Implementation Of Newborn Hearing Screening Research Articles

Implementation of Newborn Hearing Screening in Albania.

Newborn hearing screening (NHS) was implemented in Albania in four maternity hospitals in 2018 and 2019. Implementation outcome, screening outcome, and screening quality measures were evaluated. Infants were first screened by midwives and nurses before discharge from the maternity hospital and returned for follow-up screening. Acceptability, appropriateness, feasibility, adoption, fidelity, coverage, attendance, and stepwise and final-referral rates were assessed by onsite observations, interviews, questionnaires, and a screening database. A post hoc analysis was performed to identify reasons for loss to follow up (LTFU) in a multivariate logistic regression. In total, 22,818 infants were born, of which 96.6% were screened. For the second screening step, 33.6% of infants were LTFU, 40.4% for the third, and 35.8% for diagnostic assessment. Twenty-two (0.1%) were diagnosed with hearing loss of ≥40 dB, six unilateral. NHS was appropriate and feasible: most infants are born in maternity hospitals, hence nurses and midwives could perform screening, and screening rooms and logistic support were supplied. Adoption among screeners was good. Referral rates decreased steadily, reflecting increasing skill. Occasionally, screening was repeated during a screening step, contrary to the protocol. NHS in Albania was implemented successfully, though LTFU was high. It is important to have effective data tracking and supervision throughout the screening.

Follow-upII of newborn hearing screening : Evaluation of afollow-upII facility after implementation of newborn hearing screening in Germany

With the implementation of newborn hearing screening, evaluation in terms of quality and goal achievement was required. The present study evaluates afollow-upII facility from 2009 to 2016. Data of 2705 newborns were retrospectively evaluated. The annual number of patients was analyzed, as well as the median age at first presentation, at diagnosis, and at treatment, each according to the reason for presentation and the diagnosis. From 2009 to 2016, the number of presented newborns increased by 91.4%. Newborns with abnormal initial screening or risk factors were presented significantly later than those for initial screening (median 5.3 and 8.0 vs. 4.6weeks, respectively; p < 0.001). Permanently or transiently hearing-impaired patients were presented and diagnosed significantly later than those with normal hearing (age at initial presentation 6.1 and 7.6 vs. 5.4weeks, p < 0.01 and p < 0.001, respectively; age at diagnosis11.4 and23.1 vs. 5.9weeks, respectively; p < 0.001). Permanent hearing loss was treated at the age of 14.1weeks. From 2009 to 2014, the age at first presentation and at diagnosis increased and subsequently mostly decreased until 2016. The age at first presentation and at diagnosis depends on the reason for presentation and on the diagnosis. Despite increasing patient numbers, the Joint Federal Committee (Gemeinsame Bundesausschuss, G‑BA) targets were met due to effective and efficient organizational structuring of the follow-upII facility. However, early admission to afollow-upII facility is aprerequisite for the success of newborn hearing screening.

Reading Achievement of Deaf Students: Challenging the Fourth Grade Ceiling.

Historically it has been reported that deaf students do not achieve age-appropriate outcomes in reading, with this performance often being characterized in terms of a fourth grade ceiling. However, given the shifts in the field during the past 20years (e.g., widespread implementation of newborn hearing screening, advances in hearing technologies), it would be timely to question whether this continues to serve as a meaningful benchmark. To this end, the purpose of this study was to investigate reading outcomes of a Canadian cohort of school-aged deaf learners (N = 70) who all used listening and spoken language as the primary mode of communication. Specifically, the goal was to establish whether their achievement approached that of their hearing age peers and to identify demographic factors influencing performance (i.e., gender, unilateral/bilateral hearing loss, personal amplification, level of auditory functioning, grade placement, additional disabilities, home language). Results indicate that participants obtained standard scores in the average range on both the Basic Reading and Reading Comprehension clusters of the Woodcock Johnson III-Diagnostic Reading Battery (Woodcock et al., 2004), surpassing the fourth grade reading achievement ceiling often reported for this population.

