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Perceptions of pediatric primary care physicians on congenital hearing loss and cochlear implantation
Jeffrey D Carron1, Robert B Moore, Ajeet S Dhaliwal
1Dept. of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, School of Medicine, JacksonS 39216, USA.
Insights
Pediatricians in Mississippi generally understand congenital hearing loss diagnosis and treatment. Future education should focus on objective screening, early hearing aid intervention by six months, and cochlear implantation benefits.
Area of Science:
- Pediatrics
- Audiology
- Public Health
Background:
- Newborn hearing screening is recommended by the Joint Committee on Infant Hearing.
- Early diagnosis and intervention are crucial for language development in infants with sensorineural hearing loss.
- Pediatric primary care physicians play a vital role in managing congenital hearing loss.
Purpose of the Study:
- To assess Mississippi pediatric primary care physicians' knowledge of congenital hearing loss risk factors, diagnosis, and treatment.
- To evaluate understanding of cochlear implantation's role in pediatric hearing loss management.
Main Methods:
- A 16-question survey was mailed to Mississippi Academy of Family Physicians and American Academy of Pediatrics members.
- Response rate was 32% (160 out of 501 physicians).
Main Results:
- Most physicians answered the majority of questions correctly.
- Pediatricians generally had more correct responses than family practitioners.
- Physicians demonstrated general knowledge of congenital hearing loss diagnosis and treatment.
Conclusions:
- Mississippi primary care providers possess a good understanding of congenital hearing loss.
- Educational efforts should emphasize objective screening, hearing aid intervention by six months, and early cochlear implantation.
- Early intervention, including cochlear implantation, improves outcomes for prelinguistically deaf children.
Objective:
The Joint Committee on Infant Hearing recommends that all newborns undergo hearing screening during their hospital birth admission or before one month of age. Also, infants with certain risk factors should receive audiologic monitoring every six months until three years of age. Initial treatment of sensorineural hearing loss involves the use of properly fitted binaural hearing aids with cochlear implantation indicated for use in children ages twelve months and older that have derived limited benefit from amplification. Cochlear implantation before two years of age is associated with improved language acquisition. Pediatric primary care physicians are crucial to the diagnosis and treatment of congenital hearing loss. This study provides a baseline assessment of Mississippi pediatric primary care physicians' understanding of the risk factors, diagnosis, treatment options, and role of cochlear implantation with regard to congenital hearing loss.
Methods:
A single page questionnaire consisting of sixteen questions about newborn hearing loss and cochlear implantation was mailed to all active members of the Mississippi Academy of Family Physicians and the Mississippi Chapter of the American Academy of Pediatrics.
Results:
Of the 501 surveys mailed out, 160 surveys were returned completed for a resultant 32% response rate. Out of the 160 physicians returning the questionnaire, 50 were general pediatricians, 89 were family practitioners, and 21 were physicians who did not practice primary care medicine for pediatric patients. The majority of questions were answered correctly by all groups. In most instances, there was a significant statistical difference with the pediatrician group having more correct responses as compared to the family practitioner group.
Conclusions:
The data presented demonstrate that primary care providers for children within the state of Mississippi are generally knowledgeable about the diagnosis and treatment of congenital hearing loss. Aspects of newborn hearing loss diagnosis and treatment to emphasize in future education efforts include: understanding the necessity of objective screening measures for the diagnosis of hearing loss, the need for hearing aid intervention by six months of age, and the role of early cochlear implantation in the mainstreaming of prelinguistically deaf children.