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Conditions for paediatric hearing screening: a survey in 28 Finnish child welfare clinics
E Maki-Torkko1, M Sorri, M R Jarvelin
1Departments of Otolaryngology, University of Oulu, Finland.
Insights
Finnish pediatric hearing screening has many deficiencies, including incorrect screening frequency and outdated equipment, potentially delaying diagnoses. An updated audiology training program is recommended for healthcare personnel.
Area of Science:
- Pediatric Audiology
- Public Health Screening Programs
Background:
- The Finnish national pediatric hearing screening program aims to detect hearing impairments early in preschool children.
- Previous assessments suggest potential challenges in the program's implementation and effectiveness.
Purpose of the Study:
- To evaluate the current Finnish pediatric hearing screening program.
- To identify practical deficiencies affecting screening performance and referral processes.
- To understand factors contributing to delayed diagnosis of hearing impairments.
Main Methods:
- A survey involving interviews with nurses and doctors across 28 child welfare clinics.
- Assessment focused on the screening of 18,500 preschool children.
- Inquiry into screening frequency, methods, equipment usage, and personnel responsibilities.
Main Results:
- Screening was performed more frequently than recommended (4-12 times vs. 3 times).
- Non-specific frequency ranges and sound pressure levels were commonly used in screenings.
- Audiometers were underutilized (22/28 clinics) and infrequently calibrated (9/28 clinics yearly).
- Healthcare professionals had significant additional responsibilities impacting screening focus.
Conclusions:
- Significant deficiencies exist within the Finnish pediatric hearing screening program.
- These deficiencies, including procedural and equipment issues, likely contribute to delayed diagnosis of hearing loss.
- Implementation of updated pediatric audiology training for healthcare personnel is crucial.
Abstract:
The present Finnish paediatric hearing screening programme was assessed by interviewing nurses and doctors in 28 child welfare clinics responsible for the hearing screening of 18,500 preschool children. Practical issues which might have effects on both performing the screenings and referring the children with abnormal screening results were emphasised. This survey brought out a great variety of deficiencies, which may contribute to the existing delayed diagnosis of hearing impairments. Hearing screening was routinely done 4-12 times per child before school age, instead of the 3 times recommended. Methods with a nonspecific frequency range and sound pressure level were often used. Audiometers were only used in 22 of the 28 clinics, and in only 9 clinics were the audiometers calibrated yearly. The median time of working in the child health care field at that particular health centre was 7 y for the nurses and 6 y for the doctors. Both the nurses and the doctors had numerous responsibilities other than paediatric hearing screening. Implementation of an updating training programme in paediatric audiology for the personnel is recommended.