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Bicalho de Castro LGR, Carvalho SADS, Côrtes Gama AC, Gonçalves DU, Macedo de Resende L, Giraudet F, Friche AADL, Parlato-Oliveira E, Avan P. Psychometric Validation of a Hearing Screening Questionnaire for Preschoolers Based on Language Development Evaluation by Caregivers. Folia Phoniatr Logop 2024:1-8. [PMID: 38643754 DOI: 10.1159/000538989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 04/16/2024] [Indexed: 04/23/2024] Open
Abstract
INTRODUCTION This study aimed to validate three age-adjusted versions of a Hearing Screening Questionnaire for Preschoolers, in Brazilian Portuguese, based on parents' perception of their children's hearing and oral language. METHODS Psychometric validation was conducted on three questionnaires, each comprising nine items with yes/no responses. Three items focused on hearing screening at birth, and six assessed hearing and oral language. The study included 152 parents and their children, who attended daycare centers in Belo Horizonte, Brazil. The children were categorized into three age bands: 12-18 months, 19-35 months, and 36-48 months. Audiological assessments, including tympanometry, transient-evoked otoacoustic emissions (TEOAE), and pure-tone audiometry (when applicable), were performed on the children. In case of abnormal findings in the previous exams, auditory brainstem response (ABR) testing was conducted. Descriptive data, false alarm, and false-negative analyses were carried out. RESULTS Considering any type of hearing loss, whether unilateral or bilateral, the questionnaires showed a false-negative rate of 41.17% (7/17 children). However, when considering only bilateral hearing loss, the questionnaire showed a false alarm rate of 31.69% (45/142) and a false-negative rate of 30.0% (3/10). When focusing exclusively on sensorineural hearing loss, the questionnaire identified two children (1.31%), with a false-negative rate of 0% but a false-positive rate of 33.33%. CONCLUSION Language-development-oriented questionnaires allowed quick screening of potential hearing loss in preschoolers. This study found a robust hit rate with these questionnaires. Their validation signifies a promising and cost-effective tool for conducting hearing screenings in preschool children, especially in nations lacking a comprehensive school screening policy. The validated questionnaire affords an easy-to-apply, low-cost, and effective instrument for preschool hearing screening.
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Affiliation(s)
| | | | - Ana Cristina Côrtes Gama
- Post-graduation Center, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Denise Utsch Gonçalves
- Post-graduation Center, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luciana Macedo de Resende
- Post-graduation Center, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fabrice Giraudet
- UMR INSERM 1107, Neurosensory Biophysics, School of Medicine, Université Clermont Auvergne, Clermont-Ferrand, France
| | | | - Erika Parlato-Oliveira
- Post-graduation Center, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Paul Avan
- UMR INSERM 1107, Neurosensory Biophysics, School of Medicine, Université Clermont Auvergne, Clermont-Ferrand, France
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Zeitlin W, McInerney M, Balser G, Aasen P. Communication is key: at-risk families' perspectives on follow-up in New Jersey's early hearing detection and intervention program. SOCIAL WORK IN HEALTH CARE 2024; 63:74-88. [PMID: 38060627 DOI: 10.1080/00981389.2023.2292547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 11/28/2023] [Indexed: 12/28/2023]
Abstract
Babies whose families possess multiple marginalized identities are at-risk for being late or lost to follow-up although there is a universal effort to screen and treat hearing loss in babies as part of state Early Hearing Detection and Intervention (EHDI) programs. Lack of timely follow-up puts young children at risk for delays in language acquisition, social skills, cognitive development, and school success. This qualitative study explored barriers to follow-up audiological care in at-risk families in New Jersey. Using thematic analysis, this research uncovered two major findings: 1) communication normalizes failed screenings, and 2) parents need clearer and more in-depth information. Health care social workers are well-suited to address these challenges due to their training in integrated social work practice, which can help them understand the complex interplay between individuals and their environments. In doing so social workers can improve access to needed services and promote health equity.
