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Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
The status of diagnostic testing following referral from universal newborn hearing screening
1Kosair Children's Hospital, Louisville, Kentucky 40292, USA.
Insights
Most Kentucky centers fail to meet infant hearing screening guidelines. Few infants receive genetic evaluations or amplification services, impacting early intervention for hearing loss.
Area of Science:
- Pediatric Audiology
- Early Hearing Detection and Intervention (EHDI)
Background:
- The Joint Committee on Infant Hearing (JCIH) 2000 position statement outlines critical guidelines for Early Hearing Detection and Intervention (EHDI) programs.
- These guidelines specify a comprehensive audiologic test battery for infants who do not pass newborn hearing screening.
Purpose of the Study:
- To evaluate adherence to JCIH guidelines by follow-up diagnostic testing centers for infants in Kentucky.
- To assess the provision of genetic evaluations and amplification services for infants with identified hearing loss.
Main Methods:
- Reviewed services offered by 42 centers in Kentucky providing diagnostic testing for infants failing newborn hearing screening.
- Compared services against the recommended audiologic test battery outlined by the JCIH, including electrophysiologic measures (ABR, bone-conducted ABR), OAEs, high-frequency tympanometry, and acoustic reflexes.
Main Results:
- Only 3 out of 42 (7%) centers in Kentucky fully comply with the JCIH diagnostic test battery guidelines.
- Fewer than 50% of infants diagnosed with hearing loss are referred for audiology-led genetic evaluations.
- Only 19 out of 42 (45%) listed sites offer amplification services for infants with hearing loss.
Conclusions:
- Significant gaps exist in Kentucky's EHDI program, with most centers not adhering to recommended diagnostic protocols.
- Inadequate referral for genetic evaluations and limited access to amplification services hinder comprehensive care for infants with hearing loss.
Abstract:
The Joint Committee on Infant Hearing 2000 position statement includes guidelines for the development of Early Hearing Detection and Intervention programs. These guidelines provide specific recommendations for the audiologic test battery for infants who fail a newborn infant hearing screening. The recommended test battery includes electrophysiologic measures such as the ABR, frequency specific electrophysiologic tests, bone-conducted ABR, OAEs, tympanometry using high frequency probe stimuli, and acoustic reflexes. In the Commonwealth of Kentucky, 42 centers are listed as providing follow-up diagnostic testing services for infants failing the newborn hearing screening. The purpose of this investigation was to determine how many of these centers were abiding by the Joint Committee guidelines. Results show that only three of 42 centers listed are providing services that meet the guidelines. Less than 50% of infants identified with hearing loss are referred for genetic evaluations by the audiologist. Only 19 of the 42 sites listed provide amplification services for infants identified with hearing loss.
