months). However, babies were last seen at 9.4 months on average, which is earlier than recommended. Some factors positively predicted follow-up: receipt of ototoxic medication, hyperbilirubinemia requiring transfusion, ECMO, syndromes associated with hearing loss, craniofacial anomalies, and passing the newborn hearing screening. Others were negatively predictive: NICU stay >5 days, younger maternal age, and failing the newborn screening. There was no relationship between the results of the last test and whether the families continued with monitoring. Babies with risks categorized as more likely to be associated with delayed onset hearing loss were more often late to the initial follow up, but also followed up for a longer period of time. CONCLUSIONS These results demonstrate the need to focus on the barriers unique to babies with risk factors for late onset/progressive hearing loss in addition to those barriers that generally affect loss to follow up. Tools for parental engagement are recommended.
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Affiliation(s)
- Maryrose McInerney
- Montclair State University, 1 Normal Ave, Montclair, NJ, 07043, USA; Hackensack Meridian Health, Hackensack University Medical Center, Joseph M. Sanzari Children's Hospital, 30 Prospect Ave., Hackensack, NJ, 07601, USA.
| | - Rachel Scheperle
- Montclair State University, 1 Normal Ave, Montclair, NJ, 07043, USA; St. Louis Children's Hospital, One Children's Place, St. Louis, MO, 63110, USA.
| | - Wendy Zeitlin
- Montclair State University, 1 Normal Ave, Montclair, NJ, 07043, USA.
| | - Kenneth Bodkin
- Hackensack Meridian Health, Hackensack University Medical Center, Joseph M. Sanzari Children's Hospital, 30 Prospect Ave., Hackensack, NJ, 07601, USA.
| | - Barbara Uhl
- Hackensack Meridian Health, Hackensack University Medical Center, Joseph M. Sanzari Children's Hospital, 30 Prospect Ave., Hackensack, NJ, 07601, USA.
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Hurley A, Willis M, Guidry M, Bode D, Corneille ML, Mills S. A Program Review of Head Start and Elementary School Hearing Screenings. Lang Speech Hear Serv Sch 2020; 51:345-352. [DOI: 10.1044/2019_lshss-19-00012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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 review quality benchmarks from hearing screening programs conducted at local Head Start centers and preschool and elementary schools associated with our university training programs.
Method
Hearing screening results from 6,043 children were reviewed. Hearing screening was accomplished using either distortion product otoacoustic emissions (DPOAEs) at Head Start centers, pure-tone audiometry at preschool and elementary schools, and tympanometry at all settings. All children who did not pass the initial screening were screened a second time. Referrals were made if a child did not pass the automated DPOAE pass criteria for one ear, failed at least one pure-tone frequency for one ear, or had abnormal tympanometry in one ear.
Results
Refer rates were 10.9% for DPOAEs and 11.4% for pure-tone audiometry and tympanometry, with an overall refer rate of 11%.
Conclusions
Our hearing screening program review yielded refer rates that are similar to other published reports for this population. Presently, there are no published target refer rates for hearing screening programs in preschool and elementary schools. Although we were not able to complete other program quality benchmark indicators including sensitivity and specificity, these data may support benchmarks for other hearing screening programs.
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Affiliation(s)
- Annette Hurley
- Department of Communication Disorders, Louisiana State University Health Sciences Center, New Orleans
| | - Michelle Willis
- Department of Communication Disorders, Louisiana State University Health Sciences Center, New Orleans
| | - Megan Guidry
- Department of Communication Disorders, Louisiana State University Health Sciences Center, New Orleans
| | - Dan Bode
- Associated Hearing, Metairie, LA
| | - Marissa L. Corneille
- Department of Communication Disorders, Louisiana State University Health Sciences Center, New Orleans
| | - Sara Mills
- Department of Communication Disorders, Louisiana State University Health Sciences Center, New Orleans
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Meyer AC, Marsolek M, Brown N, Coverstone K. Delayed Identification of Infants Who Are Deaf or Hard of Hearing — Minnesota, 2012–2016. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2020; 69:303-306. [PMID: 32191690 PMCID: PMC7739984 DOI: 10.15585/mmwr.mm6911a6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Satish HS, Anil Kumar R, Viswanatha B. Screening of Newborn Hearing at a Tertiary Care Hospital in South India. Indian J Otolaryngol Head Neck Surg 2019; 71:1383-1390. [PMID: 31750182 DOI: 10.1007/s12070-018-1454-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 07/12/2018] [Indexed: 11/27/2022] Open
Abstract
Hearing loss can have a devastating impact on the cognitive development and psychological well-being of children and their families. Newborn hearing screening should be given special attention especially in a country like ours where the burden of this disability is heavy. Screening all newborns irrespective of risk factors helps in better detection, and hence further management can be initiated at appropriate time. To implement newborn hearing screening at Vanivilas hospital and to estimate the incidence of hearing loss among the high risk groups. To create awareness about the need for detecting childhood deafness among parents and general population. To develop a centre of excellence for evaluation, intervention and rehabilitation for hearing impaired in a tertiary care hospital. Prospective study. All neonates born in Vanivilas Hospital attached to Bangalore Medical College and Research Institute underwent hearing screening using four stage protocols with otoacoustic emission (OAE) tests and final confirmation with Brainstem evoked response audiometry (BERA) tests. May 2015-May 2017. Number of newborns screened were 26,487, and 19 (0.717/1000) newborns were detected to have hearing impairment. The incidence of hearing loss among high risk group was 0.188/1000, and among the non risk group was 0.528/1000. Newborn hearing screening must be made mandatory and multi-staged protocol based screening for hearing loss should be implemented. This will make newborn screening programme more efficient and also will help in initiating treatment at an early stage so that further damage can be prevented.
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Affiliation(s)
| | - Ramabhadraiah Anil Kumar
- Department of ENT, Bangalore Medical College and Research Institute, Fort, K.R. Road, Bengaluru, Karnataka 560002 India
| | - Borlingegowda Viswanatha
- Department of ENT, Bangalore Medical College and Research Institute, Fort, K.R. Road, Bengaluru, Karnataka 560002 India
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Mumtaz N, Babur MN, Saqulain G. Multi-level barriers & priorities accorded by policy makers for Neonatal Hearing Screening (NHS) in Pakistan: A thematic analysis. Pak J Med Sci 2019; 35:1674-1679. [PMID: 31777514 PMCID: PMC6861485 DOI: 10.12669/pjms.35.6.703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objectives: To explore the Barriers and Priorities accorded to neo-natal hearing screening at government health policy level. Methods: This exploratory descriptive study design employed qualitative parameters with purposive sampling and was conducted at Capital Administration & Development Division (CADD) and Ministry of National Health Services, Regulations & Coordination (MoNHSR&C) from June 2015 to January 2017 over a period of 18 months. Sample included stakeholders concerned with healthcare planning and policy making in Pakistan. Research included in depth interviews using a self-structured interview guide from three policy makers’ fulfilling the selection criteria. Data recorded was transcribed and thematic analyses drawn manually and verified using two separate coders. Results: Outcomes from thematic analysis drawn were Planning, Funding, Governance, Awareness, Medical and technical capacity building, Policy development, Evaluation and Sustainability. Lack of financial resources allocation due to policies and legislation top the list of barriers. The lack of research and reliable data as to the number of persons suffering from hearing loss (HL) from birth and its economic cost to the state and individual remains a policy barrier. Conclusion: The barriers to NHS are lack of financial resource allocation by the federal government, and lack of research and reliable statistics about Hearing Impairment (HI) and its economic cost.
