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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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Tananuchittikul P, Yimtae K, Chayaopas N, Thanawirattananit P, Kasemsiri P, Piromchai P. App-Based Hearing Screenings in Preschool Children With Different Types of Headphones: Diagnostic Study. JMIR Mhealth Uhealth 2023; 11:e44703. [PMID: 37962900 PMCID: PMC10662668 DOI: 10.2196/44703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 08/21/2023] [Accepted: 09/18/2023] [Indexed: 11/15/2023] Open
Abstract
Background Hearing disability in preschool children can delay or impact oral communication and social skills. Provision of hearing screening tests by standard audiometry in low- to middle-income countries is problematic due to a lack of pediatric audiologists, standard hearing equipment, and standard soundproof rooms. Therefore, an innovative hearing screening tool that is easily accessible and inexpensive such as a mobile app should be considered. Headphones have been a crucial part of hearing screenings. Audiometric headphones, which serve as the reference standard, have been used in most studies. However, since audiometric headphones are not accessible in rural areas, we hypothesized that generic headphones can also be used in hearing screenings. Objective This study aimed to determine the sensitivity, specificity, κ coefficiency, and time consumption of the PASS-Pro (Preschool Audiometry Screening System-Pro) app when using TDH39 headphones, Beyerdynamic DT 770 PRO headphones, and generic earmuff headphones compared to standard conditioned play audiometry. Methods We recruited preschool children aged 4 to 5 years to participate in this study. The children received 3 PASS-Pro screening tests using different types of headphones in a quiet room and 1 standard conditioned play audiometry in a soundproof room. All tests were administered in random order. The agreement coefficient, sensitivity, specificity, and mean test duration were determined. Results A total of 44 children participated in this study. For mild hearing loss screening, the κ coefficients between standard conditioned play audiometry and the PASS-Pro app using TDH39 headphones, Beyerdynamic DT 770 PRO headphones, and generic earmuff headphones were 0.195, 0.290, and 0.261 (P=.02, P=.002, and P=.004), respectively. The sensitivity for all headphones was 50% and the specificity was more than 88%. For moderate hearing loss screening, the κ coefficients were 0.206, 0.272, and 0.235 (all Ps=.001), respectively. The sensitivity for all headphones was 100% and the specificity was more than 92%. There were no statistical differences in sensitivity and specificity between the reference headphone (TDH39), Beyerdynamic DT 770 PRO headphone, and generic earmuff headphones (all Ps >.05). The PASS-Pro app used significantly less time to carry out hearing tests than conditioned play audiometry (P<.001). Conclusions The PASS-Pro app, used with generic headphones, is effective for conducting hearing screening tests in preschool children with high sensitivity and specificity.
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Affiliation(s)
- Pornsek Tananuchittikul
- Department of Otolaryngology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kwanchanok Yimtae
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nichtima Chayaopas
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Panida Thanawirattananit
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pornthep Kasemsiri
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Patorn Piromchai
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Ting FN, Kiing JSH, Li WW, Chan YH, Loo JHY, Kang YQ. Prevalence and Profiles of Late-Onset Hearing Loss in Preschool Children with Autism Spectrum Disorder Who Passed Newborn Hearing Screening in a South East Asian Population. J Autism Dev Disord 2023:10.1007/s10803-023-06060-0. [PMID: 37480440 DOI: 10.1007/s10803-023-06060-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 07/24/2023]
Abstract
Prevalence of hearing loss in children with autism spectrum disorder (ASD) is uncertain, as it is more challenging to assess hearing function in children with developmental difficulties (DD). We aimed to determine the prevalence and profiles of hearing loss in preschool children with ASD in a Southeast-Asian population who passed newborn hearing screening. A retrospective study of preschool children with DD (ASD, Global Developmental Delay (GDD), and Speech and Language Delay (SLD)) attending the Child Development Unit (CDU) at our hospital was performed. Three hundred and thirty-three children (ASD: n = 129; GDD: n = 110; and SLD: n = 94) underwent hearing assessments. Of these, 10.8% of children (n = 36, comprising 15 with ASD, 12 with GDD and 9 with SLD) had confirmed hearing loss. Hearing loss was predominantly bilateral in children with ASD and GDD; in those with SLD, unilateral and bilateral hearing loss were equally common. Conductive hearing loss occurred as frequently as sensorineural hearing loss in children with ASD and SLD, but was the dominant subtype in those with GDD. Moderate to severe hearing loss (n = 2) was noted only in children with ASD. Children with ASD and GDD required significantly more audiology visits and procedures to obtain conclusive hearing test results, compared to those with SLD. The need to identify hearing loss and monitor for resolution is particularly important in vulnerable populations with communication deficits, such as in those with ASD.
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Affiliation(s)
- Fang Ni Ting
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jennifer S H Kiing
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Child Development Unit, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Wei Wen Li
- Child Development Unit, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jenny H Y Loo
- Department of Otolaryngology, Head & Neck Surgery (Audiology), National University Hospital, Singapore, Singapore
- Department of Otolaryngology, Head & Neck Surgery (Audiology), National University of Singapore, Singapore, Singapore
| | - Ying Qi Kang
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Child Development Unit, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore.
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Bussé AML, Qirjazi B, Mackey AR, Kik J, Goedegebure A, Hoeve HLJ, Toçi E, Roshi E, Carr G, Toll MS, Simonsz HJ. Implementation of Newborn Hearing Screening in Albania. Int J Neonatal Screen 2023; 9:ijns9020028. [PMID: 37218893 DOI: 10.3390/ijns9020028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/19/2023] [Accepted: 04/29/2023] [Indexed: 05/24/2023] Open
Abstract
Newborn hearing screening (NHS) was implemented in Albania in four maternity hospitals in 2018 and 2019. Implementation outcome, screening outcome, and screening quality measures were evaluated. Infants were first screened by midwives and nurses before discharge from the maternity hospital and returned for follow-up screening. Acceptability, appropriateness, feasibility, adoption, fidelity, coverage, attendance, and stepwise and final-referral rates were assessed by onsite observations, interviews, questionnaires, and a screening database. A post hoc analysis was performed to identify reasons for loss to follow up (LTFU) in a multivariate logistic regression. In total, 22,818 infants were born, of which 96.6% were screened. For the second screening step, 33.6% of infants were LTFU, 40.4% for the third, and 35.8% for diagnostic assessment. Twenty-two (0.1%) were diagnosed with hearing loss of ≥40 dB, six unilateral. NHS was appropriate and feasible: most infants are born in maternity hospitals, hence nurses and midwives could perform screening, and screening rooms and logistic support were supplied. Adoption among screeners was good. Referral rates decreased steadily, reflecting increasing skill. Occasionally, screening was repeated during a screening step, contrary to the protocol. NHS in Albania was implemented successfully, though LTFU was high. It is important to have effective data tracking and supervision throughout the screening.
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Affiliation(s)
- Andrea M L Bussé
- Department of Otorhinolaryngology, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands
| | - Birkena Qirjazi
- Department of Ear, Nose and Throat Diseases-Ophthalmology, University of Medicine of Tirana, 1000 Tirana, Albania
| | | | - Jan Kik
- Department of Ophthalmology, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands
| | - Hans L J Hoeve
- Department of Otorhinolaryngology, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands
| | - Ervin Toçi
- Department of Public Health, University of Medicine of Tirana, 1000 Tirana, Albania
| | - Enver Roshi
- Department of Public Health, University of Medicine of Tirana, 1000 Tirana, Albania
| | - Gwen Carr
- Independent Consultant in Early Hearing Detection, Intervention and Family Centered Practice, Ribble Valley BB7 2RA, UK
| | - Martijn S Toll
- Department of Otorhinolaryngology, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands
| | - Huibert J Simonsz
- Department of Ophthalmology, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands
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Fitzgibbons EJ, Keszegi S, Driscoll C, Beswick R. Childhood hearing loss detected beyond the newborn screen. Int J Audiol 2023; 62:278-285. [PMID: 35225141 DOI: 10.1080/14992027.2022.2042606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To understand the characteristics of postnatal hearing loss (PNHL) identified via different referral pathways, to inform childhood hearing screening and referral practices. DESIGN Retrospective analysis of screening and audiology records. STUDY SAMPLE A cohort of 385 children who passed newborn hearing screening in Queensland, Australia between September 2004 and December 2017 and were later diagnosed with permanent hearing loss. RESULTS Neonatally identified risk factors facilitated detection for half the cohort, with PNHL detected earlier (average age of 31 months) and at a milder degree. PNHL was detected at an average age of 49 months via other pathways. Proportions of bilateral moderate or greater PNHL were greatest in children with significant medical circumstances (60.7%) and those with noted delays or concerns (39.2%), whereas childhood hearing screening programs detected greater proportions of unilateral moderate or greater PNHL (47.4%). CONCLUSIONS Risk-factor-based surveillance detects PNHL early but does not detect all cases. Screening children with speech and language delays, parental or professional concern, or with relevant medical circumstances (eg meningitis or chemotherapy) is warranted based on the types of PNHL detected. Further evidence may be required to justify the rollout of postnatal population childhood screening programs.
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Affiliation(s)
- E Jane Fitzgibbons
- Healthy Hearing Program, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Stephanie Keszegi
- Healthy Hearing Program, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Carlie Driscoll
- School of Health and Rehabilitation Services, University of Queensland, Brisbane, Australia
| | - Rachael Beswick
- Healthy Hearing Program, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
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Torrente MC, Tamblay N, Herrada J, Maass JC. Hearing loss in school-aged children. Acta Otolaryngol 2023; 143:28-30. [PMID: 36638044 DOI: 10.1080/00016489.2022.2162959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Hearing loss is a common disability affecting 5% of the world's population. A lack of opportune diagnosis affects both the individual and society. In order to develop public health policies in the field of hearing health, countries must have information about epidemiology. AIMS/OBJECTIVES In this review, we describe the information available about prevalence and incidence of hearing loss in school-aged children. MATERIAL AND METHODS Review of the literature in PubMed. RESULTS Reported prevalence of hearing loss in school-aged children varied between 0.2% and 7.8%. Several factors could explain the discrepancy in numbers such as definition of hearing loss, cause, and the inclusion of high-frequency hearing loss. The rate of delayed-onset hearing loss at the age of six years old varied between 0.6 and 0.8 per 1000. CONCLUSIONS AND SIGNIFICANCE The prevalence of hearing loss in school-aged children varied between 0.2% and 7.8%, and the rate of delayed-onset hearing loss at the age of six years old varied between 0.6 and 0.8 per 1000.
