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Ansari MS, Sood AS, Gill JS. National Infant Screening for Hearing Program in India: Necessity, Significance and Justification. Indian J Otolaryngol Head Neck Surg 2022; 74:6497-6512. [PMID: 36742677 PMCID: PMC9895613 DOI: 10.1007/s12070-021-02788-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/25/2021] [Indexed: 02/07/2023] Open
Abstract
Hearing impairment is one of the most prevalent disorder in children and adults worldwide, which not only interferes with the acquisition, development and maintenance of speech and language skills but also adversely deprive the auditory nervous system for future learning. It can have long term harmful effect on educational, social, emotional and cognitive skills in young children; restrict the vocational options and employment opportunities in adults; and can cause isolation, loneliness and depression in older adults, if remain undetected and intervened at the earliest. However, early identification and intervention is known to greatly reverse the ill effects and improve the quality of life of children and adults with hearing impairment. Current clinical means and methods to identify and intervene hearing loss are convenient, cost effective, reasonably accurate beneficial and evidenced based, can be easily employed nation-wide for early identification and intervention of hearing loss. This paper attempts to convince medical colleagues, public health care experts and policy makers by justifying the hearing, as public health issue and relevance of medical screening criteria for hearing. It also discusses the preferred model of hearing screening and intervention strategies in India.
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Affiliation(s)
- Mohammad Shamim Ansari
- Department of Audiology, Ali Yavar Jang National Institute of Speech and Hearing Disabilities (Divyangjan), (An Autonomous Institution, Under Department of Empowerment of Persons With Disabilities, Ministry of Social Justice and Empowerment, Government of India), K. C. Marg, Bandra (W), Mumbai, 400050 India
| | - Arvinder Singh Sood
- Department of ENT, Sri Guru Ram Das Institute of Medical Sciences & Research, Sri Guru Ram Das University of Health Sciences, Amritsar, Punjab India
| | - Jaskaran Singh Gill
- Department of ENT, Sri Guru Ram Das Institute of Medical Sciences & Research, Sri Guru Ram Das University of Health Sciences, Amritsar, Punjab India
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Adadey SM, Quaye O, Amedofu GK, Awandare GA, Wonkam A. Screening for GJB2-R143W-Associated Hearing Impairment: Implications for Health Policy and Practice in Ghana. Public Health Genomics 2020; 23:184-189. [PMID: 33302283 DOI: 10.1159/000512121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/23/2020] [Indexed: 11/19/2022] Open
Abstract
Genetic factors significantly contribute to the burden of hearing impairment (HI) in Ghana as there is a high carrier frequency (1.5%) of the connexin 26 gene founder variant GJB2-R143W in the healthy Ghanaian population. GJB2-R143W mutation accounts for nearly 26% of causes in families segregating congenital non-syndromic HI. With HI associated with high genetic fitness, this indicates that Ghana will likely sustain an increase in the number of individuals living with inheritable HI. There is a universal newborn hearing screening (UNHS) program in Ghana. However, this program does not include genetic testing. Adding genetic testing of GJB2-R143W mutation for the population, prenatal and neonatal stages may lead to guiding genetic counseling for individual and couples, early detection of HI for at-risk infants, and improvement of medical management, including speech therapy and audiologic intervention, as well as provision of the needed social service to enhance parenting and education for children with HI. Based on published research on the genetics of HI in Ghana, we recommend that the UNHS program should include genetic screening for the GJB2-R143W gene variant for newborns who did not pass the initial UNHS tests. This will require an upgrade and resourcing of public health infrastructures to implement the rapid and cost-effective GJB2-R143W testing, followed by appropriate genetic and anticipatory guidance for medical care.