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Affiliation(s)
- Nazia Mumtaz
- Dr. Nazia Mumtaz, PhD (Rehabilitation Sciences), In Charge Post Graduate Programs, Allied Health Sciences, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Muhammad Naveed Babur
- Dr. Muhammad Naveed Babur, PhD (Rehabilitation Sciences), Dean, Isra Institute of Rehabilitation Sciences, Isra University, Islamabad, Pakistan
| | - Ghulam Saqulain
- Dr. Ghulam Saqulain, F.C.P.S (Otorhinolaryngology), Head of Otorhinolaryngology Department, Capital Hospital, Islamabad, Pakistan
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Butcher E, Dezateux C, Cortina-Borja M, Knowles RL. Prevalence of permanent childhood hearing loss detected at the universal newborn hearing screen: Systematic review and meta-analysis. PLoS One 2019; 14:e0219600. [PMID: 31295316 PMCID: PMC6622528 DOI: 10.1371/journal.pone.0219600] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 06/27/2019] [Indexed: 11/19/2022] Open
Abstract
CONTEXT Permanent childhood hearing loss (PCHL) can affect speech, language, and wider outcomes. Adverse effects are mitigated through universal newborn hearing screening (UNHS) and early intervention. OBJECTIVE We undertook a systematic review and meta-analysis to estimate prevalence of UNHS-detected PCHL (bilateral loss ≥26 dB HL) and its variation by admission to neonatal intensive care unit (NICU). A secondary objective was to report UNHS programme performance (PROSPERO: CRD42016051267). DATA SOURCES Multiple electronic databases were interrogated in January 2017, with further reports identified from article citations and unpublished literature (November 2017). STUDY SELECTION UNHS reports from very highly-developed (VHD) countries with relevant prevalence and performance data; no language or date restrictions. DATA EXTRACTION Three reviewers independently extracted data and assessed quality. RESULTS We identified 41 eligible reports from 32 study populations (1799863 screened infants) in 6195 non-duplicate references. Pooled UNHS-detected PCHL prevalence was 1.1 per 1000 screened children (95% confidence interval [CI]: 0.9, 1.3; I2 = 89.2%). This was 6.9 times (95% CI: 3.8, 12.5) higher among those admitted to NICU. Smaller studies were significantly associated with higher prevalences (Egger's test: p = 0.02). Sensitivity and specificity ranged from 89-100% and 92-100% respectively, positive predictive values from 2-84%, with all negative predictive values 100%. LIMITATIONS Results are generalisable to VHD countries only. Estimates and inferences were limited by available data. CONCLUSIONS In VHD countries, 1 per 1000 screened newborns require referral to clinical services for PCHL. Prevalence is higher in those admitted to NICU. Improved reporting would support further examination of screen performance and child demographics.
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Affiliation(s)
- Emma Butcher
- Life Course Epidemiology and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Carol Dezateux
- Life Course Epidemiology and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Mario Cortina-Borja
- Clinical Epidemiology, Nutrition and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Rachel L. Knowles
- Life Course Epidemiology and Biostatistics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Public Health England, London, United Kingdom
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Maluleke NP, Khoza-Shangase K, Kanji A. Hearing impairment detection and intervention in children from centre-based early intervention programmes. J Child Health Care 2019; 23:232-241. [PMID: 30068223 DOI: 10.1177/1367493518788477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The study aimed to describe ages at identification and initiation of early intervention (EI) services for children enrolled in centre-based EI programmes in Gauteng, as well as to describe the nature of EI services that the children received. The researchers conducted retrospective record reviews of the EI programme files. In addition, caregivers of eight children identified with hearing impairments and enrolled in centre-based EI programmes in Gauteng completed a newly constructed questionnaire. The caregiver questionnaire produced data pertaining to the child's family demographics, background information and schooling history. Descriptive statistics were used to analyse the data, using frequency distribution and measures of central tendency. None of the children received newborn hearing screening services, thus they were identified late following maternal suspicion of hearing impairment. Late identification of the hearing impairment resulted in suboptimal initiation of EI services. All the children received aural habilitation and/or speech-language therapy services. These findings indicate that there is a great need for the establishment of widespread early hearing detection and intervention programmes that will lead to earlier identification of infant and childhood hearing impairment and timely initiation of EI services.
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Affiliation(s)
- Ntsako P Maluleke
- 1 Department of Speech Pathology and Audiology, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
| | - Katijah Khoza-Shangase
- 2 Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Amisha Kanji
- 2 Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
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Wroblewska-Seniuk K, Dabrowski P, Greczka G, Szabatowska K, Glowacka A, Szyfter W, Mazela J. Sensorineural and conductive hearing loss in infants diagnosed in the program of universal newborn hearing screening. Int J Pediatr Otorhinolaryngol 2018; 105:181-186. [PMID: 29447811 DOI: 10.1016/j.ijporl.2017.12.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 12/04/2017] [Accepted: 12/06/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of this study was to analyze infants diagnosed with sensorineural or conductive hearing deficit and to identify risk factors associated with these defects. MATERIAL AND METHODS A retrospective analysis of infants diagnosed with hearing deficit based on the database of the universal newborn hearing screening program and medical records of the patients. RESULTS 27 935 infants were covered by the universal neonatal hearing screening program. 109 (0.39%) were diagnosed with hearing deficit and referred for treatment and rehabilitation. 56 (51.4%) children were diagnosed with conductive, 38 (34.9%) with sensorineural and 15 (13.8%) with mixed type of hearing deficit. Children with sensorineural hearing deficit more frequently suffered from hyperbilirubinemia (p < 0.05), while infants with conductive hearing loss were more frequently diagnosed with isolated craniofacial anomalies (p < 0.05). The prevalence of other risk factors did not differ between the groups. Sensorineural hearing deficit occurred almost 3 times more often bilaterally than unilaterally (p < 0.05). In other types of hearing deficit, the difference was not significant. In children with conductive and mixed type of hearing loss the impairment was mainly mild while among those with sensorineural hearing deficit in almost 45% it was severe and profound (p < 0.05). When analyzing the consistency between hearing screening test by means of otoacoustic emissions and the final diagnosis of hearing deficit we found that the highest agreement rate was observed in children with sensorineural hearing loss (p < 0.01). CONCLUSIONS The prevalence of most risk factors of hearing deficit was similar in children with sensorineural, conductive and mixed type of hearing loss, only hyperbilirubinemia seemed to predispose to sensorineural hearing deficit and isolated craniofacial malformations seemed to be associated with conductive hearing loss. Sensorineural hearing deficit usually occurred bilaterally and was severe or profound, while conductive and mixed type of hearing deficit were most often of mild degree. Most children with the final diagnosis of sensorineural hearing deficit had positive result of hearing screening by means of otoacoustic emissions.
