Early Identification Of Hearing Impairment Research Articles

Hearing Loss and its Impact in the Community

Hearing is considered an important sense of the human being. Hearing impairment cannot be visible and hence its effects are not seen by others, so the deaf suffer in silence. Hearing impairment is not only a communication problem but also a community problem. Hearing loss, which is gradual and permanent, can be brought on by congenital or acquired damage to the auditory nerve and cochlear hair cells. It reduces the working ability and performance of an individual, thus diminishing one’s participation. Hearing loss is often associated with loneliness and social isolation which has an impact on cognitive and psychosocial health. Early identification of hearing impairment in a child is vital for effective management. Hearing loss has a detrimental impact on family dynamics and, as a result, the child’s development. The widespread prevalence of deafness necessitated a reliable management system and simple clinical implementation. This public health burden can be managed by raising awareness of hearing impairment. There are plenty of clinical assessment and therapy options in hearing impairment research, but lack of knowledge about it implies that public education or awareness should be prioritized more. This review article discusses the epidemiology, etiopathogenesis, clinical features, impact of hearing impairment, and its impact on the community along with current treatment options.

Comparison of Communication in Early and Late Identified Children with Hearing Impairment

Background: The significance of early detection and intervention in hearing impairment is well-documented, with substantial evidence suggesting improved language outcomes in children who are identified and receive intervention at an early age. Objective: To quantitatively compare the communicative abilities of children with hearing impairments identified early versus late and to evaluate the impact of the timing of intervention on their language development. Methods: In a cohort study of 104 children with hearing impairment, two groups were defined based on the age at identification: early (before 6 months) and late (after 6 months). Using the Communication Checklist-2, as well as standardized tests for receptive and expressive language, we assessed and compared their communication skills. Results: Early identified children demonstrated superior communication skills, with 47.1% using object pointing compared to 57.4% of late identified children. A significant contrast was observed in verbal communication, with early identified children exhibiting higher usage of creative one-word utterances at 33.3% against 31.5% in the late group. Receptive language scores were higher in the early group by an average of 12 points, while expressive language scores were higher by an average of 15 points. Late identified children showed a higher reliance on preverbal communication, with a 3.7% higher incidence of object self-injury and a 5.2% higher occurrence of object aggression. Conclusion: The findings emphasize the substantial advantage of early identification of hearing impairment for communication skills development. Early identified children not only show a greater propensity for verbal communication but also achieve higher receptive and expressive language scores, underscoring the need for prompt hearing loss detection and intervention.

Validation of LittleEARS questionnaire in Hindi language

BackgroundSubjective measures of auditory development are equally important as objective measures to obtain a realistic image of the hearing status in infants and toddlers. ObjectivesThe objectives of the current study were to translate and validate the LittleEARS questionnaire into the Hindi language, to calculate its psychometric properties and establish a regression curve of the scores obtained as a function of age, to calculate the inter-test and test retest reliability of the same. The secondary objectives were to compare the scores obtained by the normal hearing children and those with hearing impairment and to plot a regression curve of total scores obtained by the hearing-impaired children as a function of the duration of auditory training attended since their first fit of the device. Materials and methodsThe procedures involved conventional translation, reverse translation, and content validation before administering the questionnaire. The translated version was administered to parents of 59 children with normal hearing and 41 children with hearing impairment. ResultsThe finalized version had good reliability and efficient internal consistency with a Cronbach alpha value of 0.96. The mean scores obtained by the normal hearing children showed a progressive pattern as a function of age. ConclusionThe LittleEARS questionnaire has been successfully translated and validated into the Hindi language with excellent validity and reliability and can be used for screening and early identification of hearing impairment and in evaluating the outcome of audiological treatment approaches.

