Blog Archives
Families participation in Hearing Health Programs: a descriptive study
CONCLUSION: The attendance of the families at the basic health unit was less than half of the families who had been invited to take the children for hearing evaluation, regardless if the child had been submitted to the process of identification of hearing loss at the public hospital.
Newborn hearing concurrent gene screening can improve care for hearing loss: A study on 14,913 Chinese newborns
The cohort studies provided the essential population parameters for developing effective programs for hearing care of newborns in China. Hearing concurrent gene screening in newborns may confirm the abnormal results from hearing screening tests, help to find the etiologic of the hearing loss, and better recognize infants at risk for late-onset hearing loss occurring prior to speech and language development. In conclusion, a survey on 14,913 Chinese newborns proved that concurrent genetic screening could improve newborn hearing screening for hearing defects.
from the International Journal of Pediatric Otorhinolaryngology
Audiological findings in otospondylomegaepiphyseal dysplasia (OSMED) associated with a novel mutation in COL11A2
The aim of the study was to assess the audiological findings of a 4-year-old child with a homozygous COL11A2 mutation and to point out the role of continuous follow-ups in children with craniofacial syndromes after the newborn hearing screening. A 4-year-old boy with otospondylomegaepiphyseal dysplasia (OSMED) was followed up after birth for hearing loss. Transient Otoacoustic Emissions (TEOAEs), Distortion Product Otoacoustic Emissions (DPOAEs), Automated and Clinical Auditory Brainstem Response (AABR and ABR) measurements, Visual Reinforcement Audiometry, immitansmetric measurements and hearing threshold measurements were performed for audiological evaluation. The patient developed sensorineural hearing loss at 11 months of age while his hearing was normal at birth. Because of auditory-verbal training with hearing aids started at 20 months of age, he now has normal verbal communication with his peers. This study clearly demonstrates that hearing loss develops in infancy in patients with OSMED and underscores the importance of continued hearing screening beyond newborn period for early intervention of hearing impairment and communication problems.
from the International Journal of Pediatric Otorhinolaryngology
Evaluation of an automated auditory brainstem response in a multi-stage infant hearing screening
An automated auditory brainstem response (AABR) method, the Maico MB-11 with BERAphone®, has been developed for hearing screening in newborns. The aim of this study was to test the validity of this automated ABR screening method in a multistage newborn hearing screening (NHS). We applied a “five level” protocol using transient evoked otoacoustic emission (TEOAE), AABR-MB-11 with BERAphone® and conventional auditory brainstem response (ABR). TEOAE, AABR, and conventional ABR testing were performed by ENT specialists experienced in neonatal screening techniques. Among the 8,671 newborns tested (males 3,889; females 4,782), only 42 newborns were lost to follow-up and the final false-positive rate was of 0.03%. Our experience highlights that for the neonatal period, conventional auditory brainstem response is the most reliable method for assessing the hearing level and minimizing the false-positive rate. Although AABR (performed by ENT specialists experienced in neonatal screening techniques) is easy to use, fast and with a good compliance, the device is unable to provide accurate and certain diagnosis on the degree of hearing loss to allow a proper treatment.
Newborn hearing screening: An outpatient model
Objective
The purpose of this study was to assess the feasibility of implementing an outpatient model of a newborn hearing screening program with a particular focus on determining how compliance with the follow-up appointment related to specific socio-economic and demographic factors associated with the mother.
Method
Mothers who delivered their babies in public hospitals in Recife, northeast Brazil, were invited to participate in a two-step program. In Step 1 they were interviewed with regard to specific socio-economic and demographic factors, and then scheduled for a hearing screening test for their baby 1 month after discharge. In Step 2, the baby’s hearing was screened using transient otoacoustic emissions.
Results
A total of 1035 mothers consented to participate in Step 1, but only 149 returned to participate in Step 2 (14.3%). Analysis of the socio-economic and demographic factors indicated that mothers who did not comply with the scheduled newborn hearing screening (NHS) test generally had less than a high school education and came from primarily lower income families who lived in rural areas outside of Recife.
