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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
Benefit and pitfalls of newborn hearing screening
A Asma1, W H Wan Fazlina, A Almyzan
1Department of Otorhinolaryngology, Medical Faculty, Universiti Kebangsaan Malaysia, Jalan Yaakob Latif, 56000 Cheras, Kuala Lumpur, Malaysia.
Insights
Universal newborn hearing screening (UNHS) improved early diagnosis of hearing loss in infants. Despite progress in coverage and diagnosis age, high defaulter rates require attention for effective infant hearing care.
Area of Science:
- Audiology
- Neonatal Care
- Public Health
Background:
- Universal newborn hearing screening (UNHS) is crucial for early identification of hearing impairments in infants.
- Transient evoked otoacoustic emissions (TEOAE) are a reliable method for UNHS in full-term infants.
Purpose of the Study:
- To evaluate the effectiveness of UNHS using otoacoustic emissions (OAE) over a three-year period.
- To assess improvements in screening coverage, referral rates, and age of diagnosis.
- To identify challenges, such as defaulter rates, in the UNHS program.
Main Methods:
- A cross-sectional study conducted from April 2003 to December 2005.
- Screening of 13,598 newborns for hearing loss using portable otoacoustic emission (OAE) before discharge.
- Analysis of screening coverage, referral rates, age of diagnosis via auditory brainstem response (ABR), and defaulter rates.
Main Results:
- Screening coverage rates varied annually, with an overall rate of 85.9%.
- The mean age of hearing loss diagnosis significantly decreased over the study period, from 3.56 months in 2003 to 2.25 months in 2005.
- Defaulter rates at the third stage showed a decreasing trend but remained a concern, particularly in 2003 (35%).
Conclusions:
- The UNHS program demonstrated significant improvements in initial referral rates, coverage, and the age of hearing loss diagnosis.
- Despite advancements, high defaulter rates necessitate targeted interventions to ensure comprehensive infant hearing care.
- Continued efforts are needed to optimize the UNHS program and address follow-up compliance.
Abstract:
The importance of universal newborn hearing screening (UNHS) in identifying hearing-impaired infants as early as possible is already well recognized. Transient evoked otoacoustic emissions (TEOAE) have been established as a reliable method for UNHS in full term infants. This is a cross sectional study between April 2003--December 2005. Thirteen thousand five hundred and ninety eight (13,598) newborns were screened for hearing loss with portable otoacoustic emission (OAE) before discharge. The initial coverage rate during the 3 years study period was 85.9% (13,598) with 89.2% (3762), 79.0% (4480) and 90.3% (5356) for 2003, 2004 and 2005 respectively. The mean age when hearing loss was diagnosed using ABR were 3.56 months old, 3.08 months old, and 2.25 months old and 3.01 months old for 2003, 2004, 2005 respectively and it was statistically significant. The defaulter rate at the third stage during the 3 years study period was 35% (21), 15.2% (7) and 18.2% (2) for 2003, 2004 and 2005 respectively. This study showed significant improvement in initial referral rate, coverage rate and age of diagnosis. However, we need to improve on high defaulter rates.