Diagnostic ability of otoacoustic emission and automated auditory brainstem response in hearing screening of high-risk newborn

Background: Early identification of hearing impairment in infants and appropriate intervention can prevent severe psychosocial, educational, and linguistic repercussions. Infants who are not identified before 6 months of age have delays in speech and language development.Methods: This was a prospective cohort study OAE and AABR were administered to high-risk neonates discharged from NICU and the diagnostic ability to pick up hearing loss was assessed by trained audiologist. Statistical analysis was interpreted by McNemar paired Chi-square test (χ2) test. Factors which correlated with deafness were interpreted by Pearson chi-square (χ2) test.Results: Among 144 babies screened, 26 failed OAE while 6 failed AABR. Referral rate was 18.1% with OAE and 4.2% with AABR. All 6 babies failed with 40db and 90 db screening. Mean duration of NICU stay had a positive correlation with AABR positivity. Babies with higher duration of NICU stay had greater probability of hearing loss. Age and gender had no significant correlation with hearing loss. Sensitivity of OAE as 16.7 % and the specificity was 81.9 %. Positive likelihood ratio with OAE was.923. Negative likelihood ratio with OAE was 1.02. One neonate out of 6 with jaundice had profound hearing loss. Conclusions: It was concluded that in high-risk neonates the diagnostic value of DPOAE for identification of hearing loss, when used alone, was limited since OAE has higher referral rate and lower specificity compared to AABR. Babies with higher duration of NICU stay had greater probability of hearing loss.

Effectiveness of an online continuing education course in infant hearing health for primary care professionals

Objective To evaluate the effectiveness of an online continuing education course on infant hearing health for primary care professionals. Design A prospective longitudinal study with interrupted time series pre-test/post-test design. The effectiveness of the online course was assessed by comparing pre- vs. post-training performance and analysing responses to evaluations of the quality of the course. Study sample The sample comprised individuals enrolled between September 2018 and August 2019 in a Ministry of Health course, “Actions in primary care for the early identification of hearing impairment” offered on the AVASUS platform. Results Of the 2908 individuals registered, 1842 (63.3%) completed the course. Their ages ranged from 18 to 77 years, and 67.4% of them were females. Students and doctors were overrepresented among the enrollees. All Brazilian states were included in the sample. Comparisons of pre- and post-training performances showed a significant improvement in knowledge, and 99.3% of the participants provided positive comments regarding the quality of the course. Conclusions The course is an effective distance learning tool on infant hearing health for primary care professionals. The online course circumvents the limitations posed by geographical barriers and also facilitates decentralisation.

COVID-19 patients and sudden sensorineural hearing loss: a review

<p>Coronavirus disease-19 (COVID-19) is a new pandemic caused by SARS-CoV-2 virus. COVID-19 patients often present with respiratory symptoms and death is the possible outcome. The potentiality for neuro-invasion by the SARS-CoV-2 is currently a subject of great debate. However, there is a paucity of information regarding the impact of the SARS-CoV-2 on the nervous system at the present moment. The impact of the coronavirus on the auditory system is little mentioned in the literature. Sudden sensorineural hearing loss (SSNHL) is a rare symptom associated with COVID-19 infection. This hearing deterioration could be attributed to the damaging effects of viral infections on the outer hair cells of the cochlea but the exact mechanism is still unknown. Awareness about this non-specific presentation like SSNHL in COVID-19 patients is often a challenge to a clinician for early management. Early identification of the SSNHL may be helpful for the isolation of the patient and also protect their infectiousness in the early period to prevent the spread of the disease. Early identification of hearing impairment is also helpful for early medical treatment of SSNHL which can save the hearing. This article reviews the epidemiology, etiopathology, clinical presentations, investigations, and treatment of SSNHL in COVID-19 patients. This review article surely makes a baseline from where further prospective studies can be designed for this rare clinical entity in COVID-19 patients as there are not many studies are done.</p>

Validation of a Personalized Hearing Screening Mobile Health Application for Persons with Moderate Hearing Impairment.