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Affiliation(s)
- Samuel M Adadey
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana.,Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Osbourne Quaye
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana
| | - Geoffrey K Amedofu
- Department of Eye Ear Nose & Throat, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana
| | - Ambroise Wonkam
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa,
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Meinzen-Derr J, Wiley S, Creighton J, Choo D. Auditory Skills Checklist: Clinical Tool for Monitoring Functional Auditory Skill Development in Young Children with Cochlear Implants. Ann Otol Rhinol Laryngol 2016; 116:812-8. [DOI: 10.1177/000348940711601104] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: The Auditory Skills Checklist© (ASC) was developed to address the need for tools to evaluate functional auditory skill progress in very young children with sensorineural hearing loss. We describe the development, validation, and utility of the ASC for use in young children with cochlear implants. Methods: Using the ASC, we measured auditory skills in 37 subjects who received cochlear implants at no more than 36 months of age. Repeated measures analysis was conducted to determine expected auditory skill development after implantation. Interrater reliability was tested on a small subset. The ASC was compared to the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) to determine its validity in measuring functional auditory skills. Results: The ASC had excellent internal consistency (Cronbach's alpha, 0.98) and interrater reliability (intraclass correlation coefficient, 0.99), and was highly correlated with the IT-MAIS (r = 0.90). According to the repeated measures analysis, children who received a cochlear implant at 36 months of age or earlier were expected to increase their ASC score by 8 points every 3 months (beta coefficient, 8.3; p < .001). Conclusions: The ASC is a clinically relevant and easily administered tool for assessing the functional auditory skills of young children with a cochlear implant. By assessing auditory skill development over time with the ASC, we can better realize expectations for a particular child based on his or her age, hearing loss level, and management strategies in place.
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Govender S, Latiff N, Asmal N, Ramsaroop S, Mbele T. Evaluating the Outcomes of a Hearing Screening Service for Grade One Learners in Urban Areas at Durban, South Africa. J Public Health Afr 2015; 6:529. [PMID: 28299139 PMCID: PMC5349266 DOI: 10.4081/jphia.2015.529] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/15/2015] [Accepted: 04/04/2015] [Indexed: 11/23/2022] Open
Abstract
Early intervention through hearing screening can reduce the negative impact of hearing loss for children. Optimal outcomes are achieved when an appropriate screening protocol is selected, a pathway for follow up care is established, and when a hearing conservation component is included. This study aimed to describe the outcomes of a hearing screening service provided to grade one learners in urban areas at Durban. A cross-sectional design was employed. Learners (n=241) were conveniently sampled from six randomly selected schools. They were screened using otoscopy, tympanometry and pure tone audiometry. Fifty eight participants (24%) obtained a refer result, with 33% referred for diagnostic assessments, 29% for middle ear pathology and 38% for cerumen management. Findings further revealed that only 33% of referrals were followed up indicating poor compliance. Association between test results and income levels (P=0.38) as well as distance to the nearest health care facility (P=0.22) did not influence test outcomes. School aged children do present with common ear problems. Appropriate protocol selection, ensuring compliance to recommendations and education on hearing conservation are essential components of any health initiative.
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Affiliation(s)
- Samantha Govender
- Department of Audiology, University of KwaZulu-Natal, Durban, South Africa
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Pereira T, Costa KC, Pomilio MCA, Costa SMDS, Rodrigues GRI, Sartorato EL. Investigação etiológica da deficiência auditiva em neonatos identificados em um programa de triagem auditiva neonatal universal. REVISTA CEFAC 2014. [DOI: 10.1590/1982-0216201419712] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objetivo descrever os resultados da investigação etiológica da deficiência auditiva realizada em neonatos rastreados em um programa de triagem auditiva neonatal universal. Métodos estudo descritivo, transversal e prospectivo. Foram incluídos no estudo todos os neonatos diagnosticados com deficiência auditiva identificados em um programa de triagem auditiva neonatal universal no período de agosto de 2003 a dezembro de 2006. A provável etiologia da deficiência auditiva foi determinada após anamnese detalhada realizada pelo médico otorrinolaringologista; pesquisa das sorologias para toxoplasmose, rubéola, citomegalovírus, herpes, sífilis e HIV; tomografia dos ossos temporais e exames genéticos. Resultados foram diagnosticados 17 sujeitos com deficiência auditiva no período estudado. 64.7% dos casos estudados apresentaram como provável etiologia causas pré-natais, 29.4% causas peri-natais e um sujeito (5,9%) apresentou etiologia desconhecida. Das causas pré-natais, 36.4% tiveram origem genética confirmada e 36.4% etiologia presumida de hereditariedade. Foi confirmada a presença de infecções congênitas em 18.2% dos casos e um sujeito (9%) apresentou anomalia craniofacial como provável etiologia. O grau de perda auditiva mais frequente observado nos sujeitos estudados foi o profundo (47,1%). Conclusão a maior ocorrência de etiologias observada neste estudo foram as de origem pré-natal, seguida das de origem peri-natal.
