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Published on: January 23, 2017
Pediatric primary care physicians' practices regarding newborn hearing screening
Danielle S Ross1, Susanna N Visser
1Centers for Disease Control and Prevention, Atlanta, Georgia.
Insights
Pediatric primary care physicians (PCPs) need better systems to receive infant hearing screening results. Improving infrastructure can enhance early detection and intervention for hearing loss in infants.
Area of Science:
- Pediatrics
- Public Health
- Audiology
Background:
- Hearing loss affects 2-3 per 1000 US infants annually.
- Pediatric primary care physicians (PCPs) are crucial for early identification and intervention.
- Current practices of PCPs regarding infant hearing detection and intervention require examination.
Purpose of the Study:
- To survey pediatric PCPs on their practices related to early hearing detection and intervention.
- To assess physician and practice variables associated with adherence to the 2007 Joint Committee on Infant Hearing guidelines.
Main Methods:
- Utilized data from the 2008 DocStyles survey.
- Examined patient, physician, and practice variables.
- Assessed actions consistent with the 2007 Joint Committee on Infant Hearing position statement.
Main Results:
- Group-setting pediatricians and those with heavier caseloads were more likely to receive hearing screening results.
- Few PCPs contacted state early hearing detection and intervention programs for infants who failed screening.
- Referrals for audiological/speech-language assessment were inconsistent, especially for at-risk children.
Conclusions:
- Improved infrastructure is needed for PCPs to receive and request infant hearing screening results.
- Enhanced reporting and coordination of follow-up services are essential for infants with hearing loss.
- Addressing gaps in PCP practices can improve outcomes for infants with hearing loss.
Objective:
Approximately 2 to 3 out of 1000 infants are born with hearing loss in the United States each year. Pediatric primary care physicians (PCPs) can play an important role in ensuring that infants with hearing loss are identified early and provided appropriate services. In this study, pediatric PCPs were surveyed about their practices regarding early hearing detection and intervention.
Methods:
Responses from the 2008 DocStyles survey were used to examine patient, physician, and practice variables associated with actions consistent with the 2007 Joint Committee on Infant Hearing position statement, which includes follow-up protocols for medical home providers.
Results:
Pediatricians working in a group setting were more likely to receive hearing screening results than were those in individual practices or hospitals and clinics. Family/general physicians with heavier caseloads were more likely to receive hearing screening results for their pediatric patients than were those with lighter caseloads. Few pediatric PCPs reported contacting their state's early hearing detection and intervention program if they knew that an infant failed the newborn hearing screening. Although high proportions of pediatric PCPs reported referring an infant with hearing loss to an otolaryngologist, only about half reported referring a child with risk factors for hearing loss for audiological and speech-language assessment, even if the parents expressed concern or if the results of a developmental screening indicated a possible delay. Few respondents reported referring an infant with hearing loss under their care to an ophthalmologist.
Conclusions:
This study highlights the need to improve infrastructure for pediatric PCPs to receive and request infant hearing screening results to facilitate reporting and coordinate follow-up services for infants identified with hearing loss.
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