Hearing impairment is a frequent human sensory impairment. It was estimated that over 50% of those aged >75 years experience hearing impairment in the United States. Several hearing impairment–related factors are detectable through screening; thus, further deterioration can be avoided. Early identification of hearing impairment is the key to effective management. However, hearing screening resources are scarce or inaccessible, underlining the importance of developing user-friendly mobile health care systems for universal hearing screening. Mobile health (mHealth) applications (apps) act as platforms for personalized hearing screening to evaluate an individual’s risk of developing hearing impairment. We aimed to evaluate and compare the accuracy of smartphone-based air conduction and bone conduction audiometry self-tests with that of standard air conduction and bone conduction pure-tone audiometry tests. Moreover, we evaluated the use of smartphone-based air conduction and bone conduction audiometry self-tests in conductive hearing loss diagnosis. We recruited 103 patients (206 ears) from an otology clinic. All patients were aged ≥20 years. Patients who were diagnosed with active otorrhea was excluded. Moderate hearing impairment was defined as hearing loss with mean hearing thresholds >40 dB. All patients underwent four hearing tests performed by a board-certified audiologist: a smartphone-based air conduction audiometry self-test, smartphone-based bone conduction audiometry self-test, standard air-conduction pure-tone audiometry, and standard bone conduction pure-tone audiometry. We compared and analyzed the results of the smartphone-based air conduction and bone conduction audiometry self-tests with those of the standard air conduction and bone conduction pure-tone audiometry tests. The sensitivity of the smartphone-based air conduction audiometry self-test was 0.80 (95% confidence interval CI = 0.71–0.88) and its specificity was 0.84 (95% CI = 0.76–0.90), respectively. The sensitivity of the smartphone-based bone conduction audiometry self-test was 0.64 (95% CI = 0.53–0.75) and its specificity was 0.71 (95% CI = 0.62–0.78). Among all the ears, 24 were diagnosed with conductive hearing loss. The smartphone-based audiometry self-tests correctly diagnosed conductive hearing loss in 17 of those ears. The personalized smartphone-based audiometry self-tests correctly diagnosed hearing loss with high sensitivity and high specificity, and they can be a reliable screening test to rule out moderate hearing impairment among the population. It provided patients with moderate hearing impairment with personalized strategies for symptomatic control and facilitated individual case management for medical practitioners.

Implementation of National Infant Screening for Hearing Program in India: Challenges, Opportunities and Suggested Framework.

Hearing impairment is most frequent sensory deficit present in infants at birth and unaddressed hearing impairment causes severe damages to both infants and their families. In India 77,756 live children are born per day which accounts for about 25 million children annually among them approximately 1.5 lacs (@ 6 per1000) children born with hearing impairment. These children have no prospects of early identification & intervention. As a result, majority of these children suffers from oral communication difficulties, poor academic performance, reduced psychosocial & cognitive development, socioeconomic insufficiency, deprived vocational opportunities & employability. However, consequences of hearing impairment are ameliorable if timely hearing screening and effective intervention strategies are instituted. Unfortunately, India has not yet envisaged any dedicated early identification and intervention program for children with hearing impairment. However, there are ample of opportunities for implementing such program. Hence, this paper endeavours to address the necessity to plan and to implement the early identification of hearing impairment by discussing burden of disorder, suggesting means to overcome the challenges and to explore and emphasize the opportunities of purposeful utilization of available infrastructure and resources. This paper also intends to suggest a conceptual framework for planning and implementing of National Infant Screening for Hearing Program to deal with serious consequences of hearing impairment in India.

Sudden sensorineural hearing loss among coronavirus disease-19 patients

Coronavirus disease-19 (COVID-19) is a new pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus. COVID-19 patients often present with respiratory symptoms and death is the possible outcome. The potentiality for neuro-invasion by the SARS-CoV-2 is currently a subject of great debate. However, there is a paucity of information regarding impact of the SARS-CoV-2 on nervous system at the present moment. In fact, the impact of the coronavirus on the auditory system is little mentioned in the literature. Sudden sensorineural hearing loss (SSNHL) is rare symptom associated with COVID-19 infection. This hearing deterioration could be attributed to the damaging effects by viral infections on the outer hair cells of the cochlea but the exact mechanism is still unknown. Awareness about this nonspecific presentation like SSNHL in COVID-19 patients is often a challenge to a clinician for early management. Early identification of the SSNHL may be helpful for isolation of the patient and also protect their infectiousness in early period to prevent spread of the disease. Early identification of hearing impairment is also helpful for early medical treatment of SSNHL which can save the hearing. This article reviews the epidemiology, etiopathology, clinical presentations, investigations, and treatment of SSNHL in COVID-19 patients. This review article surely makes a baseline from where further prospective studies can be designed for this rare clinical entity in COVID-19 patients as not many studies are done.

