Hearing Screening Research Articles

The Construction and Application of an Internet-based Hospital-community-family Home Management Model

Objective: Based on the software, this study aims to develop a hospital-community-home management model and evaluate the impact of nursing interventions provided by home visiting nurses, aligning with national healthcare policies in China. Methods: In the Dongying area, hospitals collaborate closely with local communities and families to facilitate the smooth implementation of Internet + Nursing Services. Patients schedule appointments for a range of medical care services through mobile phone software, with staff accessing orders through the platform to provide professional treatment and nursing care to patients. Results: Currently, there are 214 registrants from 50 departments on the platform. From September 2021 to June 2023, a total of 3529 cases were handled the platform. The top 10 order items included heel blood collection (944 cases), graphic consultation (526 cases), neonatal jaundice measurement (463 cases), neonatal hearing screening (418 cases), gastrostomy tube care (368 cases), catheterization care (192 cases), venous blood sampling (155 cases), postpartum mammary gland unblocking (103 cases), surgical wound care (92 cases), PICC catheterization care (57 cases), and pressure tube placement care (57 cases). Conclusion: The hospital has successfully established a hospital-community-family home nursing model with specialist nurses playing a central role. Through the implementation ofInternet + Nursing Service, medical staff are able to provide quality medical and nursing care to patients who are unable to leave their homes, significantly improving patient convenience and conserving medical resources.

Breaking Sound Barriers: Exploring Tele-Audiology's Impact on Hearing Healthcare.

Hearing impairment is a global issue, affecting billions of people; however, there is a gap between the population affected by hearing loss and those able to access hearing healthcare. Tele-audiology, the application of telemedicine in audiology, serves as a new form of technology which aims to provide synchronous or asynchronous hearing healthcare. In this article, we reviewed some recent studies of tele-audiology-related topics to have a glimpse of the current development, associated challenges, and future advancement. Through the utilization of tele-audiology, patients can conveniently access hearing healthcare, and thus save travel costs and time. Recent studies indicate that remote hearing screening and intervention are non-inferior to the performance of traditional clinical pathways. However, despite its potential benefits, the implementation of tele-audiology faces numerous challenges, and audiologists have varying attitudes on this technology. Overcoming obstacles such as high infrastructure costs, limited reimbursement, and the lack of quality standards calls for concerted efforts to develop effective strategies. Ethical concerns, reimbursement, and patient privacy are all crucial aspects requiring in-depth discussion. Enhancing the education and training of students and healthcare workers, along with providing relevant resources, will contribute to a more efficient, systematic hearing healthcare. Future research will aim to develop integrated models with evidence-based protocols and incorporating AI to enhance the affordability and accessibility of hearing healthcare.

Psychometric Validation of a Hearing Screening Questionnaire for Preschoolers Based on Language Development Evaluation by Caregivers

Introduction: This study aimed to validate three age-adjusted versions of a Hearing Screening Questionnaire for Preschoolers, in Brazilian Portuguese, based on parents’ perception of their children’s hearing and oral language. Methods: Psychometric validation was conducted on three questionnaires, each comprising nine items with yes/no responses. Three items focused on hearing screening at birth, and six assessed hearing and oral language. The study included 152 parents and their children, who attended daycare centers in Belo Horizonte, Brazil. The children were categorized into three age bands: 12–18 months, 19–35 months, and 36–48 months. Audiological assessments, including tympanometry, transient-evoked otoacoustic emissions (TEOAE), and pure-tone audiometry (when applicable), were performed on the children. In case of abnormal findings in the previous exams, auditory brainstem response (ABR) testing was conducted. Descriptive data, false alarm, and false-negative analyses were carried out. Results: Considering any type of hearing loss, whether unilateral or bilateral, the questionnaires showed a false-negative rate of 41.17% (7/17 children). However, when considering only bilateral hearing loss, the questionnaire showed a false alarm rate of 31.69% (45/142) and a false-negative rate of 30.0% (3/10). When focusing exclusively on sensorineural hearing loss, the questionnaire identified two children (1.31%), with a false-negative rate of 0% but a false-positive rate of 33.33%. Conclusion: Language-development-oriented questionnaires allowed quick screening of potential hearing loss in preschoolers. This study found a robust hit rate with these questionnaires. Their validation signifies a promising and cost-effective tool for conducting hearing screenings in preschool children, especially in nations lacking a comprehensive school screening policy. The validated questionnaire affords an easy-to-apply, low-cost, and effective instrument for preschool hearing screening.