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Affiliation(s)
- Katarzyna Wroblewska-Seniuk
- Department of Newborns' Infectious Diseases, Poznan University of Medical Sciences, ul. Polna 33, 60-535 Poznan, Poland.
| | - Piotr Dabrowski
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, ul. Przybyszewskiego 39, 60-101 Poznan, Poland
| | - Grazyna Greczka
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, ul. Przybyszewskiego 39, 60-101 Poznan, Poland
| | - Katarzyna Szabatowska
- Students' Research Circle at the Department of Newborns' Infectious Diseases, Poznan University of Medical Sciences, Poznan, Poland, ul. Polna 33, 60-535 Poznan, Poland
| | - Agata Glowacka
- Students' Research Circle at the Department of Newborns' Infectious Diseases, Poznan University of Medical Sciences, Poznan, Poland, ul. Polna 33, 60-535 Poznan, Poland
| | - Witold Szyfter
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, ul. Przybyszewskiego 39, 60-101 Poznan, Poland
| | - Jan Mazela
- Department of Newborns' Infectious Diseases, Poznan University of Medical Sciences, ul. Polna 33, 60-535 Poznan, Poland
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Grosse SD, Mason CA, Gaffney M, Thomson V, White KR. What Contribution Did Economic Evidence Make to the Adoption of Universal Newborn Hearing Screening Policies in the United States? Int J Neonatal Screen 2018; 4:25. [PMID: 30123850 PMCID: PMC6094389 DOI: 10.3390/ijns4030025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Universal newborn hearing screening (UNHS), when accompanied by timely access to intervention services, can improve language outcomes for children born deaf or hard of hearing (D/HH) and result in economic benefits to society. Early Hearing Detection and Intervention (EHDI) programs promote UNHS and using information systems support access to follow-up diagnostic and early intervention services so that infants can be screened no later than 1 month of age, with those who do not pass their screen receiving diagnostic evaluation no later than 3 months of age, and those with diagnosed hearing loss receiving intervention services no later than 6 months of age. In this paper, we first document the rapid roll-out of UNHS/EHDI policies and programs at the national and state/territorial levels in the United States between 1997 and 2005. We then review cost analyses and economic arguments that were made in advancing those policies in the United States. Finally, we examine evidence on language and educational outcomes that pertain to the economic benefits of UNHS/EHDI. In conclusion, although formal cost-effectiveness analyses do not appear to have played a decisive role, informal economic assessments of costs and benefits appear to have contributed to the adoption of UNHS policies in the United States.
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Affiliation(s)
- Scott D Grosse
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mail Stop E-87, Atlanta, GA 30341, USA;
| | - Craig A Mason
- College of Education and Human Development, University of Maine, Orono, ME 00469, USA;
| | - Marcus Gaffney
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mail Stop E-87, Atlanta, GA 30341, USA;
| | - Vickie Thomson
- Department of Otolaryngology, University of Colorado Denver, Denver, CO 80045, USA;
| | - Karl R White
- National Center for Hearing Assessment and Management (NCHAM), Utah State University, Logan, UT 84322, USA;
- Department of Psychology, Utah State University, Logan, UT 84322, USA
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Abstract
OBJECTIVES Our aim with this article is to evaluate whether the prevalence of hearing loss is increasing among adolescents living in the United States. METHODS All available data about hearing loss among adolescents from the large, federally funded National Health and Nutrition Examination Survey (NHANES) were analyzed. By using the 4 data releases between 1994 and 2010 (a total of 6891 adolescents), the prevalence of adolescent hearing loss >15 and ≥25 dB at low frequencies (0.5, 1, and 2 kHz) and high frequencies (3, 4, 6, and 8 kHz) for bilateral, unilateral, and any loss were calculated. RESULTS Only 13 of 90 comparisons of prevalence across combinations of degree, frequency, and laterality of hearing loss revealed a statistically significant increase at P < .05. Among the 18 subgroups of degree, frequency, and laterality, 61% had a lower prevalence of hearing loss in 2010 than in 1994, and 100% of the subgroups had a lower prevalence in 2010 than in 2006. CONCLUSIONS With previous analyses of NHANES data from 1994 to 2006, researchers showed that hearing loss among US adolescents was increasing. Based on the NHANES data from 1994 to 2010 that are now available, there is no consistent evidence that hearing loss among adolescents in the United States is increasing. Results reveal that conclusions about trends using data from 2 time points can be misleading. NHANES should resume collecting audiometric data as part of their data collection protocol so that trends in the prevalence of childhood hearing loss can be documented.
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Affiliation(s)
- Tyson S Barrett
- Department of Psychology, Utah State University, Logan, Utah; and
| | - Karl R White
- Department of Psychology, Utah State University, Logan, Utah; and.,National Center for Hearing Assessment and Management, Logan, Utah
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Wroblewska-Seniuk K, Greczka G, Dabrowski P, Szyfter-Harris J, Mazela J. Hearing impairment in premature newborns-Analysis based on the national hearing screening database in Poland. PLoS One 2017; 12:e0184359. [PMID: 28910311 PMCID: PMC5598959 DOI: 10.1371/journal.pone.0184359] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 08/22/2017] [Indexed: 12/04/2022] Open
Abstract
Objectives The incidence of sensorineural hearing loss is between 1 and 3 per 1000 in healthy neonates and 2–4 per 100 in high-risk infants. The national universal neonatal hearing screening carried out in Poland since 2002 enables selection of infants with suspicion and/or risk factors of hearing loss. In this study, we assessed the incidence and risk factors of hearing impairment in infants ≤33 weeks’ gestational age (wga). Methods We analyzed the database of the Polish Universal Newborns Hearing Screening Program from 2010 to 2013. The study group involved 11438 infants born before 33 wga, the control group—1487730 infants. Screening was performed by means of transient evoked otoacoustic emissions. The risk factors of hearing loss were recorded. Infants who failed the screening test and/or had risk factors were referred for further audiological evaluation. Results Hearing deficit was diagnosed in 11% of infants ≤25 wga, 5% at 26–27 wga, 3.46% at 28 wga and 2–3% at 29–32 wga. In the control group the incidence of hearing deficit was 0.2% (2.87% with risk factors). The most important risk factors were craniofacial malformations, very low birth weight, low Apgar score and mechanical ventilation. Hearing screening was positive in 22.42% newborns ≤28 wga and 10% at 29–32 wga and in the control group. Conclusions Hearing impairment is a severe consequence of prematurity. Its prevalence is inversely related to the maturity of the baby. Premature infants have many concomitant risk factors which influence the occurrence of hearing deficit.