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Affiliation(s)
- Tânia Pereira
- Núcleo de Estudos e Pesquisas da Associação Terapêutica de Estimulação Auditiva e Linguagem, Brasil
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Schrijver I, Gardner P. Hereditary sensorineural hearing loss: advances in molecular genetics and mutation analysis. Expert Rev Mol Diagn 2014; 6:375-86. [PMID: 16706740 DOI: 10.1586/14737159.6.3.375] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hearing loss has a genetic etiology in the majority of cases and is very common. The universal newborn hearing screening program, together with remarkable recent progress in the characterization of genes associated with the function of hearing, have resulted in increased demand and exciting possibilities of detecting the molecular basis of hereditary hearing loss through DNA testing. Future molecular diagnostic assays are expected to offer a greater variety of gene-specific tests, as well as combined mutation panels, which will aid in the management of the impressive genetic heterogeneity observed in hereditary hearing loss, especially in individuals with nonsyndromic forms. This review addresses the genetics of hearing loss, discusses the most commonly offered genetic assays for nonsyndromic hearing loss, with advantages and limitations, proposes a practical testing algorithm, and highlights current developments.
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Affiliation(s)
- Iris Schrijver
- Stanford University School of Medicine, Department of Pathology & Pediatrics, L235, 300 Pasteur Drive, Stanford, CA 94305, USA.
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Barboza ACS, Resende LMD, Ferreira DBC, Lapertosa CZ, Carvalho SADS. Correlação entre perda auditiva e indicadores de risco em um serviço de referência em triagem auditiva neonatal. AUDIOLOGY: COMMUNICATION RESEARCH 2013. [DOI: 10.1590/s2317-64312013000400009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Verificar a ocorrência de perda auditiva e a sua correlação com os indicadores de risco, em bebês de um Serviço de Referência de Triagem Auditiva Neonatal. MÉTODOS: Estudo retrospectivo com casuística composta por 3151 prontuários de bebês, dos quais 803 apresentaram indicadores de risco para a deficiência auditiva. O estudo foi realizado em um Serviço de Referência em Triagem Auditiva Neonatal de um Hospital Universitário na cidade de Belo Horizonte (MG). A coleta dos dados abrangeu o período de janeiro de 2009 a dezembro de 2010. RESULTADOS: No grupo sem indicadores de risco, a ocorrência de perda auditiva foi de 1,04%, sendo 0,04% do tipo neurossensorial e 0,99% do tipo condutiva. No grupo com indicadores de risco, a ocorrência de perda auditiva foi de 8,38%: 3,10% do tipo neurossensorial e 5,27% do tipo condutiva. Na etapa de acompanhamento, uma criança (0,33%) obteve diagnóstico de perda auditiva neurossensorial de grau moderado bilateral. Os indicadores de risco mais frequentes na população estudada foram a permanência em UTI neonatal por mais de cinco dias, com 43,47%, seguido de uso de ototóxicos, 29,81% e ventilação mecânica, 28,88%. Foi observado que crianças com suspeita de síndromes têm 18 vezes mais chance de apresentar perda auditiva neurossensorial. CONCLUSÃO: A ocorrência de perda auditiva foi maior no grupo de crianças com indicadores de risco. O indicador de risco que apresenta correlação com a presença de perda auditiva neurossensorial é a suspeita de síndromes. Verifica-se a necessidade de desenvolvimento de ações de promoção da saúde para diminuição dos indicadores de risco encontrados na população atendida.