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Affiliation(s)
- Mariela C Torrente
- Hospital Clínico de la Universidad de Chile, Santiago, Chile.,Department of Otorhinolaryngology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Natalia Tamblay
- Department of Otorhinolaryngology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Javiera Herrada
- Hospital Clínico de la Universidad de Chile, Santiago, Chile
| | - Juan C Maass
- Hospital Clínico de la Universidad de Chile, Santiago, Chile.,Department of Otorhinolaryngology, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,Interdisciplinary Program of Physiology and Biophysics, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Silva VAR, Pauna HF, Lavinsky J, Hyppolito MA, Vianna MF, Leal M, Massuda ET, Hamerschmidt R, Bahmad F, Cal RV, Sampaio ALL, Felix F, Chone CT, Castilho AM. Task force Guideline of Brazilian Society of Otology ‒ hearing loss in children - Part I ‒ Evaluation. Braz J Otorhinolaryngol 2022; 89:159-189. [PMID: 36529647 PMCID: PMC9874360 DOI: 10.1016/j.bjorl.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To provide an overview of the main evidence-based recommendations for the diagnosis of hearing loss in children and adolescents aged 0 to 18 years. METHODS Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on childhood hearing loss were eligible for inclusion. The American College of Physicians' guideline grading system and the American Thyroid Association's guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. RESULTS The evaluation and diagnosis of hearing loss: universal newborn hearing screening, laboratory testing, congenital infections (especially cytomegalovirus), genetic testing and main syndromes, radiologic imaging studies, vestibular assessment of children with hearing loss, auditory neuropathy spectrum disorder, autism spectrum disorder, and noise-induced hearing loss. CONCLUSIONS Every child with suspected hearing loss has the right to diagnosis and appropriate treatment if necessary. This task force considers 5 essential rights: (1) Otolaryngologist consultation; (2) Speech assessment and therapy; (3) Diagnostic tests; (4) Treatment; (5) Ophthalmologist consultation.
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Affiliation(s)
- Vagner Antonio Rodrigues Silva
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil.
| | - Henrique Furlan Pauna
- Hospital Universitário Cajuru, Departamento de Otorrinolaringologia, Curitiba, PR, Brazil
| | - Joel Lavinsky
- Universidade Federal do Rio Grande do Sul (UFRGS), Departamento de Cirurgia, Porto Alegre, RS, Brazil
| | - Miguel Angelo Hyppolito
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Melissa Ferreira Vianna
- Irmandade Santa Casa de Misericórdia de São Paulo, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Mariana Leal
- Universidade Federal de Pernambuco (UFPE), Departamento de Cirurgia, Recife, PE, Brazil
| | - Eduardo Tanaka Massuda
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Rogério Hamerschmidt
- Universidade Federal do Paraná (UFPR), Hospital de Clínicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Curitiba, PR, Brazil
| | - Fayez Bahmad
- Universidade de Brasília (UnB), Programa de Pós-Graduação em Ciências da Saúde, Brasília, DF, Brazil; Instituto Brasiliense de Otorrinolaringologia (IBO), Brasília, DF, Brazil
| | - Renato Valério Cal
- Centro Universitário do Estado do Pará (CESUPA), Departamento de Otorrinolaringologia, Belém, PA, Brazil
| | - André Luiz Lopes Sampaio
- Universidade de Brasília (UnB), Faculdade de Medicina, Laboratório de Ensino e Pesquisa em Otorrinolaringologia, Brasília, DF, Brazil
| | - Felippe Felix
- Universidade Federal do Rio de Janeiro (UFRJ), Hospital Universitário Clementino Fraga Filho (HUCFF), Departamento de Otorrinolaringologia, Rio de Janeiro, RJ, Brazil
| | - Carlos Takahiro Chone
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Arthur Menino Castilho
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
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Xiao H, Amaerjiang N, Wang W, Li M, Zunong J, En H, Zhao X, Wen C, Yu Y, Huang L, Hu Y. Hearing thresholds elevation and potential association with emotional problems among 1,914 children in Beijing, China. Front Public Health 2022; 10:937301. [PMID: 35991012 PMCID: PMC9386347 DOI: 10.3389/fpubh.2022.937301] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/12/2022] [Indexed: 01/09/2023] Open
Abstract
Objectives School-aged children may experience hearing loss and emotional problems. Previous studies have shown a bidirectional relationship between hearing loss and emotional problems in the elderly population, and we aimed to analyze the association between hearing thresholds and emotional problems in school-aged children. Methods Based on the Beijing Child Growth and Health Cohort (PROC) study, the hearing screenings were conducted in November 2019 using pure tone audiometry. A total of 1,877 parents completed the Strengths and Difficulties Questionnaire (SDQ) to assess children's emotional and behavioral status. We used generalized linear regression analysis to assess the potential association of emotional problems with hearing thresholds, based on multiple imputed datasets with a sample size of 1,914. Results The overall pass rate of hearing screening was 91.5%. The abnormal rate of SDQ total difficulties was 55.8%. Emotional symptoms were positively associated with left ear average hearing thresholds (β = 0.24, 95%CI: 0.08–0.40), and right ear average hearing thresholds (β = 0.18, 95%CI: 0.04–0.32). Conduct problems, hyperactivity/inattention, peer problems, and prosocial behaviors had no association with the pass rate of the hearing screening. Regarding emotional symptoms, boys with many fears and who are easily scared coincided with increased right ear average hearing thresholds (β = 0.67, 95%CI: 0.01–1.33). Girls having many worries, frequently feeling unhappy and downhearted were positively associated with left and right ear average hearing thresholds, respectively (β = 0.96, 95%CI: 0.20–1.73; β = 0.72, 95%CI: 0.07–1.37). Conclusions The co-occurrence of hearing problems and emotional problems of children aged 6–8 in Beijing attracts attention. It is important to address undiscovered hearing loss and emotional problems from the perspective of comorbidity driving factors.
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Affiliation(s)
- Huidi Xiao
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Nubiya Amaerjiang
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Weiwei Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Menglong Li
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Jiawulan Zunong
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
| | - Hui En
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xuelei Zhao
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Cheng Wen
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Yiding Yu
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Lihui Huang
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Beijing, China
- Lihui Huang
| | - Yifei Hu
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing, China
- *Correspondence: Yifei Hu ;
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Miggiani P, Coninx F, Schaefer K. Validation of the LittlEARS® Questionnaire in Hearing Maltese-Speaking Children. Audiol Res 2022; 12:191-201. [PMID: 35447742 PMCID: PMC9031242 DOI: 10.3390/audiolres12020022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/25/2022] [Accepted: 04/06/2022] [Indexed: 11/27/2022] Open
Abstract
Objectives: To adapt the LittlEARS® Auditory Questionnaire into the Maltese language and evaluate the psychometric properties of the Maltese version of the questionnaire for hearing children. Methods: The English version of LittlEARS® Auditory Questionnaire was adapted into Maltese using a translation/back translation procedure. In this cross-sectional study, a total of 398 parents of normal hearing children aged between 5 days and 36 months completed the Maltese version of LittlEARS®. Psychometric validation was performed through scale analysis, item analysis, and analysis of reliability and validity. A non-linear regression model was derived to obtain normative data for expected and minimum values of total scores from the questionnaire according to age. Results: Predictive accuracy (Guttman’s lambda) was 0.921, the Cronbach’s alpha coefficient value was 0.921, and the split-half reliability coefficient was 0.949. The Pearson correlation coefficient between scores and age was 0.903. The regression analysis showed that 82% of the variance in the total scores can be explained by age. Norm curves were comparable to the original German data. Conclusion: This study confirmed that the Maltese version of LittlEARS® is a valid and reliable tool to evaluate auditory development in children less than two years of age.