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Affiliation(s)
- Wendy Zeitlin
- Social Work and Child Advocacy, Montclair State University College of Humanities and Social Sciences, Montclair, USA
| | - Maryrose McInerney
- Communication Sciences and Disorders, Montclair State University, Montclair, USA
| | - Gita Balser
- Communication Sciences and Disorders, Montclair State University, Montclair, USA
| | - Pamela Aasen
- EHDI Coordinator, New Jersey Department of Health, Trenton, USA
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Al-Rawashdeh B, Zuriekat M, Alhanbali S, Alananbeh L, Rammaha D, Al-Zghoul M, Darweesh M, Sawalha A, Al-Bakri Q, Tawalbeh M, Abdul-Baqi K. Sensorineural hearing loss among children at risk: A 16-year audiological records review in a tertiary referral center. Int J Pediatr Otorhinolaryngol 2024; 176:111780. [PMID: 37988919 DOI: 10.1016/j.ijporl.2023.111780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/17/2023] [Accepted: 11/05/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES Hearing loss (HL) constitutes an increasing worldwide health problem. Neonatal hearing screening improved early detection and management to alleviate HL detriments on the person and society. Still, HL in childhood, beyond infancy, is under-investigated, especially in developing countries. This study aimed to explore the prevalence of HL in childhood amongst Jordanian children with HL risk factors and investigate the associated risk factors. METHODS Retrospective cross-sectional review of audiological records in a tertiary public and teaching hospital. The data of 1307 children aged 0-15 years who underwent audiological assessment from 2000 to 2016 were included. A review of diagnostic audiological and medical records was conducted to investigate the prevalence of sensorineural HL in high-risk (HR) children and the most contributing risk factors. RESULTS Descriptive statistical analysis showed that the prevalence of sensorineural HL was 29.2% in the study sample. The HL was bilateral in 95% and mild to moderate HL in 73%. The mean age at the diagnosis was around 4.5 years. The most common risk factors were parental concern about their child's hearing, ototoxic drug use, and developmental and speech delay. The Chi-squared test showed that parental concern and ototoxic drug use were associated with an increased probability of having HL. CONCLUSION The prevalence of HL amongst at-risk children in Jordan is relatively high, and the diagnosis is delayed. The results highlight the importance of implementing a hearing screening program in at-risk children. This needs to start from birth and include a serial follow-up to detect cases of delayed-onset HL.
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Affiliation(s)
- Baeth Al-Rawashdeh
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Margaret Zuriekat
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Sara Alhanbali
- Department of Hearing and Speech Sciences, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan.
| | - Lubna Alananbeh
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Doaa Rammaha
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Mohammad Al-Zghoul
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Mohammad Darweesh
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Amer Sawalha
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Qais Al-Bakri
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Mohamad Tawalbeh
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan.
| | - Khader Abdul-Baqi
- Department of Special Surgery, School of Medicine, The University of Jordan & Jordan University Hospital, Amman, Jordan; Department of Hearing and Speech Sciences, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan.
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Barriers to and Facilitators of Early Hearing Detection and Intervention in the United States: A Systematic Review. Ear Hear 2023; 44:448-459. [PMID: 36579673 DOI: 10.1097/aud.0000000000001312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Early hearing detection and intervention (EHDI) is guided by the 1-3-6 approach: screening by one month, diagnosis by 3 mo, and early intervention (EI) enrollment by 6 mo. Although screening rates remain high, successful diagnosis and EI-enrollment lag in comparison. The aim of this systematic review is to critically examine and synthesize the barriers to and facilitators of EHDI that exist for families, as they navigate the journey of congenital hearing loss diagnosis and management in the United States. Understanding barriers across each and all stages is necessary for EHDI stakeholders to develop and test novel approaches which will effectively reduce barriers to early hearing healthcare. DESIGN A systematic literature search was completed in May and August 2021 for empirical articles focusing on screening, diagnosis, and EI of children with hearing loss. Two independent reviewers completed title and abstract screening, full-text review, data extraction, and quality assessments with a third independent reviewer establishing consensus at each stage. Data synthesis was completed using the Framework Analysis approach to categorize articles into EHDI journey timepoints and individual/family-level factors versus system-level factors. RESULTS Sixty-two studies were included in the narrative synthesis. Results revealed that both individual/family-level (e.g., economic stability, medical status of the infant including middle ear involvement) and system-level barriers (e.g., system-service capacity, provider knowledge, and program quality) hinder timely diagnosis and EI for congenital hearing loss. Specific social determinants of health were noted as barriers to effective EHDI; however, system-level facilitators such as care coordination, colocation of services, and family support programs have been shown to mitigate the negative impact of those sociodemographic factors. CONCLUSIONS Many barriers exist for families to obtain appropriate and timely EHDI for their children, but system-level changes could facilitate the process and contribute to long-term outcomes improvement. Limitations of this study include limited generalizability due to the heterogeneity of EHDI programs and an inability to ascertain factor interactions.