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Capone FV, Torres DDA, Lima MADMTD. Neuropatia auditiva: alerta aos pediatras. REVISTA PAULISTA DE PEDIATRIA 2011. [DOI: 10.1590/s0103-05822011000400030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Alertar os pediatras sobre a neuropatia auditiva, doença descrita recentemente e ainda desconhecida por muitos médicos. Descrever seus fatores de risco, características clínicas e diagnósticas, com a finalidade de possibilitar uma intervenção terapêutica precoce e eficaz. FONTES DE DADOS: Realizada pesquisa nas bases de dados PubMed, Lilacs e SciELO utilizando os descritores "neuropatia auditiva" e "auditory neuropathy", entre os anos de 1996 e 2010. SÍNTESE DOS DADOS: A neuropatia auditiva, também conhecida como dessincronia auditiva, descrita em 1996, caracteriza-se clinicamente pela dificuldade na compreensão das palavras, mesmo em casos de perdas auditivas leves ou moderadas. Foi relacionada a diversas neuropatias generalizadas e fatores de risco neonatais, como internação em terapia intensiva, hiperbilirrubinemia, sepse e hipóxia. Após suspeita clínica, o diagnóstico é confirmado pela presença das emissões otoacústicas associada a um potencial evocado auditivo de tronco encefálico ausente ou alterado. Sua terapêutica permanece controversa, tendo como opções a protetização auditiva, o acompanhamento fonoterápico para habilitação ou reabilitação da linguagem e, em casos de insucesso, há relatos de resultados satisfatórios com o implante coclear. CONCLUSÕES: Enfatiza-se a importância do reconhecimento pelo pediatra da neuropatia auditiva, entidade ainda pouco citada na literatura latino-americana da especialidade.
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Chapman DA, Stampfel CC, Bodurtha JN, Dodson KM, Pandya A, Lynch KB, Kirby RS. Impact of co-occurring birth defects on the timing of newborn hearing screening and diagnosis. Am J Audiol 2011; 20:132-9. [PMID: 21940980 DOI: 10.1044/1059-0889(2011/10-0049)] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Early detection of hearing loss in all newborns and timely intervention are critical to children's cognitive, verbal, behavioral, and social development. The initiation of appropriate early intervention services before 6 months of age can prevent or reduce negative developmental consequences. The purpose of this study was to assess, using large, population-based registries, the effect of co-occurring birth defects (CBDs) on the timing and overall rate of hearing screening and diagnosis. METHOD The authors linked statewide data from newborn hearing screenings, a birth defects registry, and birth certificates to assess the timeliness of newborn hearing screening and diagnosis of hearing loss (HL) for infants with and without CBDs in 485 children with confirmed HL. RESULTS Nearly one third (31.5%) of children with HL had 1 or more CBDs. The presence of CBDs prolonged the time of the initial infant hearing screening, which contributed to further delays in the subsequent diagnosis of HL. CONCLUSIONS Better coordination of HL assessment into treatment plans for children with CBDs may enable earlier diagnosis of HL and provide opportunities for intervention that will affect long-term developmental outcomes for these children.
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Affiliation(s)
- Derek A. Chapman
- Virginia Commonwealth University, Richmond
- Virginia Department of Health, Richmond
| | - Caroline C. Stampfel
- Virginia Commonwealth University, Richmond
- Virginia Department of Health, Richmond
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Dantas MBDS, Anjos CALD, Camboim ED, Pimentel MDCR. Results of a neonatal hearing screening program in Maceió. Braz J Otorhinolaryngol 2010; 75:58-63. [PMID: 19488561 PMCID: PMC9442219 DOI: 10.1016/s1808-8694(15)30832-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2007] [Accepted: 11/22/2007] [Indexed: 11/26/2022] Open
Abstract
Since 1998, after we started the support group for neonatal hearing screening, many other hearing screening programs were held in Brazil. In Alagoas, the first program started in 2003, but none of its results were published. Hearing is paramount for human communication; therefore, childhood hearing loss can impair speech acquisition, emotional, educational and social development. Aim: to present the results achieved in a neonatal hearing screening program in Maceió. Materials and Methods: a retrospective analytical study was carried out in order to study the results from tests carried out from September 2003 to December 2006 in a private hospital of Maceió. Results: from a total of 2002 newborns, 1,626 fitted the inclusion criteria, 835 (51.4%) males. The hearing screening was considered appropriate in 1416 cases (87.1%), and the most frequently found age was between 16 and 30 days. Finally, 163 (10.0%) children presented risk indicators for hearing loss, and hyperbilirubinemia was the most common indicator. Conclusions: statistical results obtained from this hearing screening program show the importance of holding such programs. This study is important because it contributes to further regional or multinational studies.