Hearing Screening of Newborns and Infants by Otoacoustic Emission

Introduction: This study was undertaken to assess the hearing of newborns and infants using otoacoustic emission as a screening tool. Screening of hearing impairment in infants is done before the third month of life, and intervention, if any, required by the age of 6 months is of prime importance. The aim of this study was to screen 215 newborns for hearing.Materials and Methods: About 215 neonates and infants were included after a thorough ENT examination and history taking. Two stage DPOAE was done on the newborns with 2, 3, 4, and 6 kHz frequencies in both ears. Newborns who failed the first OAE in any ear were tested for a second OAE in both ears within 15 days to 3 months.Result: Out of 215 cases, 10.2% (n = 22) babies had referred results for 1st DPOAE in which low birth weight, prematurity, respiratory distress syndrome, post-natal sepsis, and maternal anemia and pregnancy-induced hypertension were among the identified infantile and maternal risk factors respectively. For these infants, repeated DPOAE screening was done. On repeat DPOAE testing, all babies passed the DPOAE 2nd test.Conclusion: This study was an attempt to show the importance of developing a hearing screen with DPOAE when repeated appropriately. The hearing of all infants should be screened at no later than one month of age; those that do not pass screening should have a comprehensive audiological evaluation at no later than three months of age, and infants with confirmed hearing loss should receive appropriate intervention by six months of age.

Economic evaluation of newborn deafness gene screening as a public health intervention in China: a modelling study

BackgroundWhile global newborn hearing screening programmes (NHSP) are far from the optimal level, the combined hearing and genetic screening has emerged as an innovative approach of early healthcare interventions. There...

The Impact of Post-Birth Timing on OAE Test Efficacy: An Observational Analysis of Neonatal Hearing Screening.

The online version contains supplementary material available at 10.1007/s12070-024-04700-0.

Awareness of hearing loss in newborns and newborn hearing screening facilities among parturient

Awareness of hearing loss in newborns and newborn hearing screening facilities among parturient

Geographic, Sociodemographic, and Clinical Factors Associated With Parental Self-Efficacy in Pediatric Patients With Hearing Loss.

To identify geographic, sociodemographic, and clinical factors associated with parental self-efficacy in a diverse cohort of deaf or hard-of-hearing (DHH) children. Cross-sectional study. Tertiary children's hospital. Four hundred forty parents of DHH children aged 0 to 17 completed the 25-item Scale of Parental Involvement and Self-Efficacy (SPISE) survey from 2014 to 2022. Residential addresses were geocoded and assigned Area Deprivation Index and Social Vulnerability Index rankings, and univariable and multivariable analyses were conducted using sociodemographic and clinical variables, including sex, race/ethnicity, insurance type, survey language, age at the survey, comorbidities, newborn hearing screening results, and hearing loss laterality and severity. Compared to English and Spanish-speaking parents, Chinese-speaking parents were associated with overall lower parental self-efficacy and involvement (regression coefficient = -0.518, [-0.929, -0.106]), Cohen's d = 0.606) and lower scores on items related to their ability to affect multiple aspects of their child's development and expression of thoughts as well as competency in checking and putting on their child's sensory device. Across univariable and multivariable analyses, besides Chinese language, all other sociodemographic, clinical, and geographic variables were not associated with SPISE score. To achieve the best patient outcomes, care teams can use the SPISE to evaluate parental self-efficacy and provide targeted support to parents at risk for having lower knowledge and confidence scores about critical skills necessary to facilitate their child's auditory access and language development. Notably, this study found similar reports of parental efficacy across various sociodemographic, clinical, and geographic variables but significantly lower SPISE scores in Chinese-speaking families.