La prima infezione urinaria febbrile in bambini di età compresa tra 2 mesi e 3 anni

Conductive, mild-moderate hearing impairment in children is a very frequent condition after newborn hearing screening that easily leads to misdiagnosis. Conductive hearing impairment needs an accurate differential diagnosis to avoid inadequate treatments. The paper reports a case of bilateral, sensorineural hearing impairment of moderate degree in a 5-month male infant that was diagnosed after the failure of newborn hearing screening and because of a family history of hearing loss. His parents asked for an advice about the need of hearing aids at the Audiological and Otolaryngology Department. The diagnostic and audiological assessment recognised a conductive, moderate hearing loss associated with tympanic effusion and velar-tube dysfunction. After two months, in the follow-up, the child’s hearing threshold was normal. The case underlines the importance of early identification of hearing impairment and of a complete evaluation programme before indicating any treatment.

Concurrent genetic and standard screening test for hearing reduction

Reduction of hearing is the most common sensory impairment among newborns with an incidence of 1-3 per 1000 births. Introduction of an Auditory Newborn screening program allows early identification of hearing impairment. Mainly, congenital hearing loss in early childhood is a result of genetic changes. Due to high frequency of GJB2 pathogenic variants, its molecular characterization among sensorineural hearing reduction cases is already conducted as a routine analysis in many countries. The aim of this study is to show our initial results in the effort to determine whether genetic screening along with the standard hearing screening in newborns is justified. Otoacoustic emission (OAE) method was conducted in 223 newborns at risk of hearing impairment. Among them, 7 did not pass the test in both ears while 9 exhibited one-sided hearing loss. In all 7 children with indication of profound bilateral deafness, the diagnosis was confirmed using auditory brainstem response. Genetic screening of GJB2 gene was performed in 6 of them. Genetic analysis of GJB2 revealed homozygous state of the most common pathogenic variant 35delG in 3 (50%) of the analyzed infants. In the remaining 3 no pathogenic variant was determined. The results indicate that performing auditory OAE together with genetic screening is justified. In newborns who have not passed the hearing screening test and have profound hearing loss, without other syndrome traits, screening for mutations of GJB2 gene should be conducted. Genetic screening enables establishment of early definite diagnosis for deafness and helps in conducting adequate therapy providing timely rehabilitation and social inclusion of deaf child. Key words: hearing loss, genetic screening, auditory screening, GJB2 gene

Tympanometric screening for Otitis media of paediatric patients with respiratory tract infection in rural setting a prospective observational study

Introduction: Early identification of hearing impairment in childhood is imperative, as even a mild hearing loss can have long term consequence on the development of the Central Nervous System. Many children develop transient, fluctuant deafness due to Middle ear effusion, especially during episodes of Common cold. In this research we try to develop a Screening protocol using Impedance Audiometry for early identification of Middle ear effusions. Materials and Methods: Children between 7 months to 6 years of ages, with no previous history of hearing impairment or ear disease, who were suffering from Upper respiratory tract infection (Common cold) were selected as targets of screening. These children were then subjected to a Screening Tympanometry. A simple, quick and accurate method of screening for Middle ear fluid was “Peak” or “No peak” approach was employed to judge the curves. If a curve was obtained (similar to Jerger's classification-type “A”) child was deemed to have “Pass”. A type “B” curve was deemed highly positive and was labelled “Fail+” and any other trace like type “C” or just reduced type “A” or “As” labelled just “Fail”. Otoscopic and endoscopic examination and diligent search was carried out for signs of Middle ear effusion and confirmation was done. This was cross checked by 2 authors (First and third author) and findings confirmed. Results: Dervan child screening protocol is 91.67% (92%) sensitive and 94.23 (94%) specific is detection of Middle ear effusions. Conclusion: Dervan child Middle ear effusion protocol can be used in a cost efficient, scalable and sustainable method of screening children for Middle ear effusion. Tympanometry in selected high risk population is an accurate and reliable test for detection of Middle ear effusion