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Affiliation(s)
| | - Frans Coninx
- IfAP, Institut für Audiopädagogik, 42697 Solingen, Germany;
| | - Karolin Schaefer
- Department of Special Education and Rehabilitation, Faculty of Human Sciences, University of Cologne, 50931 Köln, Germany
- Correspondence:
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Luo H, Yang Y, Wang X, Xu F, Huang C, Liu D, Zhang L, Huang T, Ma P, Lu Q, Huang S, Yang B, Zou Y, Liu Y. Concurrent newborn hearing and genetic screening of common hearing loss variants with bloodspot-based targeted next generation sequencing in Jiangxi province. Front Pediatr 2022; 10:1020519. [PMID: 36389375 PMCID: PMC9659731 DOI: 10.3389/fped.2022.1020519] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND AIMS Concurrent hearing and genetic screening of newborns have been widely adopted as an effective strategy in early diagnosis and intervention for hearing loss in many cities in China. Here, we aimed to firstly explore the efficacy of combining conventional hearing screening with genetic screening among the large-scale newborns in Jiangxi Province. METHODS A total of 24,349 newborns from Jiangxi Maternal and Child Health Hospital were enrolled in our study from April 2021 to June 2022. Newborn hearing screening was conducted using otoacoustic emission (OAE) and automated auditory brainstem response (AABR). Meanwhile, newborn dried blood spots were collected and twenty common variants in four genes, including GJB2, SLC26A4, MT-RNR1(12SrRNA), and GJB3, were screened using a BGISEQ-500 next generation sequencing platform. Whole coding regions sequencing of GJB2 and SLC26A4 were performed by Sanger sequencing and NGS, respectively. Following up of hearing for the newborns was undertaken by phone interviews. RESULTS Among the 24,349 newborns, 7.00% (1,704/24,349) were bilaterally or unilaterally referred in their initial hearing screening, whereas 1.30% (316/24,349) exhibited bilateral or unilateral hearing loss in the repeated screening. Genetic screening revealed that 4.813% (1,172/24,349) of the screened newborns were positive for at least one mutant allele (heterozygote, homozygote, or compound heterozygote in one gene, mtDNA homoplasmy or heteroplasmy and combined variants in different genes). A total of 1,146 individuals were identified with mutant allele in one gene, including 525 of GJB2, 371 of SLC26A4, 189 as homoplasmic or heteroplasmic of MT-RNR1, and 61 of GJB3, indicating that GJB2 and SLC26A4 are the most common endemic deafness-associated genes among newborns in Jiangxi Province. Nineteen newborns were detected with combined heterozygous variants in different genes, with "c.235delC heterozygous and c.919-2A > G heterozygous" as the most prevalent genotype. Additionally, seven newborns were screened as homozygotes or compound heterozygotes responsible for congenital or late-onset prelingual hearing loss, including three cases with GJB2 c.235delC homozygous and one with SLC26A4 c.919-2A > G homozygous variant, one case with compound heterozygous variants for GJB2 and two with compound heterozygous variants for SLC26A4. Coding regions sequencing of GJB2 or SLC26A4 for overall 265 infants revealed that 14 individuals were identified as compound heterozygote with a second pathogenic variant not screened by our genetic panel. CONCLUSIONS Herein our study firstly investigated the efficacy of concurrent hearing screening and genetic screening of common hearing impairment variants among large-scale newborns in Jiangxi Province. Concurrent screening provides a more comprehensive approach for management of congenital or delayed onset prelingual hearing loss and prevention of drug-induced hearing impairment for newborns at risk as well as their maternal relatives. An insight into the molecular epidemiology for hearing loss genes among Jiangxi population will also be beneficial to the genetic counseling and birth defect prevention.
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Affiliation(s)
- Haiyan Luo
- Department of Medical Genetics, Jiangxi Key Laboratory of Birth Defect Prevention and Control, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Yan Yang
- Department of Medical Genetics, Jiangxi Key Laboratory of Birth Defect Prevention and Control, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Xinrong Wang
- Department of Medical Genetics, Jiangxi Key Laboratory of Birth Defect Prevention and Control, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Fangping Xu
- Department of Obstetrics, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, China
| | - Cheng Huang
- Department of Medical Genetics, Jiangxi Key Laboratory of Birth Defect Prevention and Control, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Danping Liu
- Department of Medical Genetics, Jiangxi Key Laboratory of Birth Defect Prevention and Control, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Liuyang Zhang
- Department of Medical Genetics, Jiangxi Key Laboratory of Birth Defect Prevention and Control, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Ting Huang
- Department of Medical Genetics, Jiangxi Key Laboratory of Birth Defect Prevention and Control, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Pengpeng Ma
- Department of Medical Genetics, Jiangxi Key Laboratory of Birth Defect Prevention and Control, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Qing Lu
- Department of Medical Genetics, Jiangxi Key Laboratory of Birth Defect Prevention and Control, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Shuhui Huang
- Department of Medical Genetics, Jiangxi Key Laboratory of Birth Defect Prevention and Control, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Bicheng Yang
- Department of Medical Genetics, Jiangxi Key Laboratory of Birth Defect Prevention and Control, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Yongyi Zou
- Department of Medical Genetics, Jiangxi Key Laboratory of Birth Defect Prevention and Control, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Yanqiu Liu
- Department of Medical Genetics, Jiangxi Key Laboratory of Birth Defect Prevention and Control, Jiangxi Maternal and Child Health Hospital, Nanchang, China
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11
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Chen DY, Lee IC, Wang XA, Wong SH. Early Biomarkers and Hearing Impairments in Patients with Neonatal Hypoxic-Ischemic Encephalopathy. Diagnostics (Basel) 2021; 11:diagnostics11112056. [PMID: 34829404 PMCID: PMC8620896 DOI: 10.3390/diagnostics11112056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 10/30/2021] [Accepted: 11/04/2021] [Indexed: 11/17/2022] Open
Abstract
Identifying biomarkers for hearing impairments (HIs) in patients with neonatal hypoxic–ischemic encephalopathy (HIE), to initialize early hearing habilitation, is crucial. Seventy-eight neonates with HIE were divided into the following two groups: those with HIs and those without HIs. We compared those patients with 11,837 newborns without HIE, and analyzed the risk factors of HIs among neonatal HIE. Of the 78 patients, 11 were confirmed to have an HI, which is a substantially higher percentage than in the 11,837 newborns without HIE (14.1% vs. 0.87%; p < 0.001). More patients with moderate-to-severe HIE had confirmed HIs (p = 0.020; odds ratio, 8.61) than those with mild HIE. Clinical staging, and blood lactate and glucose levels could be predictive factors for HIs among patients with HIE. The patients who exhibited HIs had significantly higher lactate (104.8 ± 51.0 vs. 71.4 ± 48.4; U = 181, p = 0.032) and serum glucose (159.5 ± 86.1 vs. 112.1 ± 62.3; U = 166, p = 0.036) levels than those without HIs. A higher prevalence of HIs was noted in the patients with stage III HIE than those with stage II HIE (43.8% vs. 10%; p = 0.008). The degree of HI correlated with brain anomalies and neurodevelopmental outcomes at 1 year of age. Clinical staging, and blood lactate and glucose levels could be predictive factors for HIs among patients with HIE.
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Affiliation(s)
- Da-Yang Chen
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (D.-Y.C.); (S.-H.W.)
| | - Inn-Chi Lee
- Division of Pediatric Neurology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
- Institute of Medicine, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Correspondence: ; Tel.: +886-4-2473-9535; Fax: +886-4-2471-0934
| | - Xing-An Wang
- Division of Neonatology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 40201, Taiwan;
| | - Swee-Hee Wong
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (D.-Y.C.); (S.-H.W.)
- Division of Pediatric Neurology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
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12
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Vos B, Noll D, Whittingham J, Pigeon M, Bagatto M, Fitzpatrick EM. Cytomegalovirus-A Risk Factor for Childhood Hearing Loss: A Systematic Review. Ear Hear 2021; 42:1447-1461. [PMID: 33928914 DOI: 10.1097/aud.0000000000001055] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Permanent hearing loss is an important public health issue in children with consequences for language, social, and academic functioning. Early hearing detection, intervention, and monitoring are important in mitigating the impact of permanent childhood hearing loss. Congenital cytomegalovirus (CMV) infection is a leading cause of hearing loss. The purpose of this review was to synthesize the evidence on the association between CMV infection and permanent childhood hearing loss. DESIGN We performed a systematic review and examined scientific literature from the following databases: MEDLINE, Ovid MEDLINE(R) Daily and Ovid MEDLINE(R), Embase, and CINAHL. The primary outcome was permanent bilateral or unilateral hearing loss with congenital onset or onset during childhood (birth to 18 years). The secondary outcome was progressive hearing loss. We included studies reporting data on CMV infection. Randomized controlled trials, quasi-experimental studies, nonrandomized comparative and noncomparative studies, and case series were considered. Data were extracted and the quality of individual studies was assessed with the Qualitative Assessment Tool for Quantitative Studies (McMaster University). The quality and strength of the evidence were graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). A narrative synthesis was completed. RESULTS Sixty-five articles were included in the review. Prevalence of hearing loss at birth was over 33% among symptomatic CMV-infected newborns and less than 15% in asymptomatic infections. This difference in prevalence was maintained during childhood with more than 40% prevalence reported for symptomatic and less than 30% for asymptomatic CMV. Late-onset and progressive hearing loss appear to be characteristic of congenital CMV infections. Definitions of hearing loss, degree of loss, and reporting of laterality varied across studies. All degrees and both bilateral and unilateral loss were reported, regardless of symptomatic and asymptomatic status at birth, and no conclusions about the characteristics of hearing loss could be drawn. Various patterns of hearing loss were reported including stable, progressive, and fluctuating, and improvement in hearing (sometimes to normal hearing) was documented. These changes were reported in children with symptomatic/asymptomatic congenital CMV infection, presenting with congenital/early onset/late-onset hearing loss and in children treated and untreated with antiviral medication. CONCLUSIONS Symptomatic and asymptomatic congenital CMV infection should be considered a risk factor for hearing loss at birth and during childhood and for progressive hearing loss. Therefore, CMV should be included as a risk factor in screening and surveillance programs and be taken into account in clinical follow-up of children with hearing loss.
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Affiliation(s)
- Bénédicte Vos
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,CHEO Research Institute, Ottawa, ON, Canada.,School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Dorie Noll
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,CHEO Research Institute, Ottawa, ON, Canada
| | | | | | - Marlene Bagatto
- School of Communication Sciences and Disorders and the National Centre for Audiology, Western University, London, ON, Canada
| | - Elizabeth M Fitzpatrick
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,CHEO Research Institute, Ottawa, ON, Canada
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13
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Kim KN, Yoo SM, Kang S, Kim HJ, Yun J, Lee JY. Mortality of Children with Autism Spectrum Disorder Using Data from a Large-Scale Korean National Cohort. Yonsei Med J 2021; 62:943-947. [PMID: 34558874 PMCID: PMC8470567 DOI: 10.3349/ymj.2021.62.10.943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/08/2021] [Accepted: 07/16/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study aimed to investigate the association between autism spectrum disorder (ASD) diagnosis and mortality among children using the data from a large-scale national cohort of Korean infants and children. We also explored the association between hearing impairment detected during early infancy and mortality. MATERIALS AND METHODS We performed a retrospective cohort study using the nationwide claims data of the Republic of Korea. Children born between 2007 and 2014 (n=3598904) were followed up until 2020. Cox proportional hazard models were used to examine the association between ASD diagnosis and mortality among children. Then, in order to evaluate the association between hearing impairment and mortality, Cox proportional hazard models were built using the responses related to hearing impairment asked during the first health screening (at age 4-6 months). RESULTS Of the 3598904 children born between 2007 and 2014, 32878 children (0.9%) were diagnosed with ASD until the end of 2020. We identified that ASD diagnosis was associated with higher mortality among children [hazard ratio (HR)=2.5, 95% confidence interval (CI): 2.2-2.9]. This association was stronger among girls (HR=4.8, 95% CI: 3.9-5.8) compared to boys (HR=1.9, 95% CI: 1.6-2.2). We found that hearing impairment detected during infancy was associated with higher mortality among children with ASD diagnosis. CONCLUSION ASD diagnosis was associated with higher mortality among Korean children. This association was stronger in girls than in boys. Hearing impairment detected during infancy was also associated with higher mortality among children diagnosed with ASD.
