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Screening and assessment of childhood deafness: experience from a centralized multi-disciplinary service
A E O'Hare1, J Grigor, D Cowan
1Department of Child Life and Health, University of Edinburgh, UK.
Insights
Early diagnosis of childhood sensorineural hearing impairment improved with a dedicated unit. However, high-risk infants were not identified sooner, indicating a need for targeted screening improvements.
Area of Science:
- Pediatrics
- Audiology
- Public Health
Background:
- A dedicated paediatric hearing assessment unit was established in Lothian in 1978.
- The unit aimed to streamline referrals for suspected sensorineural hearing impairment in children.
- It particularly focused on infants identified through health visitor screening programs.
Purpose of the Study:
- To evaluate the impact of a dedicated hearing assessment unit on the diagnosis of sensorineural hearing impairment in children.
- To assess changes in the age of diagnosis over a six-year period.
- To identify if high-risk groups were diagnosed earlier.
Main Methods:
- Retrospective analysis of data from a paediatric hearing assessment unit over a 6-year period.
- Calculation of the incidence of bilateral sensorineural deafness.
- Comparison of age at diagnosis between different risk groups.
Main Results:
- The incidence of bilateral sensorineural deafness was 1.3 per 1000 children.
- A significant decrease in the mean age of diagnosis was observed.
- Children in high-risk groups (e.g., adverse perinatal events, family history) were not diagnosed earlier than other children.
Conclusions:
- Health visitor screening remains valuable for early detection of hearing loss.
- Current practices do not facilitate earlier diagnosis for high-risk infants.
- Modifications to screening and referral pathways are necessary to improve early detection in vulnerable pediatric populations.
Abstract:
A paediatric hearing assessment unit was set up in Lothian in 1978 to provide a clear referral pathway for children with suspected sensorineural hearing impairment and particularly for those children detected by the health visitor screening test. Over a 6-year-period the incidence of bilateral sensorineural deafness was 1.3/1000 suggesting that all children in the region were being seen. The mean age of diagnosis fell significantly over this period. Children in high risk groups, through adverse perinatal events or a positive family history, were not detected any earlier than other children. They were therefore not contributing to this improved earlier age of diagnosis. These findings support the continuation of health visitor screening but changes in practice are needed to encourage earlier diagnosis in high-risk groups.