Newborn Hearing Screening Benefits Children, but Global Disparities Persist

There is substantial evidence that newborn hearing screening (NHS) reduces the negative sequelae of permanent childhood hearing loss (PCHL) if performed in programs that aim to screen all newborns in a region or nation (often referred to as Universal Newborn Hearing Screening or UNHS). The World Health Organization (WHO) has called in two resolutions for the implementation of such programs and for the collection of large-scale data. To assess the global status of NHS programs we surveyed individuals potentially involved with newborn and infant hearing screening (NIHS) in 196 countries/territories (in the following text referred to as countries). Replies were returned from 158 countries. The results indicated that 38% of the world’s newborns and infants had no or minimal hearing screening and 33% screened at least 85% of the babies (hereafter referred to as UNHS). Hearing screening programs varied considerably in quality, data acquisition, and accessibility of services for children with PCHL. In this article, we summarize the main results of the survey in the context of several recent WHO publications, particularly the World Report on Hearing, which defined advances in the implementation of NHS programs in the Member States as one of three key indicators of worldwide progress in ear and hearing care (EHC).

A systematic scoping review of early interventions for parents of deaf infants

Background Over 90% of the 50,000 deaf children in the UK have hearing parents, many of whom were not expecting a deaf child and may require specialist support. Deaf children can experience poorer long-term outcomes than hearing children across a range of domains. After early detection by the Universal Newborn Hearing Screening Programme, parents in the UK receive support from Qualified Teachers of the Deaf and audiologists but resources are tight and intervention support can vary by locality. There are challenges faced due to a lack of clarity around what specific parenting support interventions are most helpful. Methods The aim of this research was to complete a systematic scoping review of the evidence to identify early support interventions for parents of deaf infants. From 5577 identified records, 54 met inclusion criteria. Two reviewers screened papers through three rounds before completing data extraction and quality assessment. Results Identified parent support interventions included both group and individual sessions in various settings (including online). They were led by a range of professionals and targeted various outcomes. Internationally there were only five randomised controlled trials. Other designs included non-randomised comparison groups, pre / post and other designs e.g. longitudinal, qualitative and case studies. Quality assessment showed few high quality studies with most having some concerns over risk of bias. Conclusion Interventions commonly focused on infant language and communication followed by parental knowledge and skills; parent wellbeing and empowerment; and parent/child relationship. There were no interventions that focused specifically on parent support to understand or nurture child socio-emotional development despite this being a well-established area of poor outcome for deaf children. There were few UK studies and research generally was not of high quality. Many studies were not recent and so not in the context of recent healthcare advances. Further research in this area is urgently needed to help develop evidence based early interventions.

Newborn Hearing Screening: Experience from a Tertiary level Hospital in Nepal

Introduction Congenital hearing loss is one of the commonest causes of hearing impairment and deafness in childhood. Early diagnosis and intervention in time help a child to lead a better life with good language and communication skills. Known risk factors include cytomegalovirus infection and premature birth necessitating a stay in the neonatal intensive care unit. Universal newborn hearing screening has been implemented by many countries due to easy and non-invasive screening test and their ability to identify children who may need early intervention. Methods: All the newborns delivered between December 2018 to November 2020 were screened for congenital hearing loss. The average age at screening was more than 24 hours. Those who were referred in OAE (otoacoustic emissions testing) underwent ABR (auditory brainstem response) test and further workup as needed. Conclusions: The incidence of congenital hearing loss was 1.8 per 1000 live births. This finding is consistent with other previous research. UNHS will be cost-effective easy and feasible method for early detection of hearing loss in newborns. Pediatric health services organizations should prioritize universal newborn hearing screening as a part of the standard of care in birthing services.

Detecting Hearing Loss in Infants With a Syndrome or Craniofacial Abnormalities Following the Newborn Hearing Screen

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.

A local rehabilitation service for children with hearing loss

Objectives to discuss the issues of inter-disciplinary cooperation for improvement the pediatric audiological care using modern technologies for hearing restoration. Material and methods. An epidemiological study of hearing impairments in 3098 children registered in the Center of Pediatric Audiology (St. Petersburg) and analysis of the city pediatric audiological services were carried out. Results. The introduction of the universal newborn hearing screening helped to diagnose hearing loss in children under 1 year of age in 47% of cases. Before the screening implementation, it was diagnosed in 22% of cases. The hearing screening results testify that 26% of children meet modern requirements of early diagnosis (under 3 months) of congenital hearing loss. 54% of children registered in the Audiology Center are using hearing aids or cochlear implants. The mean age of initial amplification is 3 years 8 months. 5.4% of children got amplification under 6 months of age, 20% of children - under 1 year and 58% - under 3 years. The mean interval between diagnosis and amplification was 15.7 months, only 24% of children got amplification within 3 months after being diagnosed. A system of family-centered medical, psychological and pedagogical rehabilitation of children with hearing impairments was developed at the Center of Pediatric Audiology.

Outcomes of Universal Newborn Screening Programs: Systematic Review

Background: This systematic review examined the outcomes (age of identification and intervention, developmental outcomes, cost-effectiveness, and adverse effects on parents) of universal newborn hearing screening (UNHS) for children with permanent congenital hearing loss (PCHL). Materials and methods: Multiple electronic databases were interrogated in March and April 2020 with further reports identified from article citations and unpublished literature. UNHS reports in English with comparisons of outcomes of infants who were not screened, and infants identified through other hearing screening programs. Results: 30 eligible reports from 14 populations with 7,325,138 infants screened through UNHS from 1616 non-duplicate references were included. UNHS results in a lower age of identification, amplification, and the initiation of early intervention services and better language/literacy development. Better speech perception/production were shown in younger, but not in older, children with early identification after UNHS. No significant findings were found for behavior problems and quality of life. UNHS was found to be cost-effective in terms of savings to society. In addition, no significant parental harm was noted as a result of UNHS. Conclusions: In highly developed countries, significantly better outcomes were found for children identified early through UNHS programs. Early language development predicts later literacy and language development.

Basic principles of early intervention for children with hearing loss

Hearing loss is a common birth problem that can affect a babys ability to develop speech, language and social skills in lack of comprehensive early intervention. Early intervention occurring within the first 6 months has higher effectiveness for hearing impaired children. The introduction of universal newborn hearing screening programs allowed to identify hearing loss in the first months of life. That determines the need of immediate comprehensive early intervention for children identified with hearing loss. The main approaches of such intervention have been described in detail in the literature. However there are not well-developed, evidence-based, well-documented recommendations for family-centred early intervention for children who are deaf or hard of hearing. Similar problems are noted in many countries, that is why in 2012, within the framework of an international conference, specialists and parents of deaf and hard of hearing children developed a document (international consensus statement). The experts arrived at consensus on 10 principles guiding family-centred early intervention. These principles are presented in the article as well as a brief description of their implementation in various countries. The consensus statement has become an important document which is intended to provide a framework for professionals over the world. Knowledge of these principles allows specialists to apply evidence-based approaches working with children who are deaf of hard of hearing.