Epidemiology, aetiology and diagnosis of congenital hearing loss via hearing screening of 153 913 newborns.

Congenital hearing loss (HL), one of the most common paediatric chronic conditions, significantly affects speech and language development. Its early diagnosis and medical intervention can be achieved via newborn hearing screening. However, data on the prevalence and aetiology of congenital HL in infants who fail newborn hearing screening are limited. The sample population included 153 913 infants who underwent newborn hearing screening, and the prevalence of congenital HL, defined as moderate to profound bilateral HL (BHL) or unilateral HL (UHL) (≥40 dB HL), in one prefecture of Japan was measured to minimize the loss-to-follow-up rate, a common factor affecting the screening procedure. Comprehensive aetiological investigation, including physiology, imaging, genetic tests, and congenital cytomegalovirus screening, was performed on children diagnosed with congenital HL. The calculated prevalence of congenital HL was 1.62 per 1000 newborns (bilateral, 0.84; unilateral, 0.77). More than half of the cases with congenital bilateral or severe to profound UHL showed genetic aetiology or cochlear nerve deficiency (CND), respectively. Approximately 4% and 6% of the cases of congenital BHL and UHL were associated with congenital cytomegalovirus infection and auditory neuropathy spectrum disorder, respectively. This is an epidemiological and comprehensive aetiological study of congenital HL, as determined via newborn hearing screening according to its severity and laterality, in a large-scale general population of a developed country. Our findings can serve as a reference for optimizing care and intervention options for children with HL and their families.

Cost-effectiveness of Neonatal Hearing Screening Programs: Systematic Review.

Introduction Universal newborn hearing screening (UNHS) has been widely and strongly advocated as an early detection strategy for hearing loss in children. This intervention aims to prevent delays in speech and language development, which, in turn, has long-term beneficial effects on the social and emotional development and quality of life of individuals. However, the implementation of UNHS programs is circumstantial in different settings, for different reasons. Objectives The present systematic review aimed to identify whether the implementation of UNHS programs are cost-effective, as well as their variations by localities. Data Synthesis A search was conducted in seven databases: PubMed (Medline), Scopus, Web of Science, Embase, CINAHL, Lilacs, and Cochrane Library. Studies that included a cost analysis of UNHS programs were eligible for inclusion. Studies on evaluations of preschool or school-based programs only were excluded, among others. A total of 1,291 records were found. Of these, 23 articles were analyzed in full. All articles identified the cost-effectiveness of the UNHS programs implemented. Regarding the UNHS protocols, a wide variation was observed in all aspects: tests used, period established between tests and retests, professionals responsible for screening, environment, and criteria for defining hearing loss, limiting the generalization of this information. All studies presented values related to the expenses with the program, but none of them showed statistical elements for the described analyzes or any theoretical basis for such. Conclusion It is necessary to estimate local specific issues, as well as the accuracy of the chosen tests and the NHS protocols used, so that more accurate analyzes on cost-effectiveness are possible.

Newborn and infant hearing screening for early detection of hearing loss in Nairobi, Kenya.

Early detection of hearing loss and subsequent intervention leads to better speech, language and educational outcomes giving way to improved social economic prospects in adult life. This can be achieved through establishing newborn and infant hearing screening programs. To determine the prevalence of hearing loss in newborns and infants in Nairobi, Kenya. A cross-sectional pilot study was conducted at the National hospital and at a sub county hospital immunization clinic. A total of 9,963 babies aged 0-3 years, were enrolled in the hearing screening program through convenient sampling over a period of nine months. A case history was administered followed by Distortion Product Oto-acoustic emissions (DPOAEs) and automated auditory brainstem response (AABR) hearing screening. The screening coverage rate was 98.6% (9963/10,104). The referral rate for the initial screen was 3.6% (356/ 9,963), the return rate for follow-up rescreening was 72% (258 babies out of 356) with a lost to follow-up rate of 28% (98/356). The referral rate of the second screen was 10% (26/258). All the 26 babies referred from the second screen returned for diagnostic hearing evaluation and were confirmed with hearing loss, yielding a prevalence of 3/1000. Establishing universal newborn and infant hearing screening programs is essential for early detection and intervention for hearing loss. Data management and efficient follow-up systems are an integral part of achieving diagnostic confirmation of hearing loss and early intervention.