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Soares CP, Marques LR, Flores NGC. Triagem auditiva neonatal: aplicabilidade clínica na rotina dos médicos pediatras neonatologistas. REVISTA CEFAC 2008. [DOI: 10.1590/s1516-18462008000100015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: identificar a aplicabilidade clínica da triagem auditiva neonatal na rotina dos médicos pediatras neonatologistas no município de Maceió-AL. MÉTODOS: foi realizado um estudo transversal analítico com 36 médicos pediatras neonatologistas por meio da aplicação de um questionário com seis perguntas objetivas. RESULTADOS: observou-se que 88,9% dos pediatras neonatologistas conhecem a triagem auditiva neonatal, no entanto, 11,1% desconhecem. No serviço particular de saúde, 66,1% encaminham todos os recém-nascidos para a triagem em sua rotina. No serviço público, apenas 7,4% encaminham todos os recém-nascidos e 42,8% não encaminham. Em relação à Lei Municipal nº 5.555/06, que obriga a realização da triagem auditiva neonatal universal nas maternidades e estabelecimentos hospitalares congêneres no município de Maceió, 41,7% dos médicos declararam não conhecer. Apenas 36,1% afirmaram conhecer o trabalho fonoaudiológico na prevenção da surdez. CONCLUSÃO: neste estudo, pode-se concluir que a triagem auditiva neonatal está inserida na rotina clínica da maioria dos médicos pediatras neonatologistas que trabalham na rede particular de saúde. No entanto, observa-se carência de recursos para a implantação e continuidade do programa no serviço público e pouco conhecimento do papel do fonoaudiólogo na prevenção da surdez.
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Ferro LM, Tanner G, Erler SF, Erickson K, Dhar S. Comparison of universal newborn hearing screening programs in Illinois hospitals. Int J Pediatr Otorhinolaryngol 2007; 71:217-30. [PMID: 17097746 DOI: 10.1016/j.ijporl.2006.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2006] [Revised: 10/06/2006] [Accepted: 10/07/2006] [Indexed: 11/17/2022]
Abstract
UNLABELLED SUMMARY/OBJECTIVES: In accordance with the Joint Committee on Infant Hearing's (JCIH, 2000) position statement regarding Universal Newborn Hearing Screenings (UNHS), the state of Illinois enacted legislation requiring all birthing hospitals to conduct UNHS by 31 December 2002. Currently 100% of birthing facilities in the state of Illinois perform newborn infant hearing screenings using otoacoustic emissions (OAEs) and/or automated auditory brainstem response (AABR) measures. This study is an attempt to document current practices in hospital-based UNHS programs, as reported by program personnel, in the state of Illinois. The goal is to compare these reported practices to the recommended standards and identify factors that could lead to further refinement of the process. METHODS A modified version of the Newborn Hearing Screening Survey from the Marion Downs National Center for Infant Hearing was used to gather practice- and protocol-related data for the 2004 calendar year via the World Wide Web. Data presented here are extracted from the online survey as reported by hospital staff presumably associated with the UNHS program. RESULTS Fifty-nine of the 140 hospitals with UNHS programs responded to the Web-based survey. Nursing staff, followed by technicians, were most commonly reported to perform initial hearing screenings in both the well-baby nursery (WBN) and the neonatal intensive care unit (NICU). Audiologists appeared to participate in re-screenings at a greater number of the facilities. Automated ABR was the most common screening tool (80%) followed by Distortion Product OAEs (32%) and Transient Evoked OAEs (5%). Eighty-six percent reported referral rates that were less than 5%, with 32% reporting a referral rate less than 1%. CONCLUSIONS At the beginning of 2004, 99% of all infants born in Illinois were being screened for hearing loss. Personnel involvement and screening measures employed were comparable to the few reports available from other states. The audiologist's role was found to be fairly limited in screening, re-screening, or managing UNHS programs. Referral rates were consistent with national standards ( approximately 1%). Management of UNHS programs in small, rural facilities, tracking/monitoring high-risk infants, and other services provided to families emerged as areas with room for improvement.
