Most babies are born with normal hearing and experience the beauty of the sound from the beginning. But unfortunately there are babies born with hearing losses. Those babies can't hear their parents voice, singing or reading to them which delays the speech and language learning, New born hearing screening identifies babies at risk for hearing loss so they can be evaluated and treated early.
What is hearing screening?
Hearing "Screening" is not the same as diagnosis. The main purpose of hearing screening is to separate among apparently healthy individuals from those who are great risk for hearing loss and to refer them for diagnostic testing and guidance. Screening tests divides the populations as “pass group” and “refer group”
Persons with positive(refer) or suspicious findings must
be referred to their physicians for diagnosis and necessary treatment.
The audiological screening may cover different aspects
such as,
•
impairment
•
hearing disability
•
middle ear disorders
•
Oto-neurological disorders.
The purpose of
this write up is to focus on screening impairment for different age groups and
accordingly we can classify as
•
Neonatal screening
•
School screening
•
Industrial screening
•
Others like monitoring in special
occasions (epidemic or mass poisoning)
Today we mainly talk about neonatal (less than 4 weeks old) screening, because that is the time duration that we can find out a hearing impairment at the earliest. Usually hearing impairment is a not a visible disability, as
normal children may not begin talking until 1.5 to 2 years of age so a new born hearing play a major role in diagnosing a persons with hearing loss.
Universal Newborn Hearing screening (UNHS)
In 1994, The National institute of health
Consensus Development Conference on early identification of Hearing impairment in infants and in children
recommended UNHS.
The joint committee on infant hearing(JCIH) issued similar guidelines in 1995 and again in 2000. UNHS is also recommended by the American of Pediatrics, by the centers for disease control and prevention and in healthy people, 2010.
The joint committee on infant hearing(JCIH) issued similar guidelines in 1995 and again in 2000. UNHS is also recommended by the American of Pediatrics, by the centers for disease control and prevention and in healthy people, 2010.
UNHS is now performed worldwide compulsorily on all new born because of the significant harm of unidentified permanent congenital hearing loss. These hearing screening programs have shown benefits for newborns and JCIH has renewed up-to-date guidelines for hearing screening which have yielded successful results.
However
children with risk factors should be
screened not only at birth but also through childhood. The JCIH recommends
continued surveillance of these children because they may be at risk of
progressive hearing loss.
This recommendation includes audiologic testing every
six months until 3 yrs of age. In Low-risk children, a repeat hearing
screening is recommended before entry into the kindergarten.
The joint committee on infant hearing(JCIH) Guidelines
This included a list of risk indicators for two groups of
age. Firstly, birth through 28 days which consisted of 5 risk indicators. And
secondly, 29 days through 2 yrs which includes 10 risk indicators.
1) Birth
through 28 days
•
Illness or condition requiring admission
of 48 hrs of more in NICU.
•
Stigma or other associated findings
assiociated with hearing losss.
•
Family history of permanent hearing loss
•
Craniofacial anomalies, including pinna and ear canal.
2) 29
days through 2 yrs
•
Parental or caregiver concern regarding
speech, language and hearing or developmental delay.
•
Stigma or other associated findings
associated with hearing loss.
•
Family history of permanent childhood
hearing loss.
•
Postnatal infections associated with sensorineural hearing loss .
•
In Utero Infections.
•
Neonatal indicators: Hyperbilirubinemia
requiring exchange transfusion, persistent pulmonary hypertension associated
with mechanical ventilation
•
Syndromes associated with progressive
hearing loss
•
Neurodegenerative or sensory motor
neuropathies
•
Head trauma
•
Recent or persistent otitis media with
effusion for 3 months or more.
Test to administer?
- Otoacoustic emissions (OAE)
- Automated auditory brainstem response (aABR)
Tips for parents
- Ask your Doctor/Audiologist for New born screening test. it is available in most of the hospital
- When the screening says "Refer" make sure to meet your audiologist after 3 months of duration.
- Parents should not be afraid of the results "Refer" it can be due to amniotic fluid in the ear also,to clear cut it to the screening test again after 3.
- Earlier the diagnosis, Earlier the management.