Automated ABR and MMN extraction using a customized headband for hearing screening

ObjectiveStimuli-elicited EEG responses, known as Event-Related Potentials (ERPs), reflect the health status of underlying electrophysiological processes and are frequently used for scanning sensory pathways. Current ERP extraction systems are expensive, complex, and bulky. This study aims to overcome these limitations by developing and validating a bimodal auditory ERP extractor headband. MethodsAn affordable, portable bimodal auditory ERP extractor was developed and validated for ABR (Auditory Brainstem Response) and MMN (Mismatch Negativity) response interpretation. Auditory stimuli were created using Presentation software. Adaptive filtering-based extraction was performed in EEGLAB (MATLAB) to derive the neural inferences. Extracted responses from n = 5 young adults were validated against CE-certified acquisition systems used in clinical practice. ResultsValidation results showed the grand average responses of ABR and MMN for n = 5 subjects matched. Furthermore, with and without stimuli ERP analysis showed significant differences for identified features (p = 0.00794 for ABR wave-V amplitudes, p = 1.22 * 10−5, and p = 2.62 * 10−5 for MMN peak latencies and area under the curves), ensuring that the response was due to the presented auditory stimuli. ConclusionThe results confirm the competency of the developed system to obtain MMN and ABR from young adults. A clear contrast between latency-amplitude scatter plots further ensures the competency of a developed system to acquire ABR and MMN. SignificanceThe novelty of the study is an easy-to-operate, affordable ERP extractor with adaptive filtering, wearable design, and configurable stimuli. This system can be a potential solution for large-scale hearing screening, providing detailed neural insights, including averaged responses and inter-trial variabilities.

Effects of Natural Delivery and Cesarean Section on the Result of First Hearing Screening of Newborns.

Early detection and intervention of hearing issues in newborns are crucial for their auditory and speech development, necessitating newborn hearing screenings. This study aimed to investigate the impact of delivery methods, specifically natural delivery and cesarean section, on newborn hearing screening outcomes. A retrospective analysis was conducted on data from 600 newborns delivered at The First Affiliated Hospital of Shaoyang University between January 2020 and January 2023. The initial hearing screenings used the AccuScreen otoacoustic emission instrument. The study examined the influence of delivery method on the pass rates of newborns' first hearing screenings within and beyond 48 h postbirth. The pass rates for the initial hearing screenings, conducted within and after 48 h of birth, were significantly higher in the natural delivery group compared to the cesarean section group (P < 0.05). Furthermore, multivariate analysis identified the delivery method as a significant factor influencing the pass rates of newborns' first hearing screenings. The mode of delivery appears to affect the results of the initial hearing screenings of newborns, though further research is needed to validate these findings.

Distortion-Product Otoacoustic Emission of Cochlear Hair Cells in Pediatric Patients Presenting with Various Perinatal Morbidities

Background: Hearing plays a substantial role in the growth of intellect- as well as language-related abilities in children. Congenital hearing loss leads to deficiency and defects in the growth of various abilities such as speech leading to emotional distress. The aim of our study was to detect cochlear hair cell damage in various perinatal morbidities as measured from distortion-product otoacoustic emission (DPOAE) in the pediatric age group. Materials and Methods: A 1-year prospective observational study was conducted on 65 children comprising 28 pediatric and 37 neonatal patients attending a tertiary care hospital. Results: Among 65 children, 25% of patients having perinatal risk factors failed the OAE test. The majority of neonates passed the OAE test (97.3%) as compared to the pediatric age group (60.7%). The most common risk factor associated with OAE “fail” was neonatal jaundice (100%), followed by low birth weight (35%) and respiratory distress (36%). We found no relation of “fail” OAE test with the Apgar scale (4–6). The mean signal–noise ratio (SNR) variable was highest in the frequency range of 4 and 6 kHz in neonates with statistically significant values for the frequency band of 2, 4, and 6 kHz. The above findings confirmed that the OAE recordings observed in the group of children were reliable. Conclusion: The SNR variable of DPOAE is an effective and reliable screening tool at particular frequencies. Emphasis on hearing screening using OAE should be prioritized in cases of neonatal jaundice and respiratory distress and also for patients in the age group from &gt;1 month to 12 years.

