Identifying deafness in early childhood: requirements after the newborn hearing screen

Watkin, Peter; Baldwin, Margaret

doi:10.1136/adc.2010.185819

Cited by 128 publications

(71 citation statements)

References 15 publications

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“…Expectations are that early intervention through hearing technology will improve spoken language outcomes for children. 1,2 Childhood hearing loss is a relatively frequent disorder, affecting 1 to 3 per 1000 live births, [3][4][5] that disrupts typical language acquisition, placing children at risk for delays in language, literacy, and social development. [6][7][8] There is strong consensus that specialized intervention must be combined with early identification to develop communication skills in these children.…”

Section: Resultsmentioning

confidence: 99%

Sign Language and Spoken Language for Children With Hearing Loss: A Systematic Review

et al. 2016

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CONTEXT: Permanent hearing loss affects 1 to 3 per 1000 children and interferes with typical communication development. Early detection through newborn hearing screening and hearing technology provide most children with the option of spoken language acquisition. However, no consensus exists on optimal interventions for spoken language development. OBJECTIVE:To conduct a systematic review of the effectiveness of early sign and oral language intervention compared with oral language intervention only for children with permanent hearing loss.DATA SOURCES: An a priori protocol was developed. Electronic databases (eg, Medline, Embase, CINAHL) from 1995 to June 2013 and gray literature sources were searched. Studies in English and French were included. STUDY SELECTION:Two reviewers screened potentially relevant articles. DATA EXTRACTION:Outcomes of interest were measures of auditory, vocabulary, language, and speech production skills. All data collection and risk of bias assessments were completed and then verified by a second person. Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to judge the strength of evidence. RESULTS:Eleven cohort studies metinclusion criteria, of which 8 included only children with severe to profound hearing loss with cochlear implants. Language development was the most frequently reported outcome. Other reported outcomes included speech and speech perception.LIMITATIONS: Several measures and metrics were reported across studies, and descriptions of interventions were sometimes unclear.CONCLUSIONS: Very limited, and hence insufficient, high-quality evidence exists to determine whethersign language in combination with oral language is more effective than oral language therapy alone. More research is needed to supplement the evidence base. Ottawa, Ottawa, Ontario, Canada; b Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; c Centre for Practice-Changing Research, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; d Translational Research in Biomedicine Graduate Program, University of Split School of Medicine, Split, Croatia; f Consultant, Moncton, New Brunswick; g Audiology Clinic, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; and h Voice for Hearing-Impaired Children, Toronto, Ontario, Canada Dr Fitzpatrick conceptualized the project, fi nalized the protocol, was involved in all stages of the analysis and interpretation, wrote the fi rst draft of this manuscript, and is the study guarantor; Ms Hamel and Ms Pratt were involved in screening articles and extracted data; Ms Hamel conducted the quality assessment; Ms Hamel, Ms Pratt, Ms Stevens, and Dr Moher provided input into the fi nal manuscript; Ms Stevens contributed to the development of the methods, oversaw the screening, Early detection of permanent childhood hearing loss through population-based newborn screening has become standard care in much of the world. Expectations are that early intervention through hearing technolog...

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Section: Resultsmentioning

confidence: 99%

Sign Language and Spoken Language for Children With Hearing Loss: A Systematic Review

et al. 2016

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“…The screening personnel's knowledge of the community's language and culture may have also played a role in the high follow-up return rates in his/her ability to address negative or superstitious perceptions of hearing loss [19]. Data management and tracking systems are also critical for long-term sustainability and efficacy of a screening program and the post-neonatal care pathways [5,13,17,35]. Although no national database registry for IHS currently exists in South Africa, the study utilized an electronic internet-based database (EHDI SA Oz eSP Database System) for management and statistical analysis as part of a larger pilot research program in South Africa.…”

Section: Follow-up Ratementioning

confidence: 99%

Efficacy of a community-based infant hearing screening program utilizing existing clinic personnel in Western Cape, South Africa