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Affiliation(s)
- Lia M Ferro
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL 60208, USA
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Garcia R, Turk J. The applicability of Webster-Stratton Parenting Programmes to deaf children with emotional and behavioural problems, and autism, and their families: annotation and case report of a child with autistic spectrum disorder. Clin Child Psychol Psychiatry 2007; 12:125-36. [PMID: 17375814 DOI: 10.1177/1359104507071091] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article describes a pilot project whose objective was to explore whether the Webster-Stratton Parenting Programme may be effective for hearing parents and their deaf children who present with conduct disorders and other emotional, behavioural and developmental problems. Outcome measures aimed at overall impact in decreasing behavioural problems and improving overall family function were used. Participants were hearing parents of deaf children referred to our specialist service whose assessment had recommended a parenting skills group as treatment of choice. The children had been diagnosed with behavioural problems with or without additional comorbidity. This pilot phase focused deliberately on one participant, in order to explore whether the approach justified further, more comprehensive evaluative research. Outcome was positive, suggesting that modified Webster-Stratton approaches may well be of use in deaf children of hearing parents.
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Affiliation(s)
- Ruth Garcia
- Oxleas NHS Trust and Institute of Psychiatry, London, UK.
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Karzon RK, Lieu JEC. Initial Audiologic Assessment of Infants Referred From Well Baby, Special Care, and Neonatal Intensive Care Unit Nurseries. Am J Audiol 2006; 15:14-24. [PMID: 16803788 DOI: 10.1044/1059-0889(2006/003)] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
The purpose of the study was to evaluate the effectiveness of a 2-hr initial audiologic assessment appointment for infants referred from area universal newborn hearing screening (UNHS) programs to a clinical audiology department in an urban hospital.
Method
A prospective auditory brainstem response (ABR)-based protocol, including clicks, frequency-specific tone bursts, and bone-conducted stimuli, was administered by 10 audiologists to 375 infants. Depending on the ABR findings, additional test options included distortion product otoacoustic emissions (DPOAEs), high-frequency tympanometry, and/or otologic examination.
Results
In 88% of the 2-hr test sessions, at least 4 ABR threshold estimates were obtained (i.e., bilateral clicks and either a 500- or 1000-Hz tone burst and a 4000-Hz frequency tone burst for the better ear). The incidence of hearing loss was significantly different across nursery levels: 18% for Level I (well baby), 29% for Level II (special care), and 52% for Level III (neonatal intensive care unit). Hearing loss type was defined at the initial assessment for 35 of the 51 infants with bilateral hearing loss based on bone-conduction ABR, latency measures, DPOAEs, high-frequency tympanometry, and/or otologic examination.
Conclusions
Our findings indicate that a 2-hr test appointment is appropriate for all nursery levels to diagnose severity and type of hearing loss in the majority of infants referred from UNHS. Examination by an otolaryngologist within 24–48 hr further defines the hearing loss and facilitates treatment plans.
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Affiliation(s)
- Roanne K Karzon
- St. Louis Children's Hospital, One Children's Place, Room 3S23, St. Louis, MO 63110, USA.
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Park AH, Warner J, Sturgill N, Alder SC. A survey of parental views regarding their child's hearing loss: a pilot study. Otolaryngol Head Neck Surg 2006; 134:794-800. [PMID: 16647537 DOI: 10.1016/j.otohns.2006.01.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2005] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Assess parental perceptions of their child's sensorineural hearing loss care. METHODS Families of pediatric patients diagnosed with a sensorineural hearing loss from 2000 to 2004 were sent a survey asking about their experiences with their child's hearing loss. RESULTS One hundred eight of 389 families surveyed were studied. Thirteen percent did not know the results of the newborn screening. Twenty-two percent of the primary care physicians were not involved in the child's hearing evaluation. Forty percent of the patients underwent 4 or more audiologic tests before a diagnosis. The most common reason for delayed diagnosis was difficulty in obtaining an appointment with an audiologist. Sixty-two percent of families had difficulties obtaining hearing aids, and 58% noted difficulties obtaining cochlear implants. CONCLUSIONS Families reported multiple obstacles to obtain timely diagnosis and treatment. Otolaryngologists may need to be more involved in the evaluation and treatment of these patients. EBM RATING C-4.
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Affiliation(s)
- Albert H Park
- Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah 84132, USA.