Positive Impact of an Educational Brochure on Follow-Up for a Formal Hearing Evaluation.

Half of older persons experience serious hearing loss, yet it remains under-assessed in primary care clinics. Providers note time constraints as barriers and patients often minimize or deny their hearing loss. We tested the effectiveness of a simple hearing screen in primary care settings and whether including a brochure describing hearing loss, its consequences, and treatment would increase referrals for formal audiometric assessments. We designed a longitudinal effectiveness study assessing three interventions: Screening alone; Screening plus a brochure handed to the person testing positive; and Screening plus the brochure with a brief review. The screening was accomplished by intake personnel. The results of a positive screen were given to the primary care practitioner. The approach was designed to enable its use across a range of primary care settings. Follow-ups occurred at 4 and 8 months. A total of 111 older adults attending 7 primary care clinics screened positive for having possible hearing loss by intake personnel. A total of 46 received the educational brochure. Physicians discussed test results with two-thirds yet recommended further testing for only half of the participants. Physician recommendations were strongly motivating (OR = 9.12, 95% CI: 3.54-23.52) and those receiving the brochure were still more likely to seek further testing (OR = 2.61, 95% CI: 1.07-6.36) even when physician recommendations were controlled. Additionally, when combined, the 2 options were strongly motivating: all participants receiving both a referral and a brochure sought further testing. A simple screen and educational brochure on hearing loss improved follow-up for a formal hearing evaluation which may improve hearing health care and minimize negative outcomes. The study also identified barriers to implementation, including how to motivate practitioners and assist intake personnel in integrating hearing screening into their routine intake procedures, supporting further research. Clinical Trials Registration Number: NCT0203713 9.

Barriers to Hearing Health Care for Aging Adults: Reframing the Conversation.

Untreated age-related hearing loss (ARHL) is associated with poor health and social outcomes. Treating hearing loss can mitigate these serious issues. Although there are documented barriers to care, we can look at these barriers and potential solutions differently if we view ARHL as a gradual onset, chronic condition. This provides a framework from which to solve problems in line with how other chronic health conditions experienced by aging adults are approached. With this lens, it becomes evident that early identification and treatment of ARHL can be supported by universal senior hearing screening, appropriate Medicare coverage for devices and services, and direct access to audiological care as well as avenues for self-care are necessary ingredients to change the hearing health care landscape.

Family-Perceived Barriers and Facilitators Toward a Tele-Audiology Infant Diagnostic Testing Approach in Victoria, Australia.

Background: Universal newborn hearing screening programs allow for early identification of congenital hearing loss. However, some families experience difficulties accessing diagnostic audiology services following a refer screen result. Methods: This study aimed to assess the opinions of families who had experienced infant diagnostic audiology assessments regarding a telehealth option for these appointments within Victoria, Australia. Families who attended in-person infant diagnostic audiology appointments were sent a questionnaire exploring their experiences of the service and their opinion regarding a proposed telehealth option for infant diagnostic audiology (50 responses received). These results were also compared to those of families who were surveyed following testing in 2020, where the audiologist conducted the appointment remotely to comply with COVID-19-related social distancing recommendations at the time (10 responses received). Results: There were not significant differences between the duration or number of appointments, perceived understanding of results, or concerns regarding a tele-audiology model between families who experienced face-to-face and tele-audiology infant diagnostic audiology appointments. Opinions of infant diagnostic audiology appointments utilizing telehealth technology were largely positive, and minimal technological difficulties were identified. Conclusion: Overall positive attitudes of many families with infant diagnostic appointment experiences toward a tele-audiology option of this service suggest that offering a telehealth model of appointments may be an appropriate model to improve service access for families requiring infant diagnostic audiology in Victoria.

Newborn Hearing Screening Results for Infants With Prenatal Opioid Exposure in Southern Appalachia.