Conclusion
The results of this study highlight some socio-economic and demographic factors of the population of northeast Brazil that contribute to a low compliance rate for an outpatient model of a newborn hearing screening program. Possible solutions to the low compliance rate are considered.
from the International Journal of Pediatric Otorhinolaryngology
Wideband acoustic reflex test in a test battery to predict middle-ear dysfunction
A wideband (WB) aural acoustical test battery of middle-ear status, including acoustic-reflex thresholds (ARTs) and acoustic-transfer functions (ATFs, i.e., absorbance and admittance) was hypothesized to be more accurate than 1-kHz tympanometry in classifying ears that pass or refer on a newborn hearing screening (NHS) protocol based on otoacoustic emissions. Assessment of middle-ear status may improve NHS programs by identifying conductive dysfunction and cases in which auditory neuropathy exists. Ipsilateral ARTs were assessed with a stimulus including four broadband-noise or tonal activator pulses alternating with five clicks presented before, between and after the pulses. The reflex shift was defined as the difference between final and initial click responses. ARTs were measured using maximum likelihood both at low frequencies (0.8-2.8 kHz) and high (2.8-8 kHz). The median low-frequency ART was elevated by 24 dB in NHS refers compared to passes. An optimal combination of ATF and ART tests performed better than either test alone in predicting NHS outcomes, and WB tests performed better than 1-kHz tympanometry. Medial olivocochlear efferent shifts in cochlear function may influence ARs, but their presence would also be consistent with normal conductive function. Baseline clinical and WB ARTs were also compared in ipsilateral and contralateral measurements in adults.
from Hearing Research
Effects of background noise on recording of portable transient-evoked otoacoustic emission in newborn hearing screening
Abstract Transient-evoked otoacoustic emission (TEOAE) is a well-established screening tool for universal newborn hearing screening. The aims of this study are to measure the effects of background noise on recording of TEOAE and the duration required to complete the test at various noise levels. This study is a prospective study from June 2006 until May 2007. The study population were newborns from postnatal wards who were delivered at term pregnancy. Newborns who were more than 8-h old and passed a hearing screening testing using screening auditory brainstem response (SABRe™) were further tested with TEOAE in four different test environments [isolation room in the ward during non-peak hour (E1), isolation room in the ward during peak hour (E2), maternal bedside in the ward during non-peak hour (E3) and maternal bedside in the ward during peak hour (E4)]. This study showed that test environment significantly influenced the time required to complete testing in both ears with F [534.23] = 0.945; P < 0.001 on the right ear and F [636.54] = 0.954; P < 0.001 on the left. Our study revealed that TEOAE testing was efficient in defining the presence of normal hearing in our postnatal wards at maternal bedside during non-peak hour with a specificity of 96.8%. Our study concludes that background noise levels for acceptable and accurate TEOAE recording in newborns should not exceed 65 dB A. In addition, when using TEOAE assessment in noisy environments, the time taken to obtain accurate results will greatly increase.
from ORL -Journal for Oto-Rhino-Laryngology and Its Related Specialties
Impact of newborn hearing screening
Conclusions:
The results of this extensive study of profoundly deaf children with CIs in Flanders indicate that a newborn hearing screening program results in earlier intervention in deaf children, which beneficially influences the auditory receptive skills and speech intelligibility. Laryngoscope, 2009
from Laryngoscope
Newborn hearing screening: An outpatient model
Objective
The purpose of this study was to assess the feasibility of implementing an outpatient model of a newborn hearing screening program with a particular focus on determining how compliance with the follow-up appointment related to specific socio-economic and demographic factors associated with the mother.
Method
Mothers who delivered their babies in public hospitals in Recife, northeast Brazil, were invited to participate in a two-step program. In Step 1 they were interviewed with regard to specific socio-economic and demographic factors, and then scheduled for a hearing screening test for their baby 1 month after discharge. In Step 2, the baby’s hearing was screened using transient otoacoustic emissions.
Results
A total of 1035 mothers consented to participate in Step 1, but only 149 returned to participate in Step 2 (14.3%). Analysis of the socio-economic and demographic factors indicated that mothers who did not comply with the scheduled newborn hearing screening (NHS) test generally had less than a high school education and came from primarily lower income families who lived in rural areas outside of Recife.