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Affiliation(s)
- Kyoung-Nam Kim
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Seung-Mi Yoo
- Graduate School of Public Health, Korea University, Seoul, Korea
| | - Sungchan Kang
- Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Hyun Joo Kim
- Department of Nursing Science, Shinsung University, Dangjin, Korea
| | - Jieun Yun
- Department of Pharmaceutical Engineering, Cheongju University, Cheongju, Korea
| | - Jin Yong Lee
- Public Healthcare Center, Seoul National University Hospital, Seoul, Korea
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
- HIRA Research Institute, Health Insurance Review and Assessment Service, Wonju, Korea.
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14
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Sapp C, Stirn J, O'Hollearn T, Walker EA. Expanding the Role of Educational Audiologists After a Failed Newborn Hearing Screening: A Quality Improvement Study. Am J Audiol 2021; 30:631-641. [PMID: 34269595 DOI: 10.1044/2021_aja-21-00003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Purpose Lack of timely and proximal access to diagnostic hearing evaluation using auditory brainstem response (ABR) testing hampers the effectiveness of Early Hearing Detection and Intervention (EHDI) programs in the United States. This study measured the impact of a state-based quality-improvement (QI) project that provided diagnostic ABR equipment and training to educational audiologists distributed throughout Iowa in regional special education centers. Method We used de-identified administrative data generated by the state EHDI program to analyze markers of access to early hearing health care for infants in a preproject condition ("Baseline") compared to the implementation of diagnostic ABRs at the regional special education centers ("QI Project"). Results Our findings revealed that the QI Project was associated with improvements in timeliness of first hearing evaluation, distance traveled for first hearing evaluation, and likelihood of receiving on-guideline audiology care during the first hearing evaluation. Conclusions Following the onset of the QI Project, infants and their families had greater access to initial hearing evaluation after failed newborn hearing screening. This improvement could have cascading effects on timeliness of later intervention among those with confirmed permanent childhood hearing loss.
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Affiliation(s)
- Caitlin Sapp
- University of North Carolina Medical Center, Chapel Hill
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15
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Salamatmanesh M, Sikora L, Bahraini S, MacAskill M, Lagace J, Ramsay T, Fitzpatrick EM. Paediatric hearing aid use: a systematic review. Int J Audiol 2021; 61:12-20. [PMID: 34407727 DOI: 10.1080/14992027.2021.1962014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CONTEXT Hearing loss (HL) is one of the most common disorders present at birth. Parents' management of their child's hearing aids (HAs) and regular follow-up with healthcare providers HA are fundamental components of effective intervention. OBJECTIVE The primary objective of this systematic review was to synthesise the current literature on HA use in the paediatric population, and the secondary objective was to review the factors associated with HA use. METHODS Electronic databases, including MEDLINE, EMBASE, CINAHL, and LLBA from 2005 to 2019, were searched. Two reviewers individually screened potentially relevant articles over two phases. RESULTS Fifteen studies met this review criteria. Four studies reported HA use based on data logging records. In nine studies, the amount of HA use was evaluated based on parents' reports, and three studies concluded that parents overestimate their child's HA use. Age, degree of HL and parents' education level were the most frequently reported factors associated with a child's amount of HA use. CONCLUSIONS The results of this review will provide a foundation for future studies on the importance of monitoring HA use and the impact of consistent HA use on the language development of children with HL.
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Affiliation(s)
- Mina Salamatmanesh
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada.,CHEO Research Institute, Ottawa, ON, Canada
| | - Lindsey Sikora
- Health Sciences Library, University of Ottawa, Ottawa, ON, Canada
| | - Sayna Bahraini
- CHEO Research Institute, Ottawa, ON, Canada.,Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON, Canada
| | | | - Josée Lagace
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Tim Ramsay
- Faculty of Health Sciences, School of Epidemiology, University of Ottawa, Ottawa, ON, Canada.,Eastern Health, Clarenville, NL, USA
| | - Elizabeth M Fitzpatrick
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada.,CHEO Research Institute, Ottawa, ON, Canada
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16
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Verkleij ML, Heijnsdijk EAM, Bussé AML, Carr G, Goedegebure A, Mackey AR, Qirjazi B, Uhlén IM, Sloot F, Hoeve HLJ, de Koning HJ. Cost-Effectiveness of Neonatal Hearing Screening Programs: A Micro-Simulation Modeling Analysis. Ear Hear 2021; 42:909-916. [PMID: 33306547 PMCID: PMC8221716 DOI: 10.1097/aud.0000000000000981] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Supplemental Digital Content is available in the text. Early detection of neonatal hearing impairment moderates the negative effects on speech and language development. Universal neonatal hearing screening protocols vary in tests used, timing of testing and the number of stages of screening. This study estimated the cost-effectiveness of various protocols in the preparation of implementation of neonatal hearing screening in Albania.
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Affiliation(s)
- Mirjam L Verkleij
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Eveline A M Heijnsdijk
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Andrea M L Bussé
- Department of Otorhinolaryngology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Ophthalmology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Gwen Carr
- Independent Consultant in Early Hearing Detection, Intervention and Family Centered Practice, London, United Kingdom
| | - André Goedegebure
- Department of Otorhinolaryngology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Allison R Mackey
- Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Birkena Qirjazi
- Department of Ear, Nose and Throat Diseases-Ophthalmology, University of Tirana, Tirana, Albania
| | - Inger M Uhlén
- Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Frea Sloot
- Department of Ophthalmology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Hans L J Hoeve
- Department of Otorhinolaryngology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Harry J de Koning
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
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17
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Ching TYC, Saetre-Turner M, Marnane V, Scarinci N, Choik C, Tulloch K, Sung V. Audiologists' perspectives on management of mild bilateral hearing loss in infants and young children. Int J Audiol 2021; 61:752-760. [PMID: 34370600 DOI: 10.1080/14992027.2021.1961170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Universal newborn hearing screening programs have led to early identification of infants with congenital mild bilateral hearing loss (MBHL). The current lack of evidence-based protocols to guide audiological management of infants with MBHL has led to clinical equipoise about fitting of hearing aids. The purpose of this study was to increase understanding about the perspectives of paediatric audiologists on factors influencing their management of MBHLin infants and young children. DESIGN A qualitative descriptive research methodology involving semi-structured interviews with audiologists. STUDY SAMPLE Twenty-three paediatric audiologists in diagnostic and rehabilitation settings in Victoria, Australia. RESULTS Three main themes that influenced management were identified. These include: (1) evidence, or the lack of it, influences audiologists' practice; (2) audiologists recognise the need to be fluid; and (3) family characteristics and parents' perspectives. "Audiologists delivering family-centred practice" was identified as an overarching theme across these factors. CONCLUSIONS Audiologists recognised the importance of adopting a family-centred approach in their management of MBHL in infants and young children. Embodied in their practice was the acknowledgement of limited evidence, the consideration of multiple child and family factors, and the incorporation of perspectives of parents and families in adopting a fluid approach to provide individualised services.
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Affiliation(s)
- Teresa Y C Ching
- National Acoustic Laboratories, Hearing Australia, Sydney, Australia.,Department of Linguistics, Macquarie University, Sydney, Australia
| | | | - Vivienne Marnane
- National Acoustic Laboratories, Hearing Australia, Sydney, Australia
| | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Chermaine Choik
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Kristen Tulloch
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Valerie Sung
- Population Health, Murdoch Children's Research Institute, Melbourne, Australia.,Centre for Community Child Health and Department of General Medicine, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
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18
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Lin JJ, Gillam L, Smith L, Carew P, King A, Ching TYC, Sung V. Mild matters: parental insights into the conundrums of managing mild congenital hearing loss. Int J Audiol 2021; 61:500-506. [PMID: 34346279 DOI: 10.1080/14992027.2021.1954248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To explore and describe parental experiences related to the management of mild bilateral congenital hearing loss in children. DESIGN Using qualitative methods, we conducted semi-structured interviews with parents/caregivers until saturation of themes was achieved. We analysed transcripts using inductive content analysis. STUDY SAMPLE Caregivers of children under 3-years-old with mild bilateral sensorineural hearing loss. RESULTS We interviewed 12 parents. Parental perception of advice regarding hearing aid fitting was varied; almost all children were offered hearing aids. Perceived positives related to hearing aids: feeling empowered that action has been taken; improvements in the child's hearing perception and; facilitation of behavioural management. Perceived negatives of hearing aid use: difficulties with compliance resulting in parental frustration and guilt, damage/loss of equipment, discomfort, parental discord, altered quality of natural sound and potential bullying/stigma. Some parents were ambivalent about the effect of the hearing aids. Where hearing aids were offered and not fitted, there was significant ongoing uncertainty, and the family carried the burden of their decision. CONCLUSIONS There was a wide variation in perceived advice regarding early hearing aid fitting in children with mild bilateral hearing loss. We identified parental perceptions of positive/negative impacts of hearing aid fitting and potential perceived harms from not fitting.