Acoustic Analysis of Crying Signal in Infants with Disabling Hearing Impairment

Crying is a multimodal, dynamic behavior and the first way to communicate. Early identification of hearing impairment is critical for prevention of speech and language disorders. The present study aimed to assess the acoustic features of infant's cry signals to find possible differences between two groups including hearing-impaired (HI) infants and normal hearing (NH) control. The data were collected from 34 (17 HI, 17 NH) infants under 2 months of age. Recording of the infant cry signals was collected during the examination of the Babinski reflex and was subsequently submitted for acoustic analysis. The total duration of the recording for each infant was approximately 30 seconds. The acoustical features included fundamental frequency (F0), formants (F1, F2, and F3), intensity, jitter, shimmer, ratios of F2/F1 and F3/F1, ratio of harmonic to noise, and voice break. The recording device was an Olympus ws-321M voice recorder with 44,100Hz sampling frequency in the stereo form. Praat analysis software (version 27, 3, 5) was used to analyze the crying signals. The data were then statistically analyzed using SPSS version 21. Acoustic analysis of the crying signals showed that HI infants have lower intensity and higher F0 and voice break than NH infants. However, the other differences were not statistically significant. The results of the present study demonstrated that the acoustic components including F0, intensity, and voice break may be used as indices to discriminate HI infants from NH infants under 2 months of age. These findings can be increased our knowledge concerning the functional mechanisms of the vocal organ in HI and NH infants.

The incidence and prevalence of hearing disorders in children according to the audiological screening

One of the important tasks of children's audiology is the early identification of hearing impairment in children and the timely commencement of rehabilitation activities, such as a hearing aid, and in the presence of deep hearing loss difficult to treat with traditional methods of hearing rehabilitation, cochlear implantation should be used. Currently, due to the introduction of objective methods of hearing evaluation in clinical practice,there is a real opportunity to detect hearing disorders in children from the βirst days of life including premature newborns. In this study, we analyzed data of hearing acuity audiological screening among children at the age of 0–17 years for the period from 2015 to 2016. During this period, 4,588,365 children were examined in 2015, and 4,562,489 children were examined in 2016, within the Republic of Kazakhstan.

A functional study on gentamicin-related cochleotoxicity in its conventional dose in newborns

SummaryThe early identification of hearing impairment allows for an intervention still in the “critical” and ideal period of hearing and language stimulation. Pediatric ototoxicity is a very controversial topic. There have been variable percentages of ototoxicity cases in children with different aminoglycosides antibiotics. The main pediatric groups whom receive aminoglycosides are newborns with severe infections on the neonatal ICU.Aimto check the functional aspect of the cochlear external hair cells and treatment regimens used to treat infections during the neonatal period.Study designExperimental.Materials and Methodswe studied 26 albino guinea pigs, through distortion product otoacoustic emissions, before and after the use of gentamicin.Resultsin all the assessments, the external hair cells functional status, studied by means of the distortion product otoacoustic emissions, proved preserved.ConclusionIn the present study, we did not notice changes in outer hair cell function in the albino guinea pigs treated with gentamicin in the doses of 4 mg/Kg/ day and 2.5 mg/Kg/day every 12 hours for 10 and 14 days.

Universal newborn hearing screening: knowledge of pediatricians and neonatologists in the city of Jundiaí, São Paulo, Brazil

IntroductionHearing loss has severe emotional, psychological, and social consequences. The early identification of hearing impairment is crucial. ObjectiveTo evaluate and quantify the knowledge of neonatologists, pediatricians, and residents in pediatrics regarding detection, risk factors, early diagnosis, and referral for rehabilitation of patients with neonatal hearing loss in Jundiaí, state of São Paulo, Brazil. MethodsThis was a cross-sectional contemporary cohort study including 47 physicians from three hospitals and a questionnaire with 15 items. ResultsMost of the respondents (83%) had received information about hearing loss in their medical courses, but had no knowledge of techniques for hearing evaluation, and degrees and types of loss. All physicians agreed that in the first six months of life, it is possible to evaluate hearing function and that it is the physician's responsibility to assess the newborn. Regarding the age that the child can receive auditory rehabilitation, the end of the first year and the second year of life predominates. ConclusionMost respondents know the risk factors for the detection of neonatal hearing impairment, know how to perform procedures, and recognize the importance of diagnosis of hearing loss and the need to refer suspected cases, but most do not know the techniques used to assess hearing in newborns.