Conclusion
The results of this study highlight some socio-economic and demographic factors of the population of northeast Brazil that contribute to a low compliance rate for an outpatient model of a newborn hearing screening program. Possible solutions to the low compliance rate are considered.
from the International Journal of Pediatric Otorhinolaryngology
Electrophysiological Assessment Following Newborn Hearing Screening
from the National Library for Health
The programme includes:
Sessions on all three days
Technical aspects of OAE and AABR
Click AC threshold ABR (+practical)
Bone conduction ABR (+practical)
Tone pip ABR (+practical)
ASSR tests (+practical)
Tests for auditory neuropathy
Mistakes to avoid
Stimulus Calibration
Artefacts
Masking
Waveform interpretation
Reporting
Case studies and discussions
The course will be given by John Stevens, Steve Mason and Guy Lightfoot.
It is supported by Biosense Medical, Guymark UK and P.C. Werth who will provide BioLogic Nav-Pro, GSI Audera and Interacoustics Eclipse ABR/ASSR systems for the practical sessions.
Registration takes place between 14:30 and 15:30 on 6 October 2008.
The course ends at 16:00 on 8 October 2008.
The course attracts 12 CPD points, accredited by the British Academy of Audiology.
For further information contact:
Guy Lightfoot
g.lightfoot@liverpool.ac.uk
Where:Liverpool
When:06 Oct 2008 14:30 – 08 Oct 2008 16:00
Outcome of Newborn Hearing Screening Programme delivered by health visitors
from Child: Care, Health and Development
Background The Newborn Hearing Screening Programme (NHSP) was introduced in England in 2001 to detect congenital hearing loss in the newborn. The screen is either hospital- or community-based.
Objectives This is the first large-scale study of community-based NHSP published in the United Kingdom which aims to evaluate the performance of the community-based screen and compare it against national targets for NHSP and the outcome of national pilot projects.
Method Hearing screening data recorded for 10 074 well babies between March 2004 and December 2005 were analysed. Babies who were admitted to the Special Care Baby Unit were excluded. The case notes of all children who failed the initial hearing screen, either unilateral or bilateral, were reviewed retrospectively. Specific performance measures include coverage rate, referral rate and yield. Reasons for failure to complete the screen were identified.
Results The community programme met all the standards set by the NHSP and the results are comparable with the average of the pilot sites reported in 2004.
Conclusion The data demonstrate that a community-based hearing screening programme conducted by Health Visitors meets all the current national standards and could be implemented across wider areas in this country. Its advantages include a low false positive rate and convenience for parents living in rural areas. The babies identified can be diagnosed and rehabilitated in a time which meets national standards.
Newborn Hearing Screening in Infants With Cleft Palates
Abstract:
Objective: The high incidence of conductive hearing loss from serous effusion in patients with cleft palate is well known. This study investigates the results and interpretation of newborn hearing screening in infants with cleft palates.
Study Design: Retrospective cohort review.
Patients: One hundred fourteen newborns with cleft palate, with or without cleft lip, born between 1999 and 2005 and referred to a craniofacial anomalies clinic.
Intervention: Tympanostomy tubes were placed in 102 newborns, and follow-up audiograms were available for 104 infants.
Main Outcome Measures: Hearing screening outcomes were collected. Sex, gestational period, type of screening performed, the presence of hearing loss after tube placement, and the presence of associated syndromes were noted.
Results: Eighty-two (72%) of 114 of newborns with cleft palates passed their hearing screen. Of the 30 newborns who failed their hearing screen, and had tympanostomy tubes placed, 13 (43%) had persistent hearing loss after tube placement. Factors predicting persistent hearing loss include cleft palate alone, female infants, and the presence of an associated syndrome.
Conclusion: Newborns with cleft palate are at higher risk of failing their newborn hearing screen compared with healthy neonates. Detection of sensorineural or conductive hearing loss unrelated to middle ear effusions is more difficult in this at-risk population with cleft palate because of the high prevalence of serous otitis media.