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Affiliation(s)
| | - Lynn Gillam
- The Royal Children's Hospital, Melbourne, Australia.,The University of Melbourne, Melbourne, Australia
| | - Libby Smith
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Peter Carew
- Murdoch Children's Research Institute, Melbourne, Australia
| | | | | | - Valerie Sung
- The Royal Children's Hospital, Melbourne, Australia.,The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
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19
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Orzan E, Battelino S, Ciciriello E, Bonifacio S, Pellizzoni S, Saksida A. Reliability of parental assessment of auditory skills in young children: a cross-sectional study in Italian language. BMJ Open 2021; 11:e042297. [PMID: 34088704 PMCID: PMC8183264 DOI: 10.1136/bmjopen-2020-042297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Hearing impairments (HIs) that progress or have later onset may have specific effects on language and cognitive development, but are difficult to suspect during routine primary care visits. Family concern regarding hearing is thought to represent an important risk factor requiring audiological examination. Yet it is not clear how successful parents are in recognising the consequences or specific suspect elements of HI in young children. The aim of this study is to verify whether parents of at-risk children recognise the presence of HI through a parental questionnaire that draws attention to auditory skills development and compares them with language and communication skills. DESIGN Observational study. SETTING From 2013 to 2019, parents were administered the Questionnaire on Hearing and Communication Abilities before audiological evaluation of their children at a secondary care institute. PARTICIPANTS 309 Italian children (1-36 months old) at risk of HI. PRIMARY AND SECONDARY OUTCOME MEASURES Questionnaire sensitivity in predicting the presence and type of HI. RESULTS Parents report a decrease in auditory skills for children with sensorineural HI (Χ2(2)=14.4, p=0.003), with an increased concern expressed in 59% compared with 24% in normally hearing children. Both auditory (r=-0.18, p=0.002) and comprehension (r=-0.13, p=0.057) skills weakly but negatively correlated with a diagnosis of HI. On discriminant analysis, the positive predictive value of the questionnaire was 0.78, but with low sensitivity (0.39). CONCLUSIONS Parents of children with a verified risk of HI have some capacity to recognise non-typical auditory behaviour. Thus, it is important to assess parental concerns during primary care health visits, and a targeted questionnaire on auditory abilities can complement existing screening procedures. However, given the low sensitivity of the questionnaire, we conclude that for a reliable detection of HIs that progress or have later onset an objective screening tool is always required.
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Affiliation(s)
- Eva Orzan
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" - Trieste, Trieste, Italy
| | - Saba Battelino
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Elena Ciciriello
- Studio di Neuropsicologia e Logopedia dell'età evolutiva, Parma, Italy
| | | | | | - Amanda Saksida
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo" - Trieste, Trieste, Italy
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20
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Bussé AML, Mackey AR, Carr G, Hoeve HLJ, Uhlén IM, Goedegebure A, Simonsz HJ. Assessment of hearing screening programmes across 47 countries or regions III: provision of childhood hearing screening after the newborn period. Int J Audiol 2021; 60:841-848. [PMID: 33835906 DOI: 10.1080/14992027.2021.1897170] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To inventory provision and features of childhood hearing screening after the newborn period (CHS), primarily in Europe. DESIGN From each participating country or region, experts provided information through an extensive questionnaire: implementation year, age at screening, test method, pass criteria, screening location, screener profession, and quality indicators: coverage, referral, follow-up and detection rates, supplemented by literature sources. STUDY SAMPLE Forty-two European countries or regions, plus Russia, Malawi, Rwanda, India, and China. RESULTS CHS was performed universally with pure-tone audiometry screening (PTS) in 17 countries or regions, whereas non-universal CHS was performed in eight with PTS or whisper tests. All participating countries with universal PTS had newborn hearing screening. Coverage rate was provided from three countries, detection rate from one, and referral and follow-up rate from two. In four countries, universal PTS was performed at two ages. Earliest universal PTS was performed in a (pre)school setting by nurses (n = 9, median age: 5 years, range: 3-7), in a healthcare setting by doctors and nurses (n = 7, median age: 4.5 years, range: 4-7), or in both (n = 1). CONCLUSIONS Within universal CHS, PTS was mostly performed at 4-6 years by nurses. Insufficient collection of data and monitoring with quality indicators impedes evaluation of screening.
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Affiliation(s)
- Andrea M L Bussé
- Department of Otorhinolaryngology and Head, Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Gwen Carr
- Early Hearing Detection, Intervention and Family Centered Practice, London, UK
| | - Hans L J Hoeve
- Department of Otorhinolaryngology and Head, Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - André Goedegebure
- Department of Otorhinolaryngology and Head, Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Huibert J Simonsz
- Department of Otorhinolaryngology and Head, Neck Surgery and Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
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21
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Schickinger-Fischer B. [Early detection of unilateral connatal hearing loss via newborn hearing screening and the implementation of the SAV-concept 2017 in lower Austria and Burgenland]. Wien Med Wochenschr 2021; 172:14-19. [PMID: 33738629 DOI: 10.1007/s10354-021-00835-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/23/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recent studies showed the benefit or even need of hearing aids or cochlear implants in children with unilateral hearing loss to improve localization abilities and speech intelligibility. Therefore, the Audiology working group of the Austrian ENT society adopted the SAV-concept in 2017 (Screening Abklärung Versorgung von konnatalen Hörstörungen - Konzeptpapier 2017 AG Audiologie) to establish methods for testing, the mode of testing both ears, the desired schedule for the screening process and the subsequent therapy. METHODS The screening data were collected via questionnaires sent to all maternity and neonatal wards in different districts by responsible persons of the Austrian ENT society. Data on the implementation of the SAV concept were evaluated retrospectively based on the responses for the regions of Lower Austria and Burgenland. RESULTS The feedback, the implementation and responsibility for the screening program in respect of method and schedule differs throughout the federal states of Austria as well as in hospitals of state health organizations. CONCLUSION Austria in comparison to other European countries is missing a central documentation and tracking system via a governmental screening coordination office as the data are not generally transferred to a common birth register. Therefore, different timetables and organization for the universal new born hearing screening in the federal states as well as in state organizations were found causing a delayed diagnosis and treatment of children with unilateral hearing loss.
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22
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Palma S, Roversi MF, Alberici MP, Negri M, Chiossi C, Berardi A, Genovese E. Newborn hearing screening programme based on an integrated hospital and community care system. Results of the first 4 years of activity. Int J Pediatr Otorhinolaryngol 2021; 141:110554. [PMID: 33341716 DOI: 10.1016/j.ijporl.2020.110554] [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] [Received: 09/03/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
Since January 2012, babies born in the province of Modena, Italy, have routinely undergone hearing testing as part of a two-stage screening programme. Newborn hearing screening (NHS) has been based on an integrated hospital and community care system and this study aims to assess screening coverage, referral rates, the prevalence, type and extent of hearing loss several years into the programme. Data were collected from January 1, 2012 to December 31, 2015. Coverage was over 99% in all five facilities of the province. The ratio of "fails of the screening" to the total number of infants tested varied over the period from 1.2% to 0.9% in the third level facility, and from 0.8% to 0.4% in the other four. Although hearing loss was mainly associated with dysmorphic\syndromic diseases or a family history of hearing loss, some 23% of cases were identified with no known risk factors. We highlight the importance of the NHSP and the need for strong support from healthcare administrators to ensure high coverage. This is especially true since although the prevalence of hearing loss was higher among infants with audiological risk factors, several cases of hearing loss were found in newborns with no known risk factors.
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Affiliation(s)
| | - Maria Federica Roversi
- Paediatric Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
| | | | | | | | - Alberto Berardi
- Paediatric Neonatal Intensive Care Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
| | - Elisabetta Genovese
- Audiology, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.
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23
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Orzan E, Pizzamiglio G, Marchi R, Muzzi E, Monasta L, Torelli L, Feresin A. Modeling Postnatal Hearing Case Finding Within the Italian National Health System. Front Pediatr 2021; 9:564662. [PMID: 33777856 PMCID: PMC7994254 DOI: 10.3389/fped.2021.564662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 02/03/2021] [Indexed: 11/17/2022] Open
Abstract
Objective: Despite the successful implementation of newborn hearing screening (NHS), a debate is emerging as to what should be the best means of enabling timely diagnosis and intervention for preschoolers with educationally significant sensorineural or conductive hearing impairment (HI) missed at the time of NHS or occurred after birth. Our study aims to document the proportion and characteristics of HIs diagnosed in children in need of audiologic assessment, in order to outline the optimization areas of an operational framework for auditory surveillance during preschool age. Method: The referral routes and outcomes of 730 audiological assessments performed in 3 years within the framework of the early hearing identification program in Trieste (Italy) were retrospectively analyzed. Results: Among 570/595 completed evaluations, an HI was diagnosed in 114 children, 73.7% of which presenting an exclusively conductive HI due to middle ear effusion. HIs were found in 36/141 who failed NHS, and 60/385 preschoolers who were referred by the primary care pediatrician's surveillance activity during well-child visits, with diagnostic yield of 25.5 and 15.5%, respectively. Conclusion: Ongoing preschool surveillance in primary care setting integrated into a NHS program is feasible to conduct and may effectively identify HIs that missed NHS or were related with a risk factor. New triage instruments and protocols for immediate audiology referral could allow to obtain the diagnosis of educationally significant conductive and sensorineural HIs ahead of the development concern and in the same way reduce patient mobility, thus optimizing timing efficiency and economic impact of the program.