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Affiliation(s)
| | - Grazyna Greczka
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Dabrowski
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, Poznan, Poland
| | - Joanna Szyfter-Harris
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jan Mazela
- Department of Newborns’ Infectious Diseases, Poznan University of Medical Sciences, Poznan, Poland
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Wroblewska-Seniuk K, Greczka G, Dabrowski P, Szyfter W, Mazela J. The results of newborn hearing screening by means of transient otoacoustic emissions - has anything changed over 10 years? Int J Pediatr Otorhinolaryngol 2017; 96:4-10. [PMID: 28390612 DOI: 10.1016/j.ijporl.2017.02.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 02/14/2017] [Accepted: 02/16/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Universal newborn hearing screening (UNHS) has become the standard of care in many countries. The aim of this study was to evaluate the results of UNHS after ten years of the program in Poland and to compare them with the results of 2003. METHODS In the study, we analyze the results of UNHS in the University Hospital in Poznan, Poland. Between 01.01.2013 and 31.12.2013, 6827 children were examined by means of otoacoustic emissions. RESULTS Risk factors (RF) were identified in 772 (11.3%) newborns, which is significantly less than 10 years ago (p < 0.05). The most frequent RF were: ototoxic medications, treatment in neonatal intensive care unit (NICU) and prematurity < 33 weeks of gestation. In 2003, the most frequent were ototoxic medications and prematurity, less frequent was treatment in NICU and more common was low Apgar score. In 51 (6.6%) newborns with RF, the result of OAE was positive either unilaterally or bilaterally. In infants without RF the result was positive unilaterally in 22 (0.4%) and bilaterally in 14 (0.2%) patients. These results are significantly lower than in our former study. The relative risk of positive result was the highest in infants with complex congenital anomalies (RR = 44.99), craniofacial anomalies (RR = 17.46) and mechanical ventilation for > 5 days (RR = 10.69). In our previous study, the highest RR of positive test results was in infants with family history, congenital malformations and low Apgar score. We found that most predictive as to the final diagnosis was bilaterally positive OAE test. In most patients, the second check confirmed the diagnosis, independently of RF. The number of false positive tests at the 1st level of screening is significantly lower now than 10 years ago, probably due to better staff training. CONCLUSIONS Long term monitoring and the appropriate management of hearing deficit in children is essential. UNHS seems to be the most efficient way of finding children who require treatment of hearing impairment. The prevalence of most risk factors of hearing deficit has significantly changed over the years. The number of false positive results has significantly decreased over the years thanks to better staff training.
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Affiliation(s)
- Katarzyna Wroblewska-Seniuk
- Department of Newborns' Infectious Diseases, Poznan University of Medical Sciences, ul. Polna 33, 60-535 Poznań, Poland.
| | - Grazyna Greczka
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, ul. Przybyszewskiego 49, 60-355 Poznań, Poland
| | - Piotr Dabrowski
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, ul. Przybyszewskiego 49, 60-355 Poznań, Poland
| | - Witold Szyfter
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, ul. Przybyszewskiego 49, 60-355 Poznań, Poland
| | - Jan Mazela
- Department of Newborns' Infectious Diseases, Poznan University of Medical Sciences, ul. Polna 33, 60-535 Poznań, Poland
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Greczka G, Zych M, Wróbel M, Dąbrowski P, Szyfter Harris J, Szyfter W. Analysis of follow-up at the diagnostic level in the Polish Universal Neonatal Hearing Screening Programme. J Med Screen 2017; 25:13-16. [PMID: 29183226 DOI: 10.1177/0969141317695848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives Routine analysis showed that between 1 June and 30 November 2014, only 47.6% of expected follow-up visits at the diagnostic level were registered in the Polish Universal Neonatal Hearing Screening Programme central database. We attempted to detect and analyse the reasons for this low percentage. Methods A telephone survey questionnaire was developed for parents whose children had not registered for consultation at the diagnostic level, or had not received a final diagnosis according to the programme database. Questions aimed to verify the database records and compare these with information received from and given to parents. From the 7888 children not registered at the diagnostic level, 3239 records were randomly selected, i.e. 52.4% of those who had been expected to attend. Results Questions were answered by 1950 parents (60.2% of the selected group). Of these, 52.1% ( n = 734) had attended for diagnostic tests, but this was not recorded in the database. The most common reasons for not attending were the long waiting time for the visit (36.09%), lack of referral to a visit (25.9%) and conscious parent decision (16.35%). Conclusion The telephone survey disclosed omissions in database registration, and that in fact 83.6% of children had attended at the diagnostic level.
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Affiliation(s)
- Grażyna Greczka
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Science, Poznan, Poland
| | - Monika Zych
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Science, Poznan, Poland
| | - Maciej Wróbel
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Science, Poznan, Poland
| | - Piotr Dąbrowski
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Science, Poznan, Poland
| | - Joanna Szyfter Harris
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Science, Poznan, Poland
| | - Witold Szyfter
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Science, Poznan, Poland
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Wroblewska-Seniuk KE, Dabrowski P, Szyfter W, Mazela J. Universal newborn hearing screening: methods and results, obstacles, and benefits. Pediatr Res 2017; 81:415-422. [PMID: 27861465 DOI: 10.1038/pr.2016.250] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 09/27/2016] [Indexed: 01/02/2023]
Abstract
The incidence of sensorineural hearing loss ranges from 1 to 3 per 1,000 live births in term healthy neonates, and 2-4 per 100 in high-risk infants, a 10-fold increase. Early identification and intervention with hearing augmentation within 6 mo yields optimal effect. If undetected and without treatment, significant hearing impairment may negatively impact speech development and lead to disorders in psychological and mental behaviors. Hearing screening programs in newborns enable detection of hearing impairment in the first days after birth. Programs to identify hearing deficit have significantly improved over the two decades, and their implementation continues to grow throughout the world. Initially based on risk factors, these programs identified only 50-75% of infants with hearing loss. Current recommendations are to conduct universal hearing screening in all infants. Techniques used primarily include automated auditory brainstem responses and otoacoustic emissions that provide noninvasive recordings of physiologic auditory activity and are easily performed in neonates and infants. The aim of this review is to present the objectives, benefits, and results of newborn hearing screening programs including the pros and cons of universal vs. selective screening. A brief history and the anticipated future development of these programs will also be discussed.
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Affiliation(s)
| | - Piotr Dabrowski
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, Poznan, Poland
| | - Witold Szyfter
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jan Mazela
- Department of Newborns' Infectious Diseases, Poznan University of Medical Sciences, Poznan, Poland
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Walker EA, Spratford M, Ambrose SE, Holte L, Oleson J. Service Delivery to Children With Mild Hearing Loss: Current Practice Patterns and Parent Perceptions. Am J Audiol 2017; 26:38-52. [PMID: 28257528 DOI: 10.1044/2016_aja-16-0063] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 09/29/2016] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This study investigates clinical practice patterns and parent perception of intervention for children with mild hearing loss (HL). METHOD Ages at and delays between service delivery steps (first diagnostic evaluation, confirmation of HL, hearing aid [HA] fitting, entry into early intervention) were investigated for 113 children with mild HL. Comparisons were made to children with moderate-to-severe HL. Parents of children with mild HL reported reasons for delays and their perceptions of intervention and amplification for their children. RESULTS Seventy-four percent of children with mild HL were identified through the newborn hearing screen; 26% were identified later due to passing or not receiving a newborn hearing screen. Ninety-four percent of children with mild HL were fit with HAs, albeit at significantly later ages than children with moderate-to-severe HL. Most parents indicated that their children benefited from HA use, but some parents expressed ambivalence toward the amount of benefit. CONCLUSIONS Audiologists appear to be moving toward regularly providing amplification for children with mild HL. However, delays in HA fittings indicate that further educating professionals and parents about the benefits of early amplification and intervention is warranted to encourage timely fitting and consistent use of HAs.