Friderichs

Swanepoel

Hall

2012

International Journal of Pediatric Otorhinolaryngology

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Objective: Screening programs at primary health care immunization clinics have been proposed as an alternative to hospital-based programs in South Africa. The objective of this study was to evaluate the first systematic community-based infant hearing screening program in a developing South African community in the Western Cape.Methods: A community-based universal infant hearing screening program initiated at eight primary health care clinics in the Cape Metropolitan area was evaluated over a 19-month research period. During this time 6227 infants that were candidates for screening attended their 6, 10 or 14-week immunization visit at the relevant clinic. Clinic nurses were trained as screening personnel. A two-stage distortion product otoacoustic emissions screening protocol was utilized.The target disorder was uni-or bilateral hearing loss and infants referring the first screen were scheduled for a 4-week follow-up visit at the clinic. Diagnostic audiological and medical evaluations were scheduled at referral hospitals when indicated. The study evaluated the 3 efficacy of the program based on coverage, referral and follow-up rates and diagnostic outcomes according to guidelines specified by the Health Professions Council of South Africa 2007 Position Statement.Results: Overall coverage rate across the eight clinics was 32.4% with 2018 infants (aged 0-14 weeks) screened. The mean age of the sample at first stage screen was 3.9 weeks of age and 13.5 weeks of age for first hospital visit. Overall first stage screen referral rate was 9.5% with 62 subjects (3%) referred for diagnostic services at hospital level after a follow-up screen. The average follow-up rate for rescreens at clinic level was 85.1% and for initial diagnostic assessments at hospital level it was 91.8%. Prevalence rates were 4.5/1000 with significant hearing loss, including sensorineural (1.5/1000) and conductive (3/1000) losses, and 12.9/1000 for subjects with middle ear effusion. Conclusions:The community-based infant hearing screening program was valuable in attaining high follow-up return rates but reaching sufficient coverage may require dedicated screening personnel as opposed to existing nursing personnel.

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“…Consequently, AABR screening is conducted during the initial and follow-up screening in only 16% (12/76) of NICU programs in the South African private health care sector that offer screening. This means that 84% (64/76) of NICU hearing screening programs nationally will not identify auditory neuropathy [21,30].…”

Section: Referral and Follow-up Performance And Protocolsmentioning

confidence: 99%

Early detection of infant hearing loss in the private health care sector of South Africa

Meyer

Swanepoel

Roux

et al. 2012

International Journal of Pediatric Otorhinolaryngology

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Objective: A national survey of early hearing detection services was undertaken to describe the demographics, protocols and performance of early hearing detection, referral, follow-up and data management practices in the private health care sector of South Africa.Methods: All private hospitals with obstetric units (n=166) in South Africa were surveyed telephonically. This data was incorporated with data collected from self-administered questionnaires subsequently distributed nationally to audiology private practices providing hearing screening at the respective hospitals reporting hearing screening services (n=87). Data was analyzed descriptively to yield national percentages and frequency distributions and possible statistical associations between variables were explored.Results: Newborn hearing screening was available in 53% of private health care obstetric units in South Africa of which only 14% provided universal screening. Most (81%) of the healthy baby screening programs used only otoacoustic emission screening. Auditory brainstem response screening was employed by 24% of neonatal intensive care unit screening programs with only 16% repeating auditory brainstem response screening during the follow-up screen. Consequently 84% of neonatal intensive care unit hearing screening programs will not identify auditory neuropathy. A referral rate of less than 5% for diagnostic assessments was reported by 80% of universal programs. Follow-up return rates were reported to exceed 70% by only 28% of programs. Using multiple methods of reminding parents did not significantly increase reported follow-up return rates. Data management was mainly paper based with only 10% of programs using an electronic database primarily to manage screening data. Conclusions:A shortage of programs and suboptimal and variable protocols for early hearing detection, follow-up and data management in existing programs mean the majority of babies with hearing loss in the South African private health care sector will not be identified early. Newborn hearing screening must be integrated with hospital-based birthing services, ideally with centralized data management and quality control.

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Identifying deafness in early childhood: requirements after the newborn hearing screen

Cited by 128 publications

References 15 publications

Sign Language and Spoken Language for Children With Hearing Loss: A Systematic Review

Sign Language and Spoken Language for Children With Hearing Loss: A Systematic Review

Efficacy of a community-based infant hearing screening program utilizing existing clinic personnel in Western Cape, South Africa

Early detection of infant hearing loss in the private health care sector of South Africa

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