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Affiliation(s)
- Eva Orzan
- Institute for Maternal and Child Health Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) "Burlo Garofolo", Trieste, Italy
| | - Giulia Pizzamiglio
- Institute for Maternal and Child Health Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) "Burlo Garofolo", Trieste, Italy
| | - Raffaella Marchi
- Institute for Maternal and Child Health Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) "Burlo Garofolo", Trieste, Italy
| | - Enrico Muzzi
- Institute for Maternal and Child Health Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) "Burlo Garofolo", Trieste, Italy
| | - Lorenzo Monasta
- Institute for Maternal and Child Health Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) "Burlo Garofolo", Trieste, Italy
| | - Lucio Torelli
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Agnese Feresin
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
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Kim JH, Roh KJ, Nam GS, Son EJ. Audiologic Status of Children with Confirmed Cytomegalovirus Infection: a Case Series. J Korean Med Sci 2020; 35:e244. [PMID: 32743988 PMCID: PMC7402926 DOI: 10.3346/jkms.2020.35.e244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 06/04/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Congenital cytomegalovirus (CMV) infection is the most common non-genetic cause of sensorineural hearing loss (SHNL) in children. Only about 10% to 15% of children with congenital CMV are symptomatic, and most are not diagnosed at birth. About 7% to 15% of clinically asymptomatic patients may develop later complications, including SNHL, which is the most common sequela in clinically asymptomatic patients. In this study, hearing status was investigated in children with confirmed CMV infection and neonatal hearing screening (NHS) histories were reviewed to explore hearing loss caused by CMV. METHODS The medical records of 58 children who were diagnosed with confirmed CMV infection were reviewed for clinical symptoms and signs of CMV infection. Hearing status was evaluated with age-appropriate audiological test batteries. RESULTS A total of 58 children (M:F = 32:26 patients; age at study: mean, 5.62 years, range, 1-10 years) were diagnosed serologically with CMV infection (14 patients, 21.1%), or diagnosed via PCR of serum (5, 7.9%) and/or PCR from urine (19, 26.8%). Hearing loss was confirmed in 11 children (19.0%), being bilateral in 6 (54.5%), and unilateral in 5 (45.5%). Note that 7 of 17 ears with hearing loss passed NHS and were diagnosed only after re-evaluation when CMV infection was identified. CONCLUSION Hearing loss is a serious complication of CMV infection in children. Our results highlight the importance of timely audiological evaluation in children with clinically symptomatic CMV infection even if they pass NHS.
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Affiliation(s)
- Ji Hyung Kim
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Jin Roh
- Department of Otorhinolaryngology, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Gi Sung Nam
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Jin Son
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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25
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Uhlén I, Mackey A, Rosenhall U. Prevalence of childhood hearing impairment in the County of Stockholm – a 40-year perspective from Sweden and other high-income countries. Int J Audiol 2020; 59:866-873. [DOI: 10.1080/14992027.2020.1776405] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Inger Uhlén
- Department of Hearing and Balance, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Allison Mackey
- Department of Clinical Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Ulf Rosenhall
- Department of Hearing and Balance, Karolinska University Hospital, Stockholm, Sweden
- Division of Audiology, Department of Health and Rehabilitation, University of Gothenburg, Gothenburg, Sweden
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26
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Doerfer KW, Sander T, Konduri GG, Friedland DR, Kerschner JE, Runge CL. Development of in-house genetic screening for pediatric hearing loss. Laryngoscope Investig Otolaryngol 2020; 5:497-505. [PMID: 32596493 PMCID: PMC7314470 DOI: 10.1002/lio2.379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To evaluate the efficiency of in-house genetic testing for mutations causing the most common types of inherited, nonsyndromic, sensorineural hearing loss (SNHL). METHODS Retrospective cohort study of 200 patients at a single, pediatric medical center with suspected or confirmed hearing loss who underwent either send out vs in-house genetic testing for mutations in GJB2/GJB6, SLC26A4, and MTRNR1. Primary outcome measure was the difference in mean turnaround time for send-out vs in-house genetic testing. Additional outcomes included associations between audiometric findings and genetic test results. RESULTS One hundred four send-out tests were performed between October 2010 and June 2014, and 100 in-house tests were performed between November 2014 and November 2016. The mean turnaround time for send-out testing was 53.7 days. The mean turnaround time for in-house testing was 18.9 days. This difference was statistically significant (P < .001). The largest component of turnaround time was the amount of time elapsed between receipt of specimen in the lab and final test result. These intervals were 47.0 and 18.3 days for send-out and in-house tests, respectively. Notably, the longest turnaround time for in-house testing (43 days) was less than the average turnaround time for send-out testing. In addition, we identified two simple audiometric parameters (ie, bilateral newborn hearing screen referral and audiometry showing symmetric SNHL) that may increase diagnostic yield of genetic testing. CONCLUSIONS The development of in-house genetic testing programs for inherited SNHL can significantly reduce testing turnaround times. Newborn hearing screening and audiometry results can help clinicians identify patients most likely to benefit from genetic testing. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Karl W. Doerfer
- Medical College of Wisconsin, Department of Otolaryngology & Communication SciencesMilwaukeeWisconsinUSA
| | | | - Girija G. Konduri
- Medical College of Wisconsin, Department of NeonatologyMilwaukeeWisconsinUSA
| | - David R. Friedland
- Medical College of Wisconsin, Department of Otolaryngology & Communication SciencesMilwaukeeWisconsinUSA
| | - Joseph E. Kerschner
- Medical College of Wisconsin, Department of Otolaryngology & Communication SciencesMilwaukeeWisconsinUSA
| | - Christina L. Runge
- Medical College of Wisconsin, Department of Otolaryngology & Communication SciencesMilwaukeeWisconsinUSA
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27
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Carol Liu YC, Ibekwe T, Kelso JM, Klein NP, Shehu N, Steuerwald W, Aneja S, Dudley MZ, Garry R, Munoz FM. Sensorineural hearing loss (SNHL) as an adverse event following immunization (AEFI): Case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 2020; 38:4717-4731. [PMID: 32418788 DOI: 10.1016/j.vaccine.2020.05.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 01/22/2023]
Abstract
This is a Brighton Collaboration case definition of the term "Sensorineural Hearing Loss" to be utilized in the evaluation of adverse events following immunization. The case definition was developed by a group of experts convened by the Coalition for Epidemic Preparedness Innovations (CEPI) in the context of active development of vaccines for Lassa Fever and other emerging pathogens. The case definition format of the Brighton Collaboration was followed to develop a consensus definition and define levels of diagnostic certainty, after an exhaustive review of the literature and expert consultation. The document underwent peer review by the Brighton Collaboration Network.
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Affiliation(s)
- Yi-Chun Carol Liu
- Department of Otorhinolaryngology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Titus Ibekwe
- Department of Otorhinolaryngology, University of Abuja, Nigeria
| | - John M Kelso
- Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, CA, USA
| | - Nicola P Klein
- Kaiser Permanente Vaccine Study Center, Oakland, CA, USA
| | - Nathan Shehu
- Department of Pediatric Infectious Diseases, Jos University, Nigeria
| | - Wendy Steuerwald
- Department of Audiology, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Satinder Aneja
- Department of Pediatrics, School of Medical Sciences and Research, Sharda University, Gr Noida, India
| | - Matthew Z Dudley
- Department of International Health, and Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Flor M Munoz
- Department of Pediatrics, Section of Infectious Diseases, and Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.
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28
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Nassrallah F, Tang K, Whittingham J, Sun H, Fitzpatrick EM. Auditory, Social, and Behavioral Skills of Children With Unilateral/Mild Hearing Loss. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2020; 25:167-177. [PMID: 31836889 DOI: 10.1093/deafed/enz041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 07/17/2019] [Accepted: 09/10/2019] [Indexed: 05/27/2023]
Abstract
This study explored the impact of mild bilateral or unilateral hearing loss on auditory, social, and behavior skills in early school-aged children. Thirty-two children (aged 5-9 years) were evaluated with parent and teacher questionnaires. Most outcomes were within the range of expected scores. However, functional auditory skills were below published results for children with typical hearing. On the social skills scale, about 21.4% (parent-reported) and 20.0% (teacher-reported) of children were below one standard deviation (SD) of the normative mean (i.e., a standard score below 85). On the parent-reported behavior test, over a quarter of children scored beyond 1 SD on some subscales. Laterality of hearing loss had no effect on outcomes (p > .05). Agreement between parents and teachers varied from poor (intraclass correlation coefficient [ICC]: .162) to moderate (ICC: .448). Results indicate that these children are functioning in most areas like their peers with typical hearing. Additional research on this population of children who may benefit from early identification and amplification is warranted.
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Affiliation(s)
- Flora Nassrallah
- Faculty of Health Sciences, University of Ottawa
- Children's Hospital of Eastern Ontario Research Institute
| | - Ken Tang
- Children's Hospital of Eastern Ontario Research Institute
| | | | - Huidan Sun
- Children's Hospital of Eastern Ontario Research Institute
| | - Elizabeth M Fitzpatrick
- Faculty of Health Sciences, University of Ottawa
- Children's Hospital of Eastern Ontario Research Institute
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29
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Sato T, Nakazawa M, Takahashi S, Mizuno T, Ishikawa K, Yamada T. Outcomes of regional-based newborn hearing screening for 35,461 newborns for 5 years in Akita, Japan. Int J Pediatr Otorhinolaryngol 2020; 131:109870. [PMID: 31951982 DOI: 10.1016/j.ijporl.2020.109870] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 01/07/2020] [Accepted: 01/07/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Newborn hearing screening (NHS) has been actively performed since 2001 in Akita, Japan. The NHS coverage rate has increased yearly, and performance has been consistently >90% since 2012. The purpose of this study was to summarize NHS outcomes in the Akita prefecture of Japan and to obtain new insights for from our summarized data for the future. METHODS A total of 35,461 newborns in hospitals and clinics where hearing screening was performed in Akita from 2012 to 2016 were included. The outcome data of NHS were collected for analysis. RESULTS The overall screening coverage rate for hearing loss was 94.7%. Of the screened infants, 0.53% received a referral on the 2-stage automated auditory brainstem response (ABR), and 80.4% of referred infants had a check-up at the hospital to receive a diagnostic hearing examination. Finally, the prevalence of bilateral congenital hearing loss was 0.14%, that of bilateral moderate to profound hearing loss was 0.12%, and that of unilateral congenital hearing loss was 0.10%. Furthermore, the average consultation period in infants with risk factors was significantly later than that in infants without risk factors (p = 0.0015). Follow-up for infants diagnosed with normal hearing after diagnostic hearing examination revealed that 4.7% suffered bilateral moderate to profound hearing loss later. This percentage is significantly higher than that of the general group (p < 0.001). CONCLUSION The prevalence of bilateral congenital hearing loss was 0.14% in Akita and 0.12% of infants were diagnosed with bilateral moderate to severe hearing loss. Medical personnel should be enlightened regarding the importance of performing hearing diagnostic examinations until 3 months of age. Even if infants were diagnosed with normal hearing after a diagnostic examination, we strongly suggest continuing follow-up until they are able to perform pure tone audiometry with accuracy.
