Missing the Mark in Early Intervention for Babies Who Are Hard of Hearing or Deaf Learning Spoken Language

2010 ◽  
Vol 20 (2) ◽  
pp. 41-47 ◽  
Author(s):  
Amy McConkey Robbins ◽  
Teresa Caraway

In this article, the authors examine factors contributing to a growing early intervention (EI) crisis for babies who are hard of hearing or deaf (HH/D) whose families have chosen spoken language through listening as their desired outcome. At the core of this crisis is the difficulty of, and sometimes resistance to, incorporating nationally accepted best practices for the treatment of childhood hearing loss (Joint Committee on Infant Hearing, 2007) into the EI policies and systems that were created years before newborn hearing screening, advanced hearing technologies, and specialized therapy strategies existed. Today's infants born HH/D and their families represent a new and changing population requiring transformation in how we conceptualize, develop, and implement EI services. There is evidence that, in many cases, we are missing the mark in the ways in which this population is being served. It is our conviction that an EI model most appropriate for HH/D babies whose families have chosen spoken language through listening has features distinct from EI models proposed for children with other disabilities.

2009 ◽  
Vol 20 (01) ◽  
pp. 049-057 ◽  
Author(s):  
Yvonne S. Sininger ◽  
Amy Martinez ◽  
Laurie Eisenberg ◽  
Elizabeth Christensen ◽  
Alison Grimes ◽  
...  

Background: Newborn Hearing Screening (NHS) programs aim to reduce the age of identification and intervention of infants with hearing loss. It is generally accepted that NHS programs achieve that outcome, but few studies have compared children who were screened to those not screened in the same study and during the same time period. This study takes advantage of the emerging screening programs in California to compare children based on screening status on age at intervention milestones. Purpose: The purpose of this study was to compare the outcomes of cohorts of children with hearing loss, some screened for hearing loss at birth and others not screened. Specifically, the measures compared are the benchmarks suggested by the Joint Committee on Infant hearing for determining the quality of screening programs. Study Sample: Records from 64 children with bilateral permanent hearing loss who were enrolled in a study of communication outcomes served as data for this study. Of these children, 47 were screened with 39 failing and 8 passing, and 17 were not screened. Intervention: This study was observational and involved no planned intervention. Data Collection and Analysis: Outcome benchmarks included age at diagnosis of hearing loss, age at fitting of amplification, and age at enrollment in early intervention. Delays between diagnosis and fitting or enrollment were also calculated. Hearing screening status of the children included screened with fail outcome, screened with pass outcome, and not screened. Analysis included simple descriptive statistics, and t-tests were used to compare outcomes by groups: screened/not screened, screened pass/screened failed, and passed/not screened. Results: Children with hearing loss who had been screened as newborns were diagnosed with hearing loss 24.62 months earlier, fitted with hearing aids 23.51 months earlier, and enrolled in early intervention 19.98 months earlier than those infants who were not screened. Screening status did not influence delays in fitting of amplification or enrollment in intervention following diagnosis. Eight of the infants with hearing loss (12.5%) passed the NHS, and the ages at benchmarks of those children were slightly but not significantly earlier than infants who had not been screened. Conclusions: The age at achievement of benchmarks such as diagnosis, fitting of amplification, and enrollment in early intervention in children who were screened for hearing loss is on target with stated goals provided by the Academy of Pediatrics and the Joint Committee on Infant Hearing. In addition, children who are not screened for hearing loss continue to show dramatic delays in achievement of benchmarks by as much as 24 months. Evaluating achievement of benchmarks during the start-up period of NHS programs allowed a direct evaluation of ability of these screening programs to meet stated goals. This demonstrates, unequivocally, that the NHS process itself is responsible for improvements in age at diagnosis, hearing aid fitting, and enrollment in intervention.


Author(s):  
Philippa Horn ◽  
Carlie Driscoll ◽  
Jane Fitzgibbons ◽  
Rachael Beswick

Purpose The current Joint Committee on Infant Hearing guidelines recommend that infants with syndromes or craniofacial abnormalities (CFAs) who pass the universal newborn hearing screening (UNHS) undergo audiological assessment by 9 months of age. However, emerging research suggests that children with these risk factors are at increased risk of early hearing loss despite passing UNHS. To establish whether earlier diagnostic audiological assessment is warranted for all infants with a syndrome or CFA, regardless of screening outcome, this study compared audiological outcomes of those who passed UNHS and those who referred. Method A retrospective analysis was performed on infants with a syndrome or CFA born between July 1, 2012, and June 30, 2017 who participated in Queensland, Australia's state-wide UNHS program. Results Permanent childhood hearing loss (PCHL) yield was higher among infants who referred on newborn hearing screening (51.20%) than in those who passed. Nonetheless, 27.47% of infants who passed were subsequently diagnosed with hearing loss (4.45% PCHL, 23.02% transient conductive), but PCHL was generally milder in this cohort. After microtia/atresia, the most common PCHL etiologies were Trisomy 21, other syndromes, and cleft palate. Of the other syndromes, Pierre Robin sequence featured prominently among infants who passed the hearing screen and were subsequently diagnosed with PCHL, whereas there was a broader mix of other syndromes that caused PCHL in infants who referred on screening. Conclusion Children identified with a syndrome or CFA benefit from early diagnostic audiological assessment, regardless of their newborn hearing screening outcome.


2021 ◽  
Vol 15 (6) ◽  
pp. 2067-2071
Author(s):  
Gholam-Ali Dashti Khavidaki ◽  
Reza Gharibi

Introduction: Hearing loss is one of the most common congenital disorders. The prevalence of this disorder in different communities has been reported between 3.5 to 9 percent, which can have adverse effects on language learning, communication, and education of children. Also, early diagnosis of this disorder in newborns is not possible without the use of hearing screening. Therefore, the aim of this study was to evaluate the effectiveness of newborn hearing screening programs in Zahedan. Method: In this cross-sectional observational study, all babies born in the maternity hospitals of Zahedan city (maternity hospitals of Nabi Akram, Imam Ali, and Social Security hospitals) in 2020, were examined. In order to conduct the study, TEOAE was initially performed for all neonates. Then, based on the results obtained in the ODA test and in case of unsatisfactory response, cases were referred for re-evaluation. Infants who were rejected again in the second stage were immediately subjected to the AABR test and if they failed in this test, they were also subjected to a diagnostic ABR test. Results: Based on our results, 7700 infants were first evaluated with the OAE test. Of these, 580 (8%) had no OAE response. Out of 580 infants rejected in the first stage, 76 infants were also rejected in the second stage; Among them, 8 infants were re-diagnosed with hearing impairments. Finally, out of 3 infants who were diagnosed with hearing loss, 1 (33%) had conductive hearing loss and 2 (67%) had sensorineural hearing loss. Conclusion: Based on the findings of the present study, the implementation of a comprehensive neonatal hearing screening program is necessary for the timely and early diagnosis and treatment of hearing loss. Also, screening can improve the health of children and their personal, social, and educational development in the future. Keywords: Hearing screening, hearing loss, newborns, OAE, AABR


2005 ◽  
Vol 48 (2) ◽  
pp. 135-141 ◽  
Author(s):  
Shoichiro Fukuda ◽  
Naomi Toida ◽  
Kunihiro Fukushima ◽  
Yuko Kataoka ◽  
Kazunori Nishizaki

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