Proposals and Research
from Seminars in Hearing
Although questions remain concerning the impact of permanent unilateral hearing loss (UHL) and mild bilateral hearing loss (MBHL) on child development, there is nonetheless evidence that at least some children experience measurable problems, particularly at school age (e.g., grade retention; need for support services). After evidence-supported oral presentations and discussions among clinical experts during the 2005 National Workshop on Mild and Unilateral Hearing Loss, a series of recommendations was developed regarding (1) early identification (hearing screening), (2) audiologic assessment, (3) hearing technologies, and (4) early intervention needs of infants and young children with UHL and MBHL.
The frequency of auditory neuropathy detected by universal newborn hearing screening program
from the International Journal of Pediatric Otorhinolaryngology
Objective
Auditory neuropathy/auditory dyssynchrony (AN/AD) has become a well-accepted clinical entity. The combined use of oto-acoustic emissions (OAEs) and auditory brainstem response (ABR) testing in the universal newborn hearing screening (UNHS) has led to the easy recognition of this disorder. Although, we are now able to diagnose AN/AD reliably, little is known about its epidemiology, etiology, and especially the frequency of its occurrence. The primary goal of this study was to determine the frequency of AN/AD in the Western Anatolian region of Turkey. The secondary goal was to compare the detection rate of AN/AD before and after the implementation of the UNHS in the audiology department of Dokuz Eylul University Hospital.
Method
Between 2005 and 2007, among the 23,786 newborns who were screened by automated click evoked oto-acoustic emissions (a-CEOAE) and automated auditory brainstem responses (a-ABRs), 2236 were referred to our department. All necessary audiological tests were performed for all the referred newborns. Among them, babies with deficient or abnormal ABR in combination with normal OAEs were considered as having AN/AD. These babies were evaluated with additional diagnostic audiological tests. Furthermore, comparison of the incidence of children diagnosed with AN/AD before and after the implementation of UNHS in our audiology department was also performed.
Results
Among the referred newborns, 65 had abnormal or deficient ABR test results. Ten of these 65 newborn babies (mean diagnostic age: 5.7 months) with hearing impairment showed electrophysiological test results that were consistent with AN/AD. The frequency of AN/AD in these 65 children with hearing loss was 15.38%. Moreover, the frequency of AN/AD within UNHS was found to be 0.044%. Seven of the 10 babies with AN/AD had hyperbilirubinemia as a risk factor, which is a high rate to be emphasized. On the other hand, the retrospective investigation of children diagnosed with AN/AD in the same audiology department between 1999 and 2005 (i.e. before the implementation of UNHS) revealed only 7 children, with an average diagnostic age of 34 months.
Conclusion
After implementing the UNHS, the incidence of AN/AD in the audiology department increased from 1.16 to 4.13. Furthermore, the age of diagnosis of AN/AD decreased from 34 months to 5.7 months. This study shows that AN/AD, when screened, is a comparatively common disorder in the population of hearing-impaired infants. While newborn hearing screening provides early detection of babies with hearing loss, it also helps to differentiate AN/AD cases when the screening is performed with both a-ABR and automated oto-acoustic emission (a-OAE) tests. Thus, the routine combined use of a-ABR and a-OAE tests in UNHS programs, especially for the high-risk infants, can provide better detection of newborns with AN/AD. Furthermore, hyperbilirubinemia is merely an association and maybe etiologically linked.
Parent and professional perspectives on the Western Australian Infant Hearing Screening Program
from Deafness and Education International
This study investigated the views of parents, newborn hearing screeners and Telethon Speech and Hearing (TSH) professionals of the Western Australian Infant Screening for Hearing (WISH) Program. Three questionnaires were used to gather information from the participants. Sixteen responses to the questionnaire were obtained (five parents, five screeners and six TSH professionals) with an additional parent telephoning in her responses. Overall, results showed that families and staff involved in the WISH Program were satisfied with the hearing screening, audiological, early intervention and counselling services provided by the WISH Program and TSH. Recommendations were offered by participants to assist in improving services, as well as continuing the quality of services being offered. Major recommendations were to continue efforts to implement a statewide newborn hearing screening programme in Western Australia, to continue the WISH Program for the private sector, and to make this freely available to parents. Other suggestions included provision of consistent and clear information for parents; an enhanced database system and ongoing data entry; supply of feedback to screeners; and promotion of the WISH Program through improved education of hospital professionals and parents. Copyright © 2008 John Wiley & Sons, Ltd.
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