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Affiliation(s)
- Teruyuki Sato
- Department of Otorhinolaryngology, Omagari Kousei Medical Center, Daisen, Japan.
| | - Misao Nakazawa
- Department of Otorhinolaryngology, Akita Prefectural Center for Rehabilitation and Psychiatric Medicine, Daisen, Japan; Department of Otorhinolaryngology, Nakadori General Hospital, Akita, Japan
| | - Shin Takahashi
- Department of Otorhinolaryngology, Head & Neck Surgery. Akita University Graduate School of Medicine, Akita, Japan; Takahashi ENT & Eye Clinic, Yokote, Japan
| | - Tomomi Mizuno
- Department of Otorhinolaryngology, Head & Neck Surgery. Akita University Graduate School of Medicine, Akita, Japan
| | - Kazuo Ishikawa
- Department of Otorhinolaryngology, Japanese Red Cross Akita Hospital, Akita, Japan
| | - Takechiyo Yamada
- Department of Otorhinolaryngology, Head & Neck Surgery. Akita University Graduate School of Medicine, Akita, Japan
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30
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Shirane M, Ganaha A, Nakashima T, Shimoara S, Yasunaga T, Ichihara S, Kageyama S, Matsuda Y, Tono T. Comprehensive hearing care network for early identification and intervention in children with congenital and late-onset/acquired hearing loss: 8 years' experience in Miyazaki. Int J Pediatr Otorhinolaryngol 2020; 131:109881. [PMID: 31978747 DOI: 10.1016/j.ijporl.2020.109881] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 01/11/2020] [Accepted: 01/13/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE In 2010, we established the Miyazaki Comprehensive Hearing Care Network (MCHCN) for early identification and intervention in children with congenital and late-onset/acquired hearing loss with the cooperation of related administrative bodies in Miyazaki prefecture. The central roles of the MCHCN program are played by the Hearing Care Center (HCC) at the University of Miyazaki Hospital established in 2010 to facilitate audiological diagnoses, hearing aid interventions, and educational efforts, as well as linkage with the Department of Otolaryngology for surgical interventions. Herein, we aimed to present the main outcomes of the MCHCN program organized by the HCC at the University of Miyazaki Hospital. METHODS The MCHCN consists of two different networks, the Newborn Hearing Screening Network (NHSN) and the Pediatric Hearing Care Network (PHCN). All children suspected of having hearing loss by Newborn Hearing Screening (NHS) are referred to the HCC via the NHSN. In addition, children suspected of late-onset/acquired hearing loss by municipality-led health checkups, pediatricians, public health nurses, and childcare workers are referred to the HCC via the PHCN. Children who were born in Miyazaki prefecture between January 2010 and December 2017 and referred to the HCC for detailed hearing examination were included in this study. RESULTS Within the study period, 89,390 infants were born in Miyazaki prefecture, and 84,737 (94.9%) of them underwent NHS. A total of 698 infants and 182 children with suspected hearing loss were referred to the HCC via the NHSN and PHCN, respectively. Of the 880 referrals, 169 were diagnosed with hearing loss, which included 80 children with bilateral hearing loss and 89 children with unilateral hearing loss. Of the 80 children with bilateral hearing loss, 76 began wearing hearing aids and 15 had cochlear implants in the follow-up period. In children with bilateral conductive hearing loss, 4 children with bilateral middle ear anomalies underwent ossiculoplasty, following which two of these children no longer required hearing aids. Imaging assessments performed on 71 of the 89 children with unilateral hearing loss revealed that 20 of the 30 (66%) children who underwent CT exhibited ossicular anomalies and 28 out of the 48 (58%) children who underwent MRI were found to have ipsilateral cochlear nerve hypoplasia. Among the 169 children with hearing loss, no follow-up loss was observed during the period of this study. CONCLUSION The MCHCN that was organized at the initiative of the HCC at the University of Miyazaki Hospital has enabled the provision of comprehensive and continuous support, ranging from diagnosis to intervention, not only for children with suspected hearing loss referred based on their NHS results but also for those who pass the screening. Via this system, children with late-onset/acquired hearing loss can be identified early and can receive medical interventions tailored to the cause of their hearing loss while simultaneously avoiding a loss to follow-up.
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Affiliation(s)
- Miho Shirane
- Miyazaki University Hospital Hearing Care Center, Miyazaki, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Akira Ganaha
- Miyazaki University Hospital Hearing Care Center, Miyazaki, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Takahiro Nakashima
- Miyazaki University Hospital Hearing Care Center, Miyazaki, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Shoken Shimoara
- Miyazaki University Hospital Hearing Care Center, Miyazaki, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Taro Yasunaga
- Miyazaki University Hospital Hearing Care Center, Miyazaki, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Sakura Ichihara
- Miyazaki University Hospital Hearing Care Center, Miyazaki, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Saki Kageyama
- National Hospital Organization Miyakonojo Medical Center, 5033-1 Iwayoshi, Miyakonojo, 885-0014, Japan.
| | - Yusuke Matsuda
- Kagoshima City Hospital, 37-1 Uearata, Kagoshima, 890-8760, Japan.
| | - Tetsuya Tono
- Miyazaki University Hospital Hearing Care Center, Miyazaki, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
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31
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Fitzpatrick EM, Nassrallah F, Vos B, Whittingham J, Fitzpatrick J. Progressive Hearing Loss in Children With Mild Bilateral Hearing Loss. Lang Speech Hear Serv Sch 2020; 51:5-16. [PMID: 31913798 DOI: 10.1044/2019_lshss-ochl-19-0013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose This study investigated progressive hearing loss in a cohort of children who were identified with permanent mild bilateral hearing loss. Method This population-based study included 207 children with permanent mild bilateral hearing loss, diagnosed and followed from 2003 to 2016 in 1 region of Canada. Clinical characteristics and initial audiologic results were collected prospectively at diagnosis, and audiologic information was updated. Changes in hearing levels between the 1st and most recent assessment were analyzed to determine progressive hearing loss. Clinical characteristics were compared between children with progressive and stable hearing loss. The association between risk indicators and progressive hearing loss was explored through logistic regression. Results A total of 47.4% (94 of 207) had progressive hearing loss in at least 1 ear, and 50% (47 of 94) of those experienced more than 20-dB average drop in thresholds. For these 94 children, a total of 147 ears were affected, and 116 (78.9%) ears experienced sufficient change in thresholds to be coded as a worse category of hearing loss. In the subset of 85 children with more than 5 years of audiologic follow-up, 56.4% (53/85) showed a decrease in hearing. Of the total sample of 207 children, 137 (66.2%) continued to have mild hearing loss in the better ear. There was no association between the risk factors examined (family history of hearing loss, admission to the neonatal intensive care unit, or presence of a syndrome) and progressive hearing loss. Conclusion This study found that almost half of children with mild bilateral hearing loss showed a decrease in hearing in at least 1 ear. One third of the children first diagnosed with mild hearing loss in the better ear now have moderate or worse hearing loss in both ears. These findings point to the importance of careful long-term monitoring of children who present with mild hearing loss.
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Affiliation(s)
- Elizabeth M Fitzpatrick
- Faculty of Health Sciences, University of Ottawa, Ontario, Canada.,Child Hearing Laboratory, CHEO Research Institute, Ottawa, Ontario, Canada
| | - Flora Nassrallah
- Faculty of Health Sciences, University of Ottawa, Ontario, Canada.,Child Hearing Laboratory, CHEO Research Institute, Ottawa, Ontario, Canada
| | - Bénédicte Vos
- Child Hearing Laboratory, CHEO Research Institute, Ottawa, Ontario, Canada.,School of Public Health, Université Libre de Bruxelles, Brussels Belgium
| | - JoAnne Whittingham
- Child Hearing Laboratory, CHEO Research Institute, Ottawa, Ontario, Canada
| | - Jessica Fitzpatrick
- Child Health Evaluative Sciences Program, SickKids Research Institute,The Hospital for Sick Children, Toronto, Ontario, Canada
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Fitzpatrick EM, Cologrosso E, Sikora L. Candidacy for Amplification in Children With Hearing Loss: A Review of Guidelines and Recommendations. Am J Audiol 2019; 28:1025-1045. [PMID: 31829723 DOI: 10.1044/2019_aja-19-0061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose The 1st point in the intervention process for the majority of children is the fitting of hearing devices. The objective of this review was to compile guidelines and recommendations for candidacy criteria for children with hearing loss. Method Electronic databases (e.g., MEDLINE, Embase, and Cumulative Index of Nursing and Allied Health Literature) and websites were searched. Any document referring to children with hearing loss that discussed amplification guidelines or protocols was included. Documents specific to implantable devices or addressing only remote microphone systems were excluded. One reviewer screened all potentially relevant documents, and a subset was screened by a 2nd reviewer. Guidelines/recommendations referring to pediatric amplification candidacy were extracted. Results A total of 40 documents were included for data extraction. Studies were categorized according to hearing loss of any degree, with separate categories for documents providing specific criteria for mild bilateral, unilateral, and auditory neuropathy spectrum disorders. Guidelines ranged from generic statements about the need for amplification to criteria based on specific audiometric thresholds. In guidelines recommending audiometric cut-points, the majority considered > 25 dB HL as a criterion for consideration for amplification. Overall, guidelines for children with mild bilateral and unilateral loss remain more ambiguous, and there was some variation across the recommendations. Guidelines for auditory neuropathy spectrum disorder stressed the need to obtain results from behavioral audiometry before considering amplification. Conclusions Numerous organizations have established candidacy guidelines for pediatric amplification. Most guidelines specify criteria for amplification as audiometric threshold levels. There is considerable variation in the guidelines for mild bilateral and unilateral hearing loss with candidacy criteria ranging from 15 to 30 dB HL, and many guidelines recommend a case-by-case decision approach.