Infants prenatally exposed to opioids exhibit withdrawal symptomology that introduce physiological noise and can impact newborn hearing screening results. This study compared the referral rate and physiological noise interpreted by number of trials rejected due to artifact on initial newborn hearing screenings of infants with prenatal opioid exposure (POE) and infants with no opioid exposure (NOE). Furthermore, within the POE group, it examined the relationship of referral rates with severity of withdrawal symptomology, and with maternal and infant risk factors. This study used a retrospective cohort design of electronic medical records from six delivery hospitals in South-Central Appalachia. Newborn hearing screenings were conducted using automated auditory brainstem response (ABR) for 334 infants with POE and 226 infants with NOE. Severity of withdrawal symptomology was measured using the Modified Finnegan Neonatal Abstinence Scoring Tool, which includes observation of behaviors that introduce physiological noise. There was no significant difference in newborn hearing screening referral rate between infants with POE and infants with NOE. Referral rate was not affected by maternal or infant risk factors. Infants with POE had statistically significant higher artifact (defined as rejected ABR sweeps) than infants with NOE. There was a strong positive correlation between Finnegan scores and artifact but not referral rates. Sensitivity and specificity analysis indicated artifact decreased substantially after Day 4 of life. Referral rates of infants with POE were similar to those of infants with NOE. Nevertheless, the withdrawal symptomology of infants with POE introduces physiological noise reflected as artifact on ABR, which can affect efficiency of newborn hearing screenings.

Postponement of the Newborn Hearing Screening during the COVID-19 Pandemic; Parental Experiences and Worries.

Early identification of hearing loss through newborn hearing screening followed by an early start of intervention has proven to be effective in promoting speech and language development in children with hearing loss. During the COVID-19 pandemic, newborn hearing screening was postponed for a group of newborns in the Netherlands. Therefore, meeting the guidelines for early identification was at risk. In this study, we examine parental attitudes, beliefs, and experiences concerning the hearing screening during the COVID-19 pandemic. Our results indicated that parents (n = 1053) were very positive about newborn hearing screening and their experiences with the screening, even during the COVID-19 pandemic. Parents' beliefs on the information provision around newborn hearing screening were more inconsistent. The results showed that parents with a postponed hearing screening felt less informed about the hearing screening than parents without a postponed screening. Furthermore, child and family characteristics affected how parents experienced newborn hearing screening. Parents with a premature child were more worried about the hearing abilities of their child before the screening took place. The results also indicate that deafness in the family might lead to parental worries around newborn hearing screening.

The Cost Effectiveness of Newborn Hearing Screening Program: New Approach of Iran Ministry of Health and Medical Education in 2022

Background: In Iran’s newborn hearing screening (NHS) program, OAE and AABR are administered to early identify hearing impairment in the primary health care (PHC) system. Objectives: The aim of this study was to conduct a cost-effectiveness analysis of this program integrated into Iran's health system. Methods: We examined the cost-effectiveness of AABR and OAE screening procedures in infants less than 1 month old. TreeAge 2022 software was used for cost-effective modeling. In this study, QoL and QALY were considered as the outcome measures. To evaluate the robustness of the modeling results, we used one-way sensitivity analysis. A ± 20% variation was utilized to determine target variables and estimate the costs per identification. Results: In 2022, a total of 1,106,072 babies were born in Iran, of whom 1,006,293 underwent hearing impairment screening (coverage rate: 90.97%). Overall, 3,359 of the newborns screened were diagnosed with hearing problems, indicating a mean prevalence of 3.3 per 1000 births. The ICER was equal to 3297.2 US PPP (Purchasing Power Parity) per QALY. According to our results, the dominant cost-effective strategy for hearing impairment screening was OAE plus AABR. After 1000 iterations, the second cost-effective strategy was found to be OAE alone, according to Monte Carlo simulation modeling. Conclusions: In this study, we evaluated the cost-effectiveness of the NHS program for detecting hearing impairment in over a million births in Iran. A two-step screening approach, including OAE and AABR, was found to be the dominant cost-effective strategy to identify newborns with hearing impairment.