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Newborn hearing screening protocol in tuscany region
Stefano Berrettini1, Paolo Ghirri2, Francesco Lazzerini1
1Otolaryngology Audiology and Phoniatric Unit, University of Pisa, Pisa, Italy.
Insights
Tuscany updated its universal newborn hearing screening protocol in 2016 to better identify congenital hearing loss and manage risks for progressive or acquired hearing loss. The revised guidelines emphasize the pediatrician's role and align with current treatment standards.
Area of Science:
- Audiology
- Public Health
- Pediatrics
Background:
- Newborn hearing screening is crucial for early identification and intervention in hearing-impaired children.
- Tuscany, Italy, mandated universal newborn hearing screening in 2007, with initial guidelines issued in 2008.
- The region has updated its screening protocol based on experience and scientific literature.
Discussion:
- The revised 2016 protocol addresses risk factors for auditory neuropathy and late-onset/progressive/acquired hearing loss.
- It aims to identify congenital moderate-to-profound hearing loss while providing audiological follow-up and surveillance guidance.
- The updated guidelines highlight the role of family pediatricians in screening and audiological care.
Key Insights:
- The protocol evolution incorporates lessons learned and scientific evidence to improve newborn hearing screening.
- Emphasis is placed on comprehensive audiological management for infants with identified hearing loss or risk factors.
- Integration of pediatrician involvement and adherence to national Health Technology Assessment (HTA) guidelines are key features.
Outlook:
- Continued refinement of screening protocols to enhance early detection rates.
- Strengthening the collaborative role between audiologists and pediatricians for optimal child hearing health.
- Implementing evidence-based treatment strategies, including hearing aids and cochlear implants, for improved outcomes.
Background:
Newborn hearing screening has to be considered the first step of a program for the identification, diagnosis, treatment and habilitation/rehabilitation of children with hearing impairment.
Main Part:
In Tuscany Region of Italy, the universal newborn hearing screening is mandatory since november 2007. The first guidelines for the execution of the screening have been released in June 2008; then many other Italian regions partially or totally adopted these guidelines. On the basis of the experience from 2008 and according to the recent evidences in the scientific literature, a new screening protocol was released in Tuscany region. The new protocol is an evolution of the previous one. Some issues reported in the previous protocol and in the Joint Committee on Infant Hearing statement published in 2007 were revised, such as the risk factors for auditory neuropathy and for late onset, progressive or acquired hearing loss. The new updated guidelines were submitted to the Sanitary Regional Council and then they have been approved in August 2016. The updated screening protocol is mainly aimed to identify newborns with a congenital moderate-to-profound hearing loss, but it also provides indications for the audiological follow-up of children with risk's factor for progressive or late onset hearing loss; further it provides indications for the audiological surveillance of children at risk for acquired hearing impairment. Then, in the new guidelines the role of the family paediatrician in the newborn hearing screening and audiological follow-up and surveillance is underscored. Finally the new guidelines provide indications for the treatment with hearing aids and cochlear implant, in accordance with the recent Italian Health Technology Assessment (HTA) guidelines.
Conclusions:
In the paper we report the modality of execution of the universal newborn hearing screening in the Tuscany Region, according to the recently updated protocol. The main features of the protocol and the critical issues are discussed.