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Fang X, Li X, Zhang Q, Wan J, Sun M, Chang F, Lü J, Chen G. Universal neonatal hearing screening program in Shanghai, China: An inter-regional and international comparison. Int J Pediatr Otorhinolaryngol 2016; 90:77-85. [PMID: 27729159 DOI: 10.1016/j.ijporl.2016.08.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 08/24/2016] [Accepted: 08/25/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE By comparing the Universal Neonatal Hearing Screening (UNHS) program as implemented in Shanghai and other regions in China and countries around the world, this study makes an assessment of the Shanghai model and summarizes the experiences implementing the UNHS program, so as to provide a valuable reference for other countries or regions to carry out UNHS more effectively. Since Shanghai is one of the most developed regions in China, we also examined the relationship between economic development and the UNHS starting year and coverage rate. METHODS The study conducted a systematic review of published studies in Chinese and English on the program status of neonatal hearing screening to compare and analyze the implementation of the UNHS program in 20 cities or provinces in China and 24 regions or countries around the world. The literature search in Chinese was conducted in the three most authoritative publication databases, CNKI (China National Knowledge Infrastructure), WANFANGDATA, and CQVIP (http://www.cqvip.com/). We searched all publications in those databases with the keywords "neonatal hearing screening" (in Chinese) between 2005 and 2014. English literature was searched using the same keywords (in English). The publication database included Medline and Web of Science, and the search time period was 2000-2014. RESULTS Shanghai was one of the first regions in China to implement UNHS, and its coverage rate was among the top regions by international comparison. The starting time of the UNHS program had no relationship with the Gross Domestic Product (GDP) per capita in the same year. Economic level serves as a threshold for carrying out UNHS but is not a linear contributor to the exact starting time of such a program. The screening coverage rate generally showed a rising trend with the increasing GDP per capita in China, but it had no relationship with the area's GDP per capita in selected regions and countries around the world. The system design of UNHS is the key factor influencing screening coverage. Policy makers, program administrators, and cost-sharing structures are important factors that influence the coverage rates of UNHS. CONCLUSION When to carry out a UNHS program is determined by the willingness and preference of the local government, which is influenced by the area's social, political and cultural conditions. Mandatory hearing screening and minimal-cost to no-cost intervention are two pillars for a good coverage rate of UNHS. In terms of system design, decision-making, implementation, funding and the concrete implementation plan are all important factors affecting the implementation of the UNHS.
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Affiliation(s)
- Xingang Fang
- School of Public Health, Fudan University, Shanghai, 200032, P.R. China; China Research Center on Disability Issues at Fudan University, Shanghai, 200032, P.R. China
| | - Xi Li
- School of Public Health, Fudan University, Shanghai, 200032, P.R. China; China Research Center on Disability Issues at Fudan University, Shanghai, 200032, P.R. China
| | - Qi Zhang
- Old Dominion University, Norfolk, VA, USA
| | - Jin Wan
- School of Public Health, Fudan University, Shanghai, 200032, P.R. China; China Research Center on Disability Issues at Fudan University, Shanghai, 200032, P.R. China
| | - Mei Sun
- School of Public Health, Fudan University, Shanghai, 200032, P.R. China; China Research Center on Disability Issues at Fudan University, Shanghai, 200032, P.R. China
| | - Fengshui Chang
- School of Public Health, Fudan University, Shanghai, 200032, P.R. China; China Research Center on Disability Issues at Fudan University, Shanghai, 200032, P.R. China
| | - Jun Lü
- School of Public Health, Fudan University, Shanghai, 200032, P.R. China; China Research Center on Disability Issues at Fudan University, Shanghai, 200032, P.R. China.
| | - Gang Chen
- School of Public Health, Fudan University, Shanghai, 200032, P.R. China; China Research Center on Disability Issues at Fudan University, Shanghai, 200032, P.R. China.
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Nelson LH, Herde L, Munoz K, White KR, Page MD. Parent perceptions of their child's communication and academic experiences with cochlear implants. Int J Audiol 2016; 56:164-173. [PMID: 27780377 DOI: 10.1080/14992027.2016.1244866] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To explore parent perceptions of communication and academic experiences of cochlear implant (CI) recipients under the age of 18. DESIGN Cross-sectional survey design. Two surveys (K-12, birth-5) queried parent perceptions of the impact of CI on communication, listening in various environments and academic achievement. Surveys contained 16-23 multiple choice and/or Likert ratings, plus four open-ended questions to assess reasons for obtaining a CI, satisfaction with CI and suggestions for professionals. STUDY SAMPLE Surveys were sent to 156 parents of CI recipients; 81 surveys returned; response rate 52%. RESULTS According to parent report, 95% of K-12 children and 100% of preschool children used spoken language as their primary mode of communication; majority of K-12 children performed same as or better than peers across academic subjects; 99% of respondents were pleased with their decision to obtain a CI. The most important reasons reported for choosing CIs were for their child to use the same language as their families and to effectively communicate in hearing society. Satisfaction with CI was better in quiet than in noise. Respondents stressed the importance of audiologists having excellent skills in CI management and programming. CONCLUSIONS Respondents were positive about the benefits of obtaining CI for their child.
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Affiliation(s)
- Lauri H Nelson
- a Department of Communicative Disorders and Deaf Education , Utah State University , Logan , UT , USA
| | - Lindsey Herde
- a Department of Communicative Disorders and Deaf Education , Utah State University , Logan , UT , USA
| | - Karen Munoz
- a Department of Communicative Disorders and Deaf Education , Utah State University , Logan , UT , USA
| | - Karl R White
- a Department of Communicative Disorders and Deaf Education , Utah State University , Logan , UT , USA
| | - Michael D Page
- b Department of Audiology , Primary Children's Hospital , Salt Lake City , UT , USA and.,c Oticon Medical, LLC , Somerset , NJ , USA
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Walker EA, Holte L, Spratford M, Oleson J, Welhaven A, Harrison M. Timeliness of service delivery for children with later-identified mild-to-severe hearing loss. Am J Audiol 2015; 23:116-28. [PMID: 24018573 DOI: 10.1044/1059-0889(2013/13-0031)] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE In this study, the authors examined diagnostic and intervention services for children identified with hearing loss (HL) after the newborn period. METHOD The authors compared ages at service delivery and length of delays between service delivery steps for 57 later-identified children with HL and 193 children who referred for assessment from the newborn hearing screen (NHS). For only later-identified children, regression models were used to investigate relationships among predictor variables and dependent variables related to service delivery. RESULTS Children who referred from the NHS received follow-up services at younger ages than later-identified children. Later-identified children had significantly longer delays from HL confirmation to entry into early intervention, compared to children who referred from the NHS. For later-identified children, degree of HL predicted ages at follow-up clinical services. Children with more severe HL received services at younger ages compared to children with milder HL. Gender predicted the length of the delay from confirmation to entry into early intervention, with girls demonstrating shorter delays. CONCLUSIONS The current results lend support to the need for ongoing hearing monitoring programs after the neonatal period, particularly when children enter early intervention programs because of language/developmental delays.
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Muñoz K, Hill MM. Hearing Aid Use for Children With Hearing Loss: A Literature Review. ACTA ACUST UNITED AC 2015. [DOI: 10.1044/hhdc25.1.4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose
The purpose of this study was to complete a comprehensive literature review related to hearing aid use during early childhood.
Method
A rapid evidence assessment was completed to provide a summary of information published or presented between 1980 and 2012. A qualitative assessment was completed for all eligible material, emergent themes related to hearing aid use were synthesized, and a narrative summary was generated.
Results
Eight publications, one conference proceeding, and one presentation were identified. Three themes emerged from the review: hours of hearing aid use, factors influencing use, and suggestions about how to increase use from parents and professionals.
Conclusion
Minimal research has been done related to hearing aid use for young children with hearing loss. Further research is needed to address influences such as quality of fit, parent factors, multiple disabilities, and cultural differences and to investigate effective strategies for increasing hearing aid use.
