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Confirmation of deafness in infancy
1Audiology Department, Whipps Cross Hospital, Leytonstone, London E11 1NR, UK.
Archives of Disease in Childhood
|October 16, 1999
Summary
Universal neonatal screening for hearing impairment identifies many infants, but diagnosis confirmation is delayed, especially for temporary conditions. Early audiological testing can reduce these delays in infant hearing loss diagnosis.
Area of Science:
- Pediatric Audiology
- Neonatal Screening
- Hearing Impairment Diagnosis
Background:
- Universal neonatal hearing screening aims for early identification of hearing loss.
- Delays in confirming diagnoses can impact intervention effectiveness.
- Understanding diagnostic delays is crucial for improving infant hearing healthcare.
Purpose of the Study:
- To assess diagnostic delays in infants identified with hearing impairment via universal neonatal screening.
- To investigate the causes contributing to these delays.
Main Methods:
- Analysis of data from 25,199 screened neonates using a two-stage TEOAE and ABR testing protocol.
- Evaluation of the positive predictive value (PPV) of ABR for permanent congenital hearing impairment (PCHI).
- Measurement of delays between initial identification and audiological certainty.
Main Results:
- A targeted PCHI was identified in 1.18/1000 neonates.
- ABR showed 100% PPV for PCHI at thresholds ≥80 dBnHL, confirming severe/profound deafness.
- Significant diagnostic delays occurred, particularly for temporary conductive impairments (up to 8 months).
Conclusions:
- Diagnostic confirmation of hearing impairments identified by screening is often delayed, except for severe/profound bilateral PCHI.
- Applying a battery of audiological tests in early infancy may reduce diagnostic delays.
- Further research is needed to optimize audiological testing protocols for infants.