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Van Swol J, Wolf BJ, Toumey J, Pecha P, Patel KG. Follow-Up Care Barriers for Patients with Orofacial Clefts. Cleft Palate Craniofac J 2022; 59:1213-1221. [PMID: 34678105 PMCID: PMC10731588 DOI: 10.1177/10556656211042162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate whether a patient with a cleft's age, associated syndrome, cleft phenotype or travel distance affects their follow-up rate. DESIGN This study is a retrospective review of patients with CL/P treated by a craniofacial clinic. SETTING The setting was a craniofacial clinic at a tertiary care university hospital. PATIENTS, PARTICIPANTS Candidates were patients seen by the craniofacial clinic between January 2007 and December 2019. An initial pool of 589 patients was then reduced to 440 due to exclusion criteria. INTERVENTIONS None. MAIN OUTCOME MEASURE(S) The outcome measure was actual patient attendance to the craniofacial team compared to the team goal expectation of annual return visits. RESULTS The mean age of participants at the end of the study was 9.0 ± 5.4 years with a mean follow-up period (total possible follow-up period length based on patient age at presentation and study window) of 5.5 ± 3.6 years. There was no association between cleft phenotype, type of syndrome, or distance to the clinic with attendance. Children with syndromes had an 11% decrease in the odds of attending follow-up visits with each 1-year increase in age compared to a 4% decrease in children without syndromes. CONCLUSIONS The only significant factors determining patient attendance were the presence of a syndrome and increasing age.
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Affiliation(s)
- Joshua Van Swol
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Bethany J. Wolf
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Julia Toumey
- Craniofacial Anomalies and Cleft Palate Team, Medical University of South Carolina, Charleston, SC, USA
| | - Phayvanh Pecha
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Krishna G. Patel
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
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Ostrowski T, Mouzakes J. Financial Distress Experienced By Privately Insured Pediatric Hearing Aid Patients: A Pilot Study. Clin Pediatr (Phila) 2022; 61:596-604. [PMID: 35677991 DOI: 10.1177/00099228221090362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The high cost associated with pediatric hearing aids is a major barrier to the acquisition of these medically essential tools. This pilot study describes the experiences of pediatric hearing aid users with their private insurers' hearing aid reimbursement at one academic institution in upstate New York. The families interviewed had purchased an average of 3.6 units for an average price of $2353.40 per unit, resulting in an average cost of $877.62 after insurer reimbursement. These families had an average household income of $150 419.40 per annum and an average monthly family-rated insurance premium of $481.60. Of 36 families, 20 (55.6%) reported previous feelings of financial distress or concerns about future financial distress associated with high costs incurred from purchasing their child's hearing aids. This study reveals the financial distress associated with pediatric hearing aids and the need for expanded research into individual families' experiences and this problem on a broader scale.