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Therrell BL, Padilla CD, Loeber JG, Kneisser I, Saadallah A, Borrajo GJC, Adams J. Current status of newborn screening worldwide: 2015. Semin Perinatol 2015; 39:171-87. [PMID: 25979780 DOI: 10.1053/j.semperi.2015.03.002] [Citation(s) in RCA: 353] [Impact Index Per Article: 39.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Newborn screening describes various tests that can occur during the first few hours or days of a newborn's life and have the potential for preventing severe health problems, including death. Newborn screening has evolved from a simple blood or urine screening test to a more comprehensive and complex screening system capable of detecting over 50 different conditions. While a number of papers have described various newborn screening activities around the world, including a series of papers in 2007, a comprehensive review of ongoing activities since that time has not been published. In this report, we divide the world into 5 regions (North America, Europe, Middle East and North Africa, Latin America, and Asia Pacific), assessing the current NBS situation in each region and reviewing activities that have taken place in recent years. We have also provided an extensive reference listing and summary of NBS and health data in tabular form.
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Affiliation(s)
- Bradford L Therrell
- National Newborn Screening and Genetics Resource Center (NNSGRC), Austin, TX; Department of Pediatrics, University of Texas Health Science Center at San Antonio, San Antonio, TX.
| | - Carmencita David Padilla
- College of Medicine, University of the Philippines Manila, Manila, Philippines; Newborn Screening Reference Center, National Institutes of Health (Philippines), Manila, Ermita, Philippines
| | - J Gerard Loeber
- International Society for Neonatal Screening, Bilthoven, Netherlands
| | - Issam Kneisser
- Newborn Screening Unit, Medical Genetic Unit, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Amal Saadallah
- Newborn Screening and Biochemical Genetics Laboratory, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Gustavo J C Borrajo
- Programa de Detección de Errores Congénitos, Fundación Bioquímica Argentina, La Plata, Argentina
| | - John Adams
- Canadian Organization for Rare Disorders, Toronto, Ontario, Canada
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Haghshenas M, Zadeh P, Javadian Y, Fard H, Delavari K, Panjaki H, Gorji H. Auditory screening in infants for early detection of permanent hearing loss in northern iran. Ann Med Health Sci Res 2014; 4:340-4. [PMID: 24971205 PMCID: PMC4071730 DOI: 10.4103/2141-9248.133456] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Undiagnosed hearing loss can cause disorders in speech and language and delay in social and emotional development. Aim: This study aimed to screen for hearing loss in all newborns born in Babol city during 2009-2011. Subjects and Methods: Fifteen thousand one hundred and sixty-five newborns (49% [7430/15165] male and 51% [7735/15165] female) born during a 30-month period in Babol, underwent hearing screening by the otoacoustic emission (OAE) test at the age of 15 days. In infants referred at this stage, an auditory brainstem response (ABR) test was the next investigation. Data analyzed using Statistical Package for the Social Sciences software Version 16 (Chicago, IL, USA, 16) through descriptive statistic method. Results: In the first screening stage, 10.8% (1648/15165) cases were referred to the second stage for further investigation. 9.4% (154/1648) were lost to follow-up from among the referred cases despite continuous contact and education about the importance of the problem. Among the participants in the second stage, 6.2% (92/1494) were referred to the third stage and underwent ABR and OAE testing. 14.1% (13/92) were lost at this stage. Of the remaining participants, 34.2% (27/79) were diagnosed with a hearing loss. Therefore, the incidence of hearing loss in this study was 1.8/1,000 newborns. Conclusion: Given the prevalence of hearing loss in this study, implementation of a universal newborn hearing screening program is recommended.
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Affiliation(s)
- M Haghshenas
- Department of Pediatrics, Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Py Zadeh
- Department of Pediatrics, Non-Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Y Javadian
- Department of Rehabilitation, Babol University of Medical Sciences, Babol, Iran
| | - Ha Fard
- Audiologist, B. Saddress, Babol University of Medical Sciences, Babol, Iran
| | - K Delavari
- Pediatrist, Babol University of Medical Sciences, Babol, Iran
| | - Hsa Panjaki
- GP, Department of Employment, Ministry of Health Affair, Tehran, Iran
| | - Hamh Gorji
- Department of Education Development Centre, Mazandaran University of Medical Science, Sari, Iran
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Alvarenga KDF, Araújo ES, Melo TMD, Martinez MAN, Bevilacqua MC. Questionnaire for monitoring auditory and language development in the first year. Codas 2014; 25:16-21. [PMID: 24408165 DOI: 10.1590/s2317-17822013000100004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 04/09/2012] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To validate a monitoring questionnaire about hearing and language development applied by community health agents in the first year of life. METHODS Seventy six community health agents, previously trained on infant hearing health, administered a questionnaire to the families of 304 children with ages from 0 to 1 year. The questionnaire contains questions regarding hearing and language development and, for all age groups, the question "Does your child hear well?" was presented. The validity of the questionnaire was assessed by analyzing false positive and false negative rates of the identified children. A double-blind study was conducted so that all children assessed by the questionnaire were submitted to hearing evaluation performed by audiologists. RESULTS Four children (1.32%) were diagnosed with sensorineural hearing loss (two unilateral), and 69 (22.7%) with conductive hearing loss. The monitoring questionnaire showed specificity of 96% and sensitivity of 67%, with a false-negative rate of 33% for not identifying the unilateral hearing loss, and a false-positive rate of 4%. CONCLUSION The questionnaire used has shown to be feasible and relevant to actions of the community health agents of the Family Health Strategy program, with high specificity and moderate sensitivity. The use of the validated instrument should be considered to complement Newborn Hearing Screening Programs, in order to identify late onset or acquired hearing loss.
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Uhler K, Thomson V, Cyr N, Gabbard SA, Yoshinaga-Itano C. State and Territory EHDI Databases: What We Do and Don't Know About the Hearing or Audiological Data From Identified Children. Am J Audiol 2014; 23:34-43. [DOI: 10.1044/1059-0889(2013/13-0015)] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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 define the information currently collected by state and territory Early Hearing Detection and Intervention (EHDI) coordinators and to determine whether best practice guidelines are used.
Method
A multiple-choice electronic survey querying areas of diagnostic assessment, amplification, early intervention (EI) and medical information regarding hearing loss was sent to all state and territory EHDI coordinators.
Results
Seventy percent of surveys were completed. Diagnostic, amplification, and Part C services were tracked by the majority of respondents. Additionally, medical prenatal and postnatal risks were collected.
Conclusion
Data collected on audiologic screening and diagnostic evaluations has increased. On the basis of these results, it is difficult to discern whether best practices are being used for each child. A delay in reporting a confirmed hearing loss was observed. Amplification results suggest that systems are not in place to ensure consistency and accountability for fitting amplification in infants. The results of this survey identified audiologic and EI information tracked by states to help provide a framework to monitor quality care in the future.
