Comparison between hearing screening-detected cases and sporadic cases of delayed-onset hearing loss in preschool-age children

A systematic review of the prevalence of late identified hearing loss in childhood

OBJECTIVES

The objective of this systematic review was to assess the evidence about the prevalence of permanent hearing loss for children not identified from newborn hearing screening (NHS).

DESIGN

Articles were grouped into three categories based on the methodological approach: (1) all participants received diagnostic testing, (2) otoacoustic emission (OAE) or pure tone screening was completed and those not passing were referred for a diagnostic test, and (3) data were retrieved from archival records. Study characteristics, prevalence, and contextual factors were synthesised and narratively described.

STUDY SAMPLE

30 peer-reviewed articles.

RESULTS

Prevalence of permanent hearing loss per 1,000 children ranged from 0.32 to 77.87 (M = 7.30; SD = 16.87). Variations in the criteria for inclusion contributed to prevalence differences. Prevalence was higher when unilateral and milder degrees of hearing loss were included, and older children had higher prevalence (M = 13.71; SD = 23.21) than younger children (M = 1.57; SD = 0.86).

CONCLUSION

There is scant research on prevalence of childhood hearing loss after NHS that utilised methods to accurately differentiate between permanent and temporary hearing loss. Rigorous research is needed on the prevalence of permanent childhood hearing loss to inform strategies for monitoring, identification, intervention, and management.

Childhood hearing loss detected beyond the newborn screen

OBJECTIVE

To understand the characteristics of postnatal hearing loss (PNHL) identified via different referral pathways, to inform childhood hearing screening and referral practices.

DESIGN

Retrospective analysis of screening and audiology records.

STUDY SAMPLE

A cohort of 385 children who passed newborn hearing screening in Queensland, Australia between September 2004 and December 2017 and were later diagnosed with permanent hearing loss.

RESULTS

Neonatally identified risk factors facilitated detection for half the cohort, with PNHL detected earlier (average age of 31 months) and at a milder degree. PNHL was detected at an average age of 49 months via other pathways. Proportions of bilateral moderate or greater PNHL were greatest in children with significant medical circumstances (60.7%) and those with noted delays or concerns (39.2%), whereas childhood hearing screening programs detected greater proportions of unilateral moderate or greater PNHL (47.4%).

CONCLUSIONS

Risk-factor-based surveillance detects PNHL early but does not detect all cases. Screening children with speech and language delays, parental or professional concern, or with relevant medical circumstances (eg meningitis or chemotherapy) is warranted based on the types of PNHL detected. Further evidence may be required to justify the rollout of postnatal population childhood screening programs.

School-based hearing screening in Sweden - An evaluation of current practices

OBJECTIVES

Routines for school hearing screening vary between municipalities in Sweden, and no study has been carried out to investigate how this is conducted throughout the country. The aim of the present study was to determine the extent of school hearing screening, and how it is performed in all the municipalities in Sweden.

METHODS

An online survey was used to collect information on school hearing screening from municipalities in Sweden (N = 290). The survey included questions on the performance of hearing screening, including stimulus level and frequencies tested, the criteria for referral for further hearing evaluation, as well as the equipment and room used for testing, and who carried out the screening. Questions were also included on experience of, and attitudes towards hearing screening.

RESULTS

Answers were received from 225 municipalities (response rate 78%). Universal school hearing screening was performed in 202 municipalities, while in the other municipalities hearing screening was performed when a child was evaluated due to speech delay or learning difficulties. Many different protocols were used involving different stimulus levels, frequencies, and referral criteria. The most common was testing with pure tone audiometry with a lowest stimulus level of 20 dB HL at five frequencies, 500-6000 Hz. Hearing screening was usually performed in the preparation class (6 years of age), while in other municipalities it was performed in year 1 (7 years of age). Hearing screening was usually performed once in primary school, while some municipalities carried out screening once in primary school and once in high school. More rarely, hearing screening was conducted twice in primary school. In 25 % of the municipialities, newly arrived immigrant children were screened. Difficulties in performing hearing screening were reported, such as lack of soundproof rooms, lack of time and technical difficulties. There was an opinion among the participants that identifying students with hearing loss is important, as it affects their learning ability and communication skills. and they expressed a desire for national guidelines.

CONCLUSIONS

Hearing screening is performed in the vast majority of municipally run schools in Sweden. The way in which screening was performed varied regarding the stimulus level and frequencies used, as well as the criteria for referral to a specialist. The attitude towards hearing screening was positive among the participants. Hearing screening of newly immigrated children is important as their previous medical history is often unknown. There is a need for national guidelines on hearing screening of Swedish schoolchildren. Efforts must continue to ensure that the same level of healthcare regarding children's hearing is provided throughout the whole of Sweden.

Evaluation of an internet-based speech-in-noise screening test for school-age children

OBJECTIVE

To evaluate a Dutch online speech-in-noise screening test (in Dutch: "Kinderhoortest") in normal-hearing school-age children. Sub-aims were to study test-retest reliability, and the effects of presentation type and age on test results.

DESIGN

An observational cross-sectional study at school. Speech reception thresholds (SRTs) were obtained through the online test in a training condition, and two test conditions: on a desktop computer and smartphone. The order of the test conditions was counterbalanced.

STUDY SAMPLE

Ninety-four children participated (5-12 years), of which 75 children were normal-hearing (≤25 dB HL at 0.5 kHz, ≤20 dB HL at 1-4 kHz).

RESULTS

There was a significant effect for test order for the two test conditions (first or second test), but not for presentation type (desktop computer or smartphone) (repeated measures analyses, F(1,75) = 12.48, p < 0.001; F(1,75) = 0.01, p = 0.982). SRT significantly improved by age year (first test: 0.25 dB SNR, 95% CI: -0.43 to -0.08, p = 0.004. Second test: 0.29 dB SNR, 95% CI: -0.46 to -0.11; p = 0.002).

CONCLUSIONS

The online test shows potential for routine-hearing screening of school-age children, and can be presented on either a desktop computer or smartphone. The test should be evaluated further in order to establish sensitivity and specificity for hearing loss in children.