Modeling Postnatal Hearing Case Finding Within the Italian National Health System.

Objective: Despite the successful implementation of newborn hearing screening (NHS), a debate is emerging as to what should be the best means of enabling timely diagnosis and intervention for preschoolers with educationally significant sensorineural or conductive hearing impairment (HI) missed at the time of NHS or occurred after birth. Our study aims to document the proportion and characteristics of HIs diagnosed in children in need of audiologic assessment, in order to outline the optimization areas of an operational framework for auditory surveillance during preschool age.Method: The referral routes and outcomes of 730 audiological assessments performed in 3 years within the framework of the early hearing identification program in Trieste (Italy) were retrospectively analyzed.Results: Among 570/595 completed evaluations, an HI was diagnosed in 114 children, 73.7% of which presenting an exclusively conductive HI due to middle ear effusion. HIs were found in 36/141 who failed NHS, and 60/385 preschoolers who were referred by the primary care pediatrician's surveillance activity during well-child visits, with diagnostic yield of 25.5 and 15.5%, respectively.Conclusion: Ongoing preschool surveillance in primary care setting integrated into a NHS program is feasible to conduct and may effectively identify HIs that missed NHS or were related with a risk factor. New triage instruments and protocols for immediate audiology referral could allow to obtain the diagnosis of educationally significant conductive and sensorineural HIs ahead of the development concern and in the same way reduce patient mobility, thus optimizing timing efficiency and economic impact of the program.

Implementation of Newborn Hearing Screening in Rizal, Philippines, and Northern California: Lessons Learned

Objective. The universal newborn hearing screening program has been implemented in the Philippines for the past ten years. However, screening rates in the country are still low. The current study aimed to describe the universal newborn hearing screening program (UNHSP) delivery system in Rizal, Philippines, and Northern California. Methods. The study utilized a case study research design using data triangulation of FGD, KII, and document review to characterize and compare the implementation of the Universal Newborn Hearing Screening Program in Rizal Province and Northern California. Results. Several differences were found in the protocols for newborn hearing screening in Rizal, Philippines, and Northern California, including centralization of the program, availability of surveillance data, screening protocols, and tracking system. Conclusion. There is an immense need to disseminate universal newborn hearing screening among healthcare practitioners and create a system to monitor and evaluate real-time data.

Childhood hearing screening: achievements, difficulties, and possible ways to improve

Hearing impairment is the most common sensory impairment that is seen among adults and children. The frequency of congenital hearing loss is well-known due to implementation of newborn hearing screening. Hearing may change throughout a lifetime due to different factors and, therefore, the number of hearing impaired children increases with age. Introduction of universal newborn hearing screening has enabled earlier detection of hearing loss including unilateral and minimal disorders. Nevertheless, despite significant progress made in this field, there is still a group of hearing impairments that stay undiagnosed timely. Auditory neuropathy spectrum disorders, late-onset hearing loss, low-frequency and minimal hearing impairment are sometimes missed in newborn hearing screening or they manifest later. These types of hearing disorders are covered in detail in this review as well as possible ways of increasing the effectiveness of early diagnosis.

One Tool in the Toolkit Is Not Enough: Making the Case for Using Multisensory Approaches in Aural Habilitation of Children With Reduced Hearing

PurposeThis article proposes modifications to current rehabilitation methods for infants and children who are deaf or have reduced hearing. The widespread implementation of newborn hearing screening has resulted in numerous benefits to infants with reduced hearing and their families. Collectively, despite the enormous audiologic benefit that many children receive from both hearing assistive technologies and the provision of direct services aimed to support their development, numerous children with reduced hearing continue to perform below the levels of their counterparts with typical hearing in their ability to demonstrate age-appropriate functional use of language skills.ConclusionsStudies suggest that the brains of all infants and children (including those who are deaf, who have reduced hearing, and/or who utilize hearing assistance technology) benefit from the input of multiple senses. Cognitive neuroscience and hearing science suggest a significant benefit to engaging multiple modalities for communication and increasing the amount of information that is accessible to infants and young children who are deaf or hard of hearing.By using brain science to inform the rehabilitation of children with reduced hearing, this article concludes that therapy should be multimodal while minimizing use of discrete skills, thinking of language and communication opportunities as a continuum. Further recommendations for rehabilitation are provided.