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Arnold CL, Davis TC, Humiston SG, Bocchini JA, Bass PF, Bocchini A, Kennen EM, White K, Forsman I. Infant hearing screening: stakeholder recommendations for parent-centered communication. Pediatrics 2006; 117:S341-54. [PMID: 16735261 DOI: 10.1542/peds.2005-2633n] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The purpose of this study was to identify what stakeholders considered best practices for parent-provider communication regarding newborn hearing screening and diagnosis. We used consensus data to develop educational materials for parents. METHODS We conducted 29 focus groups and 23 individual interviews between October 2003 and May 2004. Participants included (1) English- and Spanish-speaking parents of infants <18 months of age who had experience with hospital-based newborn hearing screening; (2) parents of children with hearing loss; (3) primary care providers who provide prenatal care or care for newborns; and (4) audiologists, audiology technicians, and hospital nurses. RESULTS Communication to parents about hospital-based newborn hearing screening was limited. Most parents first learned about the screening in the hospital, but all stakeholders thought a more opportune time for education was before the birth. For parents of infants who did not pass the newborn hearing screening, stakeholders recommended direct communication about the urgency of diagnostic testing. They also indicated that primary care providers needed current information regarding hearing screening, diagnostic testing, and early intervention. All stakeholders thought that a brief brochure for parents to take home would be helpful for hospital-based screening and, if necessary, subsequent diagnostic testing. Primary care providers requested basic, to-the-point information. CONCLUSIONS The most opportune time to begin discussion of newborn hearing screening is before the birth. Providers need up-to-date information on current standards of hearing screening, diagnosis, and intervention. User-friendly patient education materials, such as those we developed, could assist providers in educating parents.
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Affiliation(s)
- Connie L Arnold
- Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA.
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Abstract
Tremendous progress has been made in our understanding of the molecular basis of hearing and hearing loss. Through recent advances, we have begun to understand the fascinating biology of the auditory system and unveiled new molecular mechanisms of hearing impairment. Changes in the diagnostic impact of genetic testing have occurred, as well as exciting developments in therapeutic options. Molecular diagnosis, which is already a reality for several hearing-associated genes, will doubtlessly continue to increase in the near future, both in terms of the number of mutations tested and the spectrum of genes. Genetic analysis for hearing loss is mostly used for diagnosis and treatment, and relatively rarely for reproductive decisions, in contrast to other inherited disorders. Inherited hearing loss, however, is characterized by impressive genetic heterogeneity. An abundance of genes carry a large number of mutations, but specific mutations in a single gene may lead to syndromic or non-syndromic hearing loss. Some mutations predominate in individual ethnic groups. For clinical and laboratory diagnosticians, it is challenging to keep abreast of the unfolding discoveries. This review aims to provide the framework pertinent to diagnosticians and a practical approach to mutation analysis in the hearing impaired.
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Affiliation(s)
- Iris Schrijver
- Department of Pathology and Pediatrics, L235, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305, USA.
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Spivak L, Sokol H. Beyond newborn screening: early diagnosis and management of hearing loss in infants. Adv Neonatal Care 2005; 5:104-12. [PMID: 15806451 DOI: 10.1016/j.adnc.2004.12.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
As a result of the 1993 National Institutes of Health Consensus Statement recommending hearing screening for all infants before discharge from the newborn nursery, there are an increasing number of newborns identified with hearing impairment requiring follow-up services. Research has shown that hearing-impaired infants who receive intervention by the time they are 6 months adjusted gestational age are likely to develop language that is equal to their normal-hearing peers. Newborn hearing screening will not attain its goal of early intervention for hearing loss unless a comprehensive follow-up program is in place. The neonatal nurse plays an important role in the follow-up program by providing information to parents and stressing the importance of follow-up. Follow-up for infants identified through the screening process includes rescreening within 4 to 6 weeks of discharge and a full diagnostic evaluation for infants who fail the rescreening. The diagnostic evaluation includes Auditory Brainstem Response (ABR), Otoacoustic Emissions (OAE), and middle ear assessment. The course of treatment or therapy and the type of amplification chosen for hearing-impaired infants depends on the type and degree of hearing loss as well as the communication mode chosen by the family. The ultimate goal of early audiological diagnosis of hearing loss is to begin treatment as soon as possible to minimize delays in speech/language and academic development. This article focuses on what needs to happen after newborn hearing screening to ensure early and optimal intervention for hearing-impaired infants.
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Affiliation(s)
- Lynn Spivak
- Hearing and Speech Center, Long Island Jewish Medical Center, New Hyde Park, NY 11042, USA.
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