Health Teachers' Perceptions and Teaching Practices Regarding Hearing Loss Conservation

Background Limited research has examined the role of school health personnel in the prevention and early identification of hearing impairment. Purpose This study assessed high school health teachers' perceptions and teaching practices regarding hearing loss conservation. Methods A 26-item survey based on selected components of the health belief model and self-efficacy was developed on hearing loss in students and their teaching practices regarding hearing loss conservation. A national random sample of 600 health teachers was obtained from the US Department of Education. Results A 3-wave mailing was used to achieve a 47% response rate (n = 281). One in 7 (15%) health teachers felt very confident in providing information regarding noise-induced hearing loss and 9% felt very confident in providing referral for students. Common hearing loss prevention topics taught were potential damaging effects of music/other sounds (30%), anatomy and physiology of hearing (16%), impact of hearing loss (15%), and sources of personal protection (15%). Discussion Results suggest that more training and information on hearing is needed and desired by health educators. Translation to Health Education Practice School health teachers need to assess threats to adolescent hearing loss and incorporate hearing loss conservation into the curriculum and serve as a resource person to others regarding this topic.

On the threshold of effective well infant nursery hearing screening in Western Sicily

ObjectiveTo determine the feasibility and effectiveness of well-infant nursery hearing screening programme for the early identification of hearing impairment, based on transient evoked otoacoustic emission (TEOAE) with a high “screen sensitivity” reducing the number of more expensive secondary level exams. MethodsThe newborns were screened by non-specialist health workers in well babies nursery at the twentieth day of life for 6 years consecutive. Based on PASS/FAIL criteria and presence/absence of audiological risk factors the newborns were divided into four groups each one with its personal step programme: G1 – PASS without risk factor, free to go home; G2 – PASS with risk factor, retest at the age of 7 months; G3 – FAIL without risk factor, re-screening after 2 weeks for a maximum of four times before audiology assessment; G4 – FAIL with risk factor, retest after 2 weeks. ResultsThe coverage rate increased progressively from 89.8% to 92%. The referral rate was 1.51% after second stage with a specificity value of 98.78%. The four-stage screening performed for G3 reduced the numbers of global audiology assessment to 0.91% with a final global specificity of 99.4±0.4%. ConclusionLess than 1% of infants underwent audiological assessment; the false positives resulted 0.62% with hearing loss global incidence of 2.95/1000 and a mean age of confirmation of 3.5 months of age. It is reasonable to think that this screening programme could be implement to overall 42 Western Sicily birth centres within few years.

School Nurses' Role in Identifying and Referring Children at Risk of Noise-Induced Hearing Loss

Young people are likely to experience noise-induced hearing loss (NIHL), as the use of personal listening devices and other damaging factors (e.g., video games) increases. Little research has examined the role of school health personnel in the prevention and early identification of hearing impairment. A 32-item, valid and reliable survey was developed regarding elementary and middle school nurses' practices concerning hearing loss screening and prevention. The survey instrument was based on the Stages of Change theory and the Health Belief Model. A random sample of 800 nurses was obtained from The National Association of School Nurses. A two-wave mailing was used to achieve a 58% response rate. Forty eight percent indicated there were not many educational programs that addressed NIHL in students. Performing hearing screenings routinely can help identify those students at risk. School nurses need to become advocates for policies and programs that mandate hearing screenings and educational programs to help reduce hearing loss.

Ideological Barriers to American Sign Language: Unpacking Linguistic Resistance

Although there have been significant advances in the status and use of ASL in the United States, there also have often been backlashes to such developments. The latter have typically been manifested in controversies over beliefs about the nature of ASL as a "real" or an "appropriate" language for study. This has been the case, for instance, in four particular areas: efforts to achieve official recognition of ASL, early identification of hearing impairment and ASL, the rise of ASL-English bilingual/bicultural education programs, and the teaching of ASL as a foreign language in educational institutions. In this article, the debate over the status of ASL is addressed as an example of ideological beliefs that impact linguistic judgments and policies. Also discussed are the major challenges to the status of ASL with respect to formal legislative recognition, its use as a medium of instruction, and its designation as a legitimate foreign language, all of which are both empirically and conceptually problematic. Further, it is suggested that the resistance to ASL is grounded in large part in a misunderstanding of the nature of human language and of the nature, structure, and history of natural sign languages in general and ASL in particular.