Feasibility of infant hearing screening from a developing country context: the South African experience

Purpose: To explore the feasibility of infant hearing screening from a developing country context.Methods: A descriptive research design was employed, using a combination of surveys, questionnaires and face-to-face semi-structured interviews; as well as conduction of audiological measures such as otoacoustic emissions (OAEs) and automated auditory brainstem responses (AABR) during hearing screening. Participants comprised low–risk neonates, high-risk neonates and primary health care nursing managers.Results: Findings indicated that (1) screening at the Midwife Obstetric Unit 3-day assessment clinic may be more practical; (2) screening at primary health care clinics is not feasible until the identified barriers are addressed and; (3) factors such as ambient noise levels, availability of space for screening and time of discharge influence the practicability and efficiency of screening within a hospital context.Conclusion: There are a number of factors which influence the practicability and efficiency of newborn hearing screening. Each of these factors may vary depending on the level of healthcare setting and may either facilitate or act as barriers toward the implementation of newborn hearing screening in the South African context.

The HI HOPES data set of deaf children under the age of 6 in South Africa: maternal suspicion, age of identification and newborn hearing screening.

BackgroundIdentification of deafness before 3 months of age substantially improves the socio-linguistic and cognitive development of deaf children. Existing studies demonstrating the feasibility of newborn hearing screening in South Africa have used small samples unrepresentative of general population characteristics. This study establishes the characteristics of the largest data set of deaf infants and their families in South Africa on which there is baseline and longitudinal data (n = 532); explores its representativeness in terms of socio-demographic features and reports on access to and quality of newborn hearing screening within the sample. It examines specifically the relationship between age of maternal suspicion of childhood deafness and age of identification of deafness by cohort characteristics.MethodsSecondary analysis, using descriptive and inferential statistics, of a pre-existing longitudinal data set (n = 532) of deaf infants under 6 years of age, and their families, collected as routine monitoring of the HI HOPES (HH) early intervention programme.ResultsThe HH cohort is representative in terms of racial profile and private/public health care use but displays slightly higher level of maternal education and slightly lower socio-economic status than national comparators. 102 out of 532 infants had undergone newborn hearing screening, resulting in 29 true positives, 15 of whom would have met the criteria for targeted screening. Later onset deafness does not account for the 73 false negatives. The median age of maternal suspicion (n = 247) of infant deafness was 18 months; the median age of identification of 28 months. Age of identification was unrelated to private/public health care status. The median delay between age of suspicion and age of identification was significantly longer in the public sector (7 m; IQR 0–15 m) compared to the private sector (2 m; IQR 0–8.5 m) (p = 0.035). Age of suspicion was unrelated to level of maternal education. Earlier age of suspicion did not predict earlier identification.ConclusionTargeted screening as timely response to maternal suspicion offers a viable means to reduce substantially the age of identification of deafness in South Africa until implementation of newborn hearing screening on a population-wide basis can be justified.

EXPERIENCE IN THE USE OF AUDIOLOGICAL SCREENING IN TERMS OF VINNYTSIA NEONATAL CENTER

Recently, much attention is paid to the problem loss hearing by newborns, which is observed more often than other congenital lesions (phenylketonuria, Down’s syndrome, and others). The use of selective screening in modern terms has low diagnostic value. There have been shown the advantages of universal hearing screening in newborns. Recommendations for implementation of newborn hearing screening were formulated in Ukraine. There were shown the advantages of two-stage audiological screening, which includes registration of otoacoustic emissions in the first phase and auditory evoked potential - in the second. There were demonstrated present standards of effective screening: hearing screening should be extended to all newborns; screening method should help identify all children with significant bilateral hearing loss; false-positive results (children with normal hearing who didn’t pass the screening) should not exceed 3%; false-negative results (children with hearing impairment who passed the screening) should be 0%; there must be an effective communication system that would ensure transmission of the results of the screening test from the hospital to parents and responsible medical professionals who provide primary care and also direction of the newborns who have not undergone screening test to audiological examination. A brief analysis of the conduction of audiological screening was shown in terms of Vinnitsa neonatal center. It is noted that early detection of hearing impairment with subsequent rehabilitation is a determining factor for the further psycho-emotional and speech development of children.

