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Neonatal hearing screening
A M Oudesluys-Murphy1, H L van Straaten, R Bholasingh
1Department of Paediatrics, Zuiderziekenhuis, Rotterdam, The Netherlands.
Insights
Early diagnosis of congenital hearing impairment is crucial. Universal neonatal hearing screening, particularly using automated auditory brainstem responses, offers the best chance for optimal infant development and care.
Area of Science:
- Pediatrics
- Audiology
- Neonatology
Background:
- Congenital hearing impairment affects 0.1% of newborns and 1-2% of NICU graduates.
- Early diagnosis and intervention before 6 months significantly improve developmental outcomes.
- Current diagnostic ages are often delayed (18-30 months), missing the critical intervention window.
Purpose of the Study:
- To highlight the importance of early diagnosis for congenital hearing impairment.
- To advocate for universal neonatal hearing screening over high-risk group screening.
- To discuss available methods for neonatal hearing screening.
Main Methods:
- Review of current neonatal hearing screening practices.
- Discussion of screening methods, including distraction tests and automated auditory brainstem responses.
- Analysis of the effectiveness of universal versus targeted screening.
Main Results:
- Screening by 9 months misses cases and delays intervention.
- Targeted screening for high-risk groups fails to identify 30-50% of infants with hearing loss.
- Universal neonatal screening is necessary for early detection.
Conclusions:
- Automated measurement of auditory brainstem responses is the most effective method for universal neonatal hearing screening.
- Early detection through universal screening maximizes opportunities for intervention and positive developmental trajectories.
Unlabelled:
Severe congenital hearing impairment is an important handicap affecting 0.1% of live-born infants and 1%-2% of graduates of Neonatal Intensive Care Units. The prognosis for intellectual, emotional, language and speech development in the hearing-impaired child is improved when the diagnosis is made early and intervention is begun before the age of 6 months. The usual age at diagnosis of hearing impairment is at least 18-30 months (or even later in cases of less severe hearing impairment) where there are no screening programmes. When screening is carried out using distraction methods at the age of approximately 9 months some hearing-impaired infants are missed and those discovered are at least 15-18 months before intervention begins. Neonatal screening could give hearing-impaired children the best chances for optimal care and development. Universal neonatal hearing screening is necessary, because, when neonatal hearing screening is restricted to high risk groups 30%-50% of infants with hearing loss are not discovered. The methods available for neonatal hearing screening are discussed in this paper.
Conclusion:
In our view automated measurement of auditory brainstem responses is the most valuable method for universal neonatal hearing screening.