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Early identification of hearing loss and centralized newborn hearing screening facility-the Cochin experience
1Cochin Hospital, Cochin, Kerala. abrahamkpaul@gmail.com
Insights
Early detection of infant hearing loss is crucial for development. A practical, two-stage screening using otoacoustic emissions (OAE) and auditory brainstem response (ABR) can be a model for developing countries.
Area of Science:
- Pediatrics
- Audiology
- Public Health
Background:
- Congenital hearing loss is a common birth defect impacting speech and cognitive development.
- Early detection and intervention before six months are critical for optimal outcomes.
- Current screening protocols are often lacking in many hospitals.
Purpose of the Study:
- To propose a practical and viable two-stage hearing screening protocol for newborns.
- To establish a model screening program for replication in other cities and developing countries.
Main Methods:
- A two-stage screening approach: initial screening with otoacoustic emissions (OAE).
- Follow-up screening with auditory brainstem response (ABR) for infants who fail OAE.
- Centralized facility model to serve multiple hospitals.
Main Results:
- The proposed two-stage protocol is practical and cost-effective.
- It targets more expensive ABR testing only for infants who fail initial OAE screening.
- A centralized facility model enhances program viability.
Conclusions:
- The described two-stage hearing screening program is a practical and replicable model.
- It addresses the need for early detection of infant hearing loss in resource-limited settings.
- Implementation can improve developmental outcomes for newborns with hearing impairments.
Abstract:
Significant hearing loss is one of the most common major abnormalities present at birth. If undetected, it will impede speech, language and cognitive development. Significant bilateral hearing loss is present in 1 to 3 per 1000 new born infants in the well-baby nursery population and in 2 to 4 per 100 infants in the intensive care unit population. It is an established fact that if hearing loss is present it should be detected and remediated before the baby is 6 months old. Neither universal screening nor a high risk screening, exists in majority of the hospitals in our country. In such a situation, a centralized facility catering to all hospitals in the city is a practical option. A two-stage screening protocol is projected, in which infants are screened first with otoacoustic emissions (OAE). Infants who fail the OAE are screened with auditory brainstem response (ABR). This two tier screening program (the second tier being ABR, which is more expensive) is required only for a selected few, making the program more practical and viable. It is the practicability of this program that makes it relevant for replication in other cities of the country, making it a model screening program for any developing country.