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Affiliation(s)
- Tyler Ostrowski
- Department of Otolaryngology-Head and Neck Surgery, Albany Medical Center, Albany, NY, USA
| | - Jason Mouzakes
- Department of Otolaryngology-Head and Neck Surgery, Albany Medical Center, Albany, NY, USA
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Sahoo KC, Dwivedi R, Athe R, Bhattacharya D, Rajsekhar K, Pati S. Stakeholders' Perspective for Improved Universal Newborn Hearing Screening Uptake in Odisha, India. J Trop Pediatr 2021; 67:5905598. [PMID: 32929505 DOI: 10.1093/tropej/fmaa062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Universal Newborn Hearing Screening (UNHS) is a significant public health initiative as early diagnosis and intervention are critical for children's cognitive development. In India, priority for UNHS has been provided since 2013; however, there are various operational challenges associated with it. There is a lack of multi-stakeholders perspective on UNHS, which is crucial for improving the service intake. Therefore, this study attempted to understand the perspective of various stakeholders to explore the practices, processes and technologies used in the existing UNHS landscape in Odisha, India. The qualitative in-depth interviews were conducted among various stakeholders including 15 mothers, 5 service providers (audiologists), 10 districts and state-level programme managers. Data were analysed using content analysis approaches. Two major themes emerged were 'social-shaping of technology for UNHS' and 'mothers' understanding and experience on UNHS'. Employee retention, equipment limitations, facilities maintenance and little knowledge among mothers about hearing screening have been described as major operational challenges. The study revealed that to increase universal coverage 'screening technology should be socially shaped'. There seems to be a need for 'portable technology with ease to use and better diagnostic accuracy' for first-stage screening at various levels of healthcare facilities along with community literacy on UNHS.
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Affiliation(s)
- Krushna Chandra Sahoo
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, Department of Health Research, ICMR-Regional Medical Research Centre, Bhubaneswar 751023, Odisha, India
| | - Rinshu Dwivedi
- Department of Science and Humanities, Indian Institute of Information Technology, Tiruchirappalli 620015, Tamil Nadu, India
| | - Ramesh Athe
- Department of Humanities and Science, Indian Institute of Information Technology, Dharwad 580029, Karnataka, India
| | - Debdutta Bhattacharya
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, Department of Health Research, ICMR-Regional Medical Research Centre, Bhubaneswar 751023, Odisha, India
| | - Kavitha Rajsekhar
- Department of Health Research, Ministry of Health and Family Welfare, Health Technology Assessment in India (HTAIn), New Delhi 110001, India
| | - Sanghamitra Pati
- Health Technology Assessment in India (HTAIn), Regional Resource Hub, Department of Health Research, ICMR-Regional Medical Research Centre, Bhubaneswar 751023, Odisha, India
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Zeitlin W, McInerney M, Aveni K, Scheperle R, Chontow K. Better late than never? Maternal biopsychosocial predictors of late follow-up from new Jersey's early hearing detection and intervention program. Int J Pediatr Otorhinolaryngol 2021; 145:110708. [PMID: 33882338 DOI: 10.1016/j.ijporl.2021.110708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/16/2021] [Accepted: 04/03/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Early hearing detection and intervention programs are designed to mitigate consequences of hearing loss in infants. Most research examining compliance with program protocols has examined factors related to being lost to follow-up. Another group that warrants study are babies who return for follow-up outside the timelines recommended by public health organizations. This research seeks to identify maternal factors that are associated with late follow-up at the point of diagnosis of hearing loss. STUDY DESIGN The sampling frame for this study included all babies born in New Jersey in a two-year period. Our final sample consisted of 716 babies who needed diagnostic evaluations and completed them. Five hundred twenty-six babies completed their exams on-time while 190 completed them late. Logistic regression was completed to identify maternal factors related to late follow-up, and additional statistics were utilized to understand characteristics of babies who were late. RESULTS In the final modeling, maternal education (OR = 0.52), WIC participation (OR = 2.11), and health insurance status (OR = 2.04) were significantly predictive of being late (X2 (6) = 77.71; p < 0.01). Mothers for whom postpartum depression (OR = 1.89) was a concern were more also likely to have babies who were late. Needing to repeat a diagnostic audiologic exam was most predictive of lateness (OR = 5.32). Over one-third of babies who had confirmed hearing loss completed their testing late. CONCLUSIONS Late completion of diagnostic hearing tests may contribute to delays in children hitting developmental milestones in a timely manner. Low socioeconomic status mothers and those with postpartum depression may have difficulty following up with recommended hearing tests. Limitations include data quality issues inherent in using administrative data.
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Affiliation(s)
- Wendy Zeitlin
- Montclair State University, Department of Social Work and Child Advocacy, 1 Normal Avenue, Montclair, NJ, 07043, USA.
| | - MaryRose McInerney
- Montclair State University, Department Communication Science and Disorders, USA
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