The changing context for sign bilingual education programs: issues in language and the development of literacy

The widespread implementation of newborn hearing screening and advances in amplification technologies (including cochlear implants) have fundamentally changed the educational landscape for deaf learners. These changes are discussed in terms of their impact on sign bilingual education programs with a focus on the relationships between language and the development of literacy and the changing role of signed language in this process.

Trends in age of identification and intervention in infants with hearing loss.

In 1993, 11 hospitals in the United States were known to screen more than 90% of newborns for hearing loss. By 2000, approximately 1,000 hospitals reported screening at least 90% of their babies. This study was designed to identify trends in the age of identification and intervention for infants and young children with hearing loss in light of expanded implementation of newborn hearing screening. Parents of children under 6 yr of age with a confirmed hearing loss were surveyed. The survey instrument was designed to investigate three questions: 1) is the age of identification and intervention earlier for babies whose hearing is screened at birth compared with those whose hearing is not screened; 2) when hearing is screened at birth, do ages of diagnosis of hearing loss and intervention meet the guide-lines established in 2000, by the Joint Committee on Infant Hearing (Reference Note 1), and 3) what are the barriers to timely identification and intervention? Six hundred fifty-seven parents received the mailing. Responses of 151 parents of children with hearing loss, born between 1996 and 2000, were analyzed. Parents from 41 states provided information. Approximately half the children reported on were screened for hearing loss at birth. Age of identification and hearing aid fitting varied substantially based on degree of hearing loss and whether the cause of hearing loss was known or unknown; however, diagnosis and intervention occurred at an earlier age for infants screened at birth. Findings indicate that when hearing is screened at birth, infants with more severe degrees of hearing loss and an unknown cause tend to be identified and receive intervention within the 2000 timelines proposed by the Joint Committee on Infant Hearing. Barriers to timely identification and intervention are discussed. Before widespread implementation of newborn hearing screening, age of identification and intervention were consistently reported to exceed 2 yr of age. The results reported here indicate a trend toward earlier identification and hearing aid fitting with the implementation of newborn hearing screening. Although limited to literate and English speaking respondents, the study provides supporting evidence that newborn hearing screening lowers the ages of identification and intervention.

유소아 난청의 조기 진단과 치료

The goal of this thesis is to emphasize implementation of newborn hearing screening, audiologic assessment and early intervention. Newborn hearing screening alone will not assure early identification or positive outcomes for the development of communication and language. The development of communication and language requires input from a wide variety of professionals and consumers. Screening is only the first step in a comprehensive program, which must also include assessment and intervention. System development, equipment issues, followup procedures, data management and a tracking system are all pertinent factors. The goal of universal newborn hearing screening is to identify infants with hearing loss by 3 months of age and to provide appropriate intervention by 6 months of age then carry on their life with normal hearing persons. Early identification of hearing loss and rapid rehabilitative intervention are the two key elements that will give an infant the best chance to develop normal speech and allow the family members to make appropriate adjustments that will enhance communication in the home and social environment. The importance of early intervention with hearing aid fitting and the consideration of new technologies such as cochlear implantation are emphasized for the quality of life of hearing-impaired children. For the successful accomplishment of above goals, the multidisciplinary advisory board should be developed to help ensure input from relevant groups such as audiology, otolaryngology, pediatrics, nursing, hospital administration members of deaf community, educators of the deaf, parents of deaf children and social services. In conclusion, auditory screening test should be performed routinely for all newborn infants with the national compassionate insights and financial supports. (J Clinical Otolaryngol 2001;12:193-202)