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Affiliation(s)
- Kristin Uhler
- Marion Downs Hearing Center at the University of Colorado Hospital, University of Colorado at Boulder
| | - Vickie Thomson
- Marion Downs Hearing Center at the University of Colorado Hospital, University of Colorado at Boulder
| | - Nicole Cyr
- Marion Downs Hearing Center at the University of Colorado Hospital, University of Colorado at Boulder
| | - Sandra Abbott Gabbard
- Marion Downs Hearing Center at the University of Colorado Hospital, University of Colorado at Boulder
| | - Christine Yoshinaga-Itano
- Marion Downs Hearing Center at the University of Colorado Hospital, University of Colorado at Boulder
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Galvan C, Case E, Todd Houston K. Listening and Learning: Using Telepractice to Serve Children and Adults with Hearing Loss. ACTA ACUST UNITED AC 2014. [DOI: 10.1044/teles4.1.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Families of children with hearing loss and adults who also have been diagnosed with hearing loss require audiologic management, effective hearing technology, and consistent intervention or rehabilitation to improve their communication. Parents of young children with hearing loss who have chosen a listening and spoken language approach, such as Auditory-Verbal Therapy (AVT), may struggle to find qualified providers who can deliver these services. Similarly, adults with hearing loss also may find it challenging to enroll in aural rehabilitation services due to a lack of availability. The Telepractice and eLearning Laboratory (TeLL) in the School of Speech-Language Pathology and Audiology at the University of Akron has developed a model of telepractice service delivery to provide AVT to families of young children with hearing loss and adult aural rehabilitation services. This paper describes the rationale for establishing these services and a general framework that guides service delivery.
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Affiliation(s)
- Corinne Galvan
- School of Speech-Language Pathology and Audiology, University of AkronAkron, OH
| | - Elizabeth Case
- School of Speech-Language Pathology and Audiology, University of AkronAkron, OH
| | - K. Todd Houston
- School of Speech-Language Pathology and Audiology, University of AkronAkron, OH
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Matulat P, Fabian S, Köhn A, Spormann-Lagodziski M, Lang-Roth R, Rissmann A, Gross M, am Zehnhoff-Dinnesen A. [Quality of universal newborn hearing screening results : Multicenter analysis of data recorded between 2009 and 2012 in four German states]. HNO 2014; 62:171-9. [PMID: 24557064 DOI: 10.1007/s00106-013-2817-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bearing in mind the impending evaluation of newborn hearing screening in Germany, this study investigated whether multicenter analysis of the screening results from four German states is possible and to what extent the results meet national quality and outcome criteria. MATERIALS AND METHODS The screening data from 170 hospitals and a total of 533,150 newborns (21 % of all German newborns) from 2009 to 2012 were evaluated according to definite rules and analyzed in terms of averages, as well as over time. RESULTS During the investigated period and averaged over the hospitals, the quality criteria "percentage of screened newborns" (91.4 %) and "percentage requiring further follow-up" (5.0 %), the "day of screening" (day 4), as well as the target parameter "age at diagnosis" (4.8 months) were not met. Steady improvements were observed over time: in the last year of the evaluation, 95.3 % of children were examined; only 4.8 % required follow-up and the age at diagnosis decreased to 4.2 months. On average, 83 % of the babies were screened before day 4. The steady reduction in variance of most of the variables from the participating hospitals indicates continual improvement. CONCLUSION A multicenter analysis of screening data is possible and valid in the case of good quality data.
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Affiliation(s)
- P Matulat
- Klinik für Phoniatrie und Pädaudiologie, Universitätsklinikum Münster, Kardinal-von-Galen-Ring 10, 48149, Münster, Deutschland,
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Blaiser KM, Behl D, Callow-Heusser C, White KR. Measuring Costs and Outcomes of Tele-Intervention When Serving Families of Children who are Deaf/Hard-of-Hearing. Int J Telerehabil 2013; 5:3-10. [PMID: 25945213 PMCID: PMC4352990 DOI: 10.5195/ijt.2013.6129] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Optimal outcomes for children who are deaf/hard-of-hearing (DHH) depend on access to high quality, specialized early intervention services. Tele-intervention (TI), the delivery of early intervention services via telehealth technology, has the potential to meet this need in a cost-effective manner. METHOD Twenty-seven families of infants and toddlers with varying degrees of hearing loss participated in a randomized study, receiving their services primarily through TI or via traditional in-person home visits. Pre- and post-test measures of child outcomes, family and provider satisfaction, and costs were collected. RESULTS The TI group scored statistically significantly higher on the expressive language measure than the in-person group (p =.03). A measure of home visit quality revealed that the TI group scored statistically significantly better on the Parent Engagement subscale of the Home Visit Rating Scales-Adapted & Extended (HOVRS-A+; Roggman et al., 2012). Cost savings associated with providing services via TI increased as the intensity of service delivery increased. Although most providers and families were positive about TI, there was great variability in their perceptions. CONCLUSIONS Tele-intervention is a promising cost-effective method for delivering high quality early intervention services to families of children who are DHH.
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Affiliation(s)
- Kristina M Blaiser
- Department of Communicative Disorders and Deaf Education, College of Education and Human Services, Utah State University, Logan, UT
| | - Diane Behl
- National Center for Hearing Assessment and Management, Utah State University, Logan, UT
| | | | - Karl R White
- National Center for Hearing Assessment and Management, Utah State University, Logan, UT
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Foust T, Eiserman W, Shisler L, Geroso A. Using otoacoustic emissions to screen young children for hearing loss in primary care settings. Pediatrics 2013; 132:118-23. [PMID: 23733793 DOI: 10.1542/peds.2012-3868] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Otoacoustic emissions (OAE) technology, used widely in newborn hearing screening programs and validated by professional organizations as a reliable and objective tool, is beginning to be recognized as superior to subjective methods when screening young children in a variety of settings. This study examines the efficacy of integrating OAE hearing screening into services routinely provided in health care settings. METHODS Three federally funded clinics serving low-income and uninsured people in a metropolitan area participated in the 10-month study. Subjects included 846 children (842 in the target population <5 years of age and 4 older siblings) who were screened during routine visits to their primary care providers using a distortion product OAE instrument. A multistep screening and diagnostic protocol, incorporating middle ear evaluation and treatment, was followed when children did not pass the initial screening. Audiological evaluation was sought for children not passing a subsequent OAE screening. RESULTS Of the 846 children screened, 814 (96%) ultimately passed the screening or audiological assessment and 29 (3%) exited the study. Three children (1 was <5 years of age and 2 were >5) were identified with permanent hearing loss. CONCLUSIONS The rate of identification of permanent hearing loss in this study is similar to findings from a study of OAE screening in early childhood educational settings. OAE screening holds the potential for being an effective method for helping to identify young children with permanent hearing loss in primary care settings.
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Affiliation(s)
- Terry Foust
- Intermountain Healthcare, Salt Lake City, UT, USA
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Semenov YR, Yeh ST, Seshamani M, Wang NY, Tobey EA, Eisenberg LS, Quittner AL, Frick KD, Niparko JK. Age-dependent cost-utility of pediatric cochlear implantation. Ear Hear 2013; 34:402-12. [PMID: 23558665 PMCID: PMC3744006 DOI: 10.1097/aud.0b013e3182772c66] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Cochlear implantation (CI) has become the mainstay of treatment for children with severe-to-profound sensorineural hearing loss (SNHL). Yet, despite mounting evidence of the clinical benefits of early implantation, little data are available on the long-term societal benefits and comparative effectiveness of this procedure across various ages of implantation-a choice parameter for parents and clinicians with high prognostic value for clinical outcome. As such, the aim of the present study is to evaluate a model of the consequences of the timing of this intervention from a societal economic perspective. Average cost utility of pediatric CI by age at intervention will be analyzed. DESIGN Prospective, longitudinal assessment of health utility and educational placement outcomes in 175 children recruited from six U.S. centers between November 2002 and December 2004, who had severe-to-profound SNHL onset within 1 year of age, underwent CI before 5 years of age, and had up to 6 years of postimplant follow-up that ended in November 2008 to December 2011. Costs of care were collected retrospectively and stratified by preoperative, operative, and postoperative expenditures. Incremental costs and benefits of implantation were compared among the three age groups and relative to a nonimplantation baseline. RESULTS Children implanted at <18 months of age gained an average of 10.7 quality-adjusted life years (QALYs) over their projected lifetime as compared with 9.0 and 8.4 QALYs for those implanted between 18 and 36 months and at >36 months of age, respectively. Medical and surgical complication rates were not significantly different among the three age groups. In addition, mean lifetime costs of implantation were similar among the three groups, at approximately $2000/child/year (77.5-year life expectancy), yielding costs of $14,996, $17,849, and $19,173 per QALY for the youngest, middle, and oldest implant age groups, respectively. Full mainstream classroom integration rate was significantly higher in the youngest group at 81% as compared with 57 and 63% for the middle and oldest groups, respectively (p < 0.05) after 6 years of follow-up. After incorporating lifetime educational cost savings, CI led to net societal savings of $31,252, $10,217, and $6,680 for the youngest, middle, and oldest groups at CI, respectively, over the child's projected lifetime. CONCLUSIONS Even without considering improvements in lifetime earnings, the overall cost-utility results indicate highly favorable ratios. Early (<18 months) intervention with CI was associated with greater and longer quality-of-life improvements, similar direct costs of implantation, and economically valuable improved classroom placement, without a greater incidence of medical and surgical complications when compared to CI at older ages.
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Affiliation(s)
- Yevgeniy R. Semenov
- Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Susan T. Yeh
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Meena Seshamani
- Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nae-Yuh Wang
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Emily A. Tobey
- University of Texas at Dallas, Callier Center for Communication Disorders, Dallas, TX
| | | | | | - Kevin D. Frick
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - John K. Niparko
- Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Musengi M, Ndofirepi A, Shumba A. Rethinking education of deaf children in Zimbabwe: challenges and opportunities for teacher education. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2013; 18:62-74. [PMID: 23109616 DOI: 10.1093/deafed/ens037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The study explores the communication challenges faced by teacher trainees in teaching deaf learners and the opportunities that they present. A critical disabilities study approach within the qualitative paradigm was employed to collect interview data from 14 trainee teachers (6 were men and 8 women) and 5 of their specialist mentors (all of them were women) at 3 special schools in Zimbabwe. The trainees were aged 28-45. Data were analyzed using theme identification methods. Results showed that all the mentors and trainees without deaf assistants tended to teach using spoken language and even though they had no prior experience with them, they were suspicious of the use of deaf assistants, whom they saw as synonymous with sign language. Scepticism about using sign language was based on the idea that it was inadequate, would interfere with spoken language development, and would not enable learners to be included in a nondeaf world. It was also established that most of the mentors and trainees with deaf assistants used spoken language to teach, although this tended to be in combination with signs. Based on these challenges, opportunities to develop the education of deaf learners are discussed and recommendations made.
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Affiliation(s)
- Martin Musengi
- School of Education, Faculty of Humanities, Central University of Technology, Free State, Bloemfontein 9300, South Africa
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Smolkin T, Anton Y, Ulanovsky I, Blazer S, Mick O, Makhoul MI, Makhoul IR. Impact of gestational age on neonatal hearing screening in vaginally-born late-preterm and early-term infants. Neonatology 2013; 104:110-5. [PMID: 23839312 DOI: 10.1159/000350554] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 03/01/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Late-preterm and early-term (LP-ET) infants, defined herein as 35(0)-37(6) weeks' gestation, often fail on 1st otoacoustic emissions (OAE) test. HYPOTHESIS LP-ET infants fail more than term infants (38(0)-42 weeks' gestation) on the 1st OAE test. Aim : To evaluate the effect of gestational age on the 1st OAE test. METHODS We studied 1,572 vaginally-delivered (VD) infants ≥35 weeks' gestation (1.1.2011-30.9.2011). Perinatal and neonatal variables and results of OAE tests were recorded. RESULTS LP-ET infants, compared to full-term infants, had a significantly 2-fold higher need for repeated hearing tests: 80.2 versus 43.3 tests/1,000 neonates, respectively (p = 0.026). Univariate analysis showed that late prematurity and age at 1st OAE were significantly associated with failure on 1st OAE. At age 24-42 h, failure on 1st OAE was 2-fold higher in the LP-ET infants than in full-term infants: 9.4 versus 4.7% (p = 0.02). Risk for failure on 1st OAE was age-dependent: 9-fold higher when 1st OAE was performed at 24-42 h of age (5.3%) versus 0.6% after age 42 h. Multivariate analysis showed that variables that were independently significantly associated with failure on 1st OAE included late prematurity (OR 2.0 (1.1-3.7)) and age at 1st OAE (OR 9.2 (1.2-70.7)). CONCLUSIONS Compared to term infants, VD LP-ET infants had 2-fold higher rates of failure on 1st OAE (up to 42 h of life) and needed repeated hearing tests. Failure rates after 42 h become negligible in both groups. In VD LP-ET infants, 1st OAE is better performed after 42 h of age.
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Affiliation(s)
- Tatiana Smolkin
- Department of Neonatology, Meyer Children's Hospital, Rambam Medical Center, Haifa, Israel
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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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Araújo ES, Lima FDS, Alvarenga KDF. Monitoramento de crianças com indicadores de risco para a deficiência auditiva. REVISTA CEFAC 2012. [DOI: 10.1590/s1516-18462012005000077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: descrever uma proposta de monitoramento de crianças, no primeiro ano de vida, que não foram identificadas na triagem auditiva neonatal, mas apresentavam indicadores de risco para deficiência auditiva. MÉTODO: participaram do estudo 258 crianças de risco que haviam obtido o resultado "passa" no Programa de Triagem Auditiva Neonatal Universal da Maternidade Santa Isabel - Bauru/SP no período de junho a novembro de 2008. Foi aplicado, via telefone, um questionário de acompanhamento do desenvolvimento da audição e da linguagem, validado em estudo anterior, contendo questões sobre a audição e a linguagem. Para cada questão havia duas possibilidades de resposta "sim" ou "não" e considerou-se como "falha", a obtenção de pelo menos uma resposta "não". Tal resultado refletia no agendamento da criança para realização de uma avaliação audiológica imediata. RESULTADOS: o questionário foi aplicado com 169 famílias, com as demais não foi obtido contato. Deste total, 164 (97,04%) apresentaram resultado "passa" e cinco (2,96%) resultado "falha". Dentre as cinco crianças, apenas três compareceram para avaliação audiológica e destas, uma não apresentava alterações e duas apresentavam perda auditiva condutiva. Observou-se prevalências distintas entre os fatores de risco e não houve relação (p>0,05) dos mesmos com a evasão no processo de monitoramento. CONCLUSÃO: o monitoramento por meio de aplicação de questionário via telefone mostrou-se viável, entretanto, é necessário o desenvolvimento de estratégias que favoreçam sua execução.
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