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Affiliation(s)
- Elizabeth M. Fitzpatrick
- Faculty of Health Sciences, University of Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | | | - Lindsey Sikora
- Faculty of Health Sciences, University of Ottawa, Ontario, Canada
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Feresin A, Ghiselli S, Marchi R, Staffa P, Monasta L, Orzan E. Who misses the newborn hearing screening? Five years' experience in Friuli-Venezia Giulia Region (Italy). Int J Pediatr Otorhinolaryngol 2019; 124:193-199. [PMID: 31203055 DOI: 10.1016/j.ijporl.2019.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 05/19/2019] [Accepted: 05/19/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Permanent hearing impairment is the most common sensory disorder in newborns. The Universal Newborn Hearing Screening (UNHS) is widely adopted as a cost-effective procedure to achieve early identification and treatment of congenital hearing impairment, with the final goal of an improved linguistic and cognitive outcome for hearing impaired children. The Italian Ministry of Health has recently comprised UNHS in the Essential Level of Health Assistance. Nevertheless, programs still vary both across and within Italian Regions in terms of coverage, testing, referral and tracking protocols. In Friuli-Venezia Giulia region the program for the early identification of newborn and childhood hearing impairment is operative since 2012. In order to minimize the lost to follow-up cases, UNHS and childhood hearing surveillance activities have been organized in close collaboration among birth centres, paediatric audiology services, territorial Family Paediatricians and the sole regional centre for paediatric hearing loss management. MATERIAL AND METHODS We performed a five years' retrospective analysis of the UNHS experience in Friuli-Venezia Giulia comparing the UNHS activity of year 2013 and year 2017. The focus of the study concerns the "missing" cases. Three different typologies of "miss" cases ("documentation-miss", "access-miss" and "pathway-miss") have been defined in correspondence with main reasons for their occurrence. RESULTS Births in Friuli-Venezia Giulia were 9465 and 8432, respectively in 2013 and 2017. International quality indicators improved with a gain of efficiency in 5 years' experience. However, "missing" cases were 486 in 2013 and 321 in 2017, mainly due to the lack of an efficient documentation system. CONCLUSION UNHS programs have proven to be valuable and cost-effective in Friuli-Venezia Giulia and other Italian regions. New resources and efforts are required to achieve a complete standardization and informatisation of the UNHS data to avoid documentation gaps. A possible strategy would point to the opportunity to unify data management systems for all the ongoing newborn screening programs (metabolic, hearing and visual), linking the integrated IT system with the regional repository of current datasets.
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Affiliation(s)
- Agnese Feresin
- Audiology and Otorhinolaryngology Unit, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.
| | - Sara Ghiselli
- Audiology and Otorhinolaryngology Unit, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Raffaella Marchi
- Audiology and Otorhinolaryngology Unit, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Paola Staffa
- Audiology and Otorhinolaryngology Unit, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Eva Orzan
- Audiology and Otorhinolaryngology Unit, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
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Vos B, Noll D, Pigeon M, Bagatto M, Fitzpatrick EM. Risk factors for hearing loss in children: a systematic literature review and meta-analysis protocol. Syst Rev 2019; 8:172. [PMID: 31315672 PMCID: PMC6637473 DOI: 10.1186/s13643-019-1073-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/17/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Hearing loss in newborns and children is a public health concern, due to high prevalence and negative effects on their development. Early detection and intervention of childhood hearing loss may mitigate these negative effects. Population-based newborn hearing screening programs have been established worldwide to identify children at risk for congenital hearing loss and to follow children at risk for late onset or progressive hearing loss. This article presents the protocol for a systematic review that aims to review the risk factors associated with permanent hearing loss in children, including congenital, early, or late onset. Risk factors associated with progressive hearing loss will be investigated as a secondary aim. METHODS Scientific literature from the following databases will be investigated: MEDLINE, Ovid MEDLINE(R) Daily and Ovid MEDLINE(R), Embase, and CINAHL. The primary outcome is a permanent bilateral or unilateral hearing loss with congenital onset or onset during childhood (birth to 18 years). The secondary outcome is progressive hearing loss. Studies must report data on risk factors associated with permanent hearing loss; risk factors may be present at birth or later and result in immediate or delayed hearing loss. Randomized controlled trials, quasi-experimental studies, nonrandomized comparative and non-comparative studies, and case series will be included. The risk of bias will be assessed using the Qualitative Assessment Tool for Quantitative Studies (McMaster University). If aggregation of data is possible for a subsection of studies, we will pool data using meta-analysis techniques. If aggregation of data is not possible, a qualitative synthesis will be presented. We will assess the quality and strength of the overall body of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). The systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. DISCUSSION The resulting information will inform the update of a provincial audiological surveillance protocol for the Ontario Infant Hearing Program and will be applicable to early hearing detection and intervention (EHDI) programs worldwide. SYSTEMATIC REVIEW REGISTRATION We have registered the protocol in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42018104121.
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Affiliation(s)
- Bénédicte Vos
- Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
- Child Hearing Laboratory, CHEO Research Institute, 401 Smyth Road, Ottawa, Ontario K1H 8L1 Canada
- School of Public Health, Université libre de Bruxelles (ULB), Route de Lennik 808 CP 598, 1070 Brussels, Belgium
| | - Dorie Noll
- Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
- Child Hearing Laboratory, CHEO Research Institute, 401 Smyth Road, Ottawa, Ontario K1H 8L1 Canada
| | - Marie Pigeon
- Audiology Department, CHEO, 401 Smyth Road, Ottawa, Ontario K1H 8L1 Canada
| | - Marlene Bagatto
- School of Communication Sciences and Disorders and the National Centre for Audiology, Western University, 1201 Western Road, London, Ontario N6G 1H1 Canada
| | - Elizabeth M. Fitzpatrick
- Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
- Child Hearing Laboratory, CHEO Research Institute, 401 Smyth Road, Ottawa, Ontario K1H 8L1 Canada
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Prevalence of permanent childhood hearing loss detected at the universal newborn hearing screen: Systematic review and meta-analysis. PLoS One 2019; 14:e0219600. [PMID: 31295316 PMCID: PMC6622528 DOI: 10.1371/journal.pone.0219600] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 06/27/2019] [Indexed: 11/19/2022] Open
Abstract
Context Permanent childhood hearing loss (PCHL) can affect speech, language, and wider outcomes. Adverse effects are mitigated through universal newborn hearing screening (UNHS) and early intervention. Objective We undertook a systematic review and meta-analysis to estimate prevalence of UNHS-detected PCHL (bilateral loss ≥26 dB HL) and its variation by admission to neonatal intensive care unit (NICU). A secondary objective was to report UNHS programme performance (PROSPERO: CRD42016051267). Data sources Multiple electronic databases were interrogated in January 2017, with further reports identified from article citations and unpublished literature (November 2017). Study selection UNHS reports from very highly-developed (VHD) countries with relevant prevalence and performance data; no language or date restrictions. Data extraction Three reviewers independently extracted data and assessed quality. Results We identified 41 eligible reports from 32 study populations (1799863 screened infants) in 6195 non-duplicate references. Pooled UNHS-detected PCHL prevalence was 1.1 per 1000 screened children (95% confidence interval [CI]: 0.9, 1.3; I2 = 89.2%). This was 6.9 times (95% CI: 3.8, 12.5) higher among those admitted to NICU. Smaller studies were significantly associated with higher prevalences (Egger’s test: p = 0.02). Sensitivity and specificity ranged from 89–100% and 92–100% respectively, positive predictive values from 2–84%, with all negative predictive values 100%. Limitations Results are generalisable to VHD countries only. Estimates and inferences were limited by available data. Conclusions In VHD countries, 1 per 1000 screened newborns require referral to clinical services for PCHL. Prevalence is higher in those admitted to NICU. Improved reporting would support further examination of screen performance and child demographics.
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Mizuno T, Nakazawa M, Sato T, Takahashi S, Yamada T. Diagnosis of hearing impairment in 48 children who were cleared at the newborn hearing screening. ACTA ACUST UNITED AC 2019. [DOI: 10.4295/audiology.62.52] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Tomomi Mizuno
- Department of Otorhinolaryngology, Head & Neck Surgery. Akita University Graduate School of Medicine
| | - Misao Nakazawa
- Akita Prefectural Center for Rehabilitation and Psychiatric Medicine
- Department of Otorhinolaryngology, Nakadori General Hospital
| | - Teruyuki Sato
- Department of Otorhinolaryngology, Omagari Kosei Medical Center
| | - Shin Takahashi
- Department of Otorhinolaryngology, Head & Neck Surgery. Akita University Graduate School of Medicine
- Takahashi ENT & Eye Clinic
| | - Takechiyo Yamada
- Department of Otorhinolaryngology, Head & Neck Surgery. Akita University Graduate School of Medicine
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Cedars E, Kriss H, Lazar AA, Chan C, Chan DK. Use of otoacoustic emissions to improve outcomes and reduce disparities in a community preschool hearing screening program. PLoS One 2018; 13:e0208050. [PMID: 30532159 PMCID: PMC6287830 DOI: 10.1371/journal.pone.0208050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 11/09/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Hearing loss substantially impacts pediatric development, and early identification improves outcomes. While intervening before school-entry is critical to optimize learning, early-childhood hearing screening practices are highly variable. Conditioned play audiometry (CPA) is the gold standard for preschool hearing screening, but otoacoustic emission (OAE) testing provides objective data that may improve screening outcomes. OBJECTIVES To compare outcomes of a community-based low-income preschool hearing program before and after implementation of OAE in a single-visit, two-tiered paradigm. We hypothesized that this intervention would reduce referral rates and improve follow-up while maintaining stable rates of diagnosed sensorineural hearing loss. METHODS We performed a cohort study of 3257 children screened from July 2014-June 2016. Department of Public Health data were analyzed pre- and post-implementation of second-line OAE testing for children referred on CPA screening with targeted follow-up by DPH staff. Primary outcomes included referral rates, follow-up rates, and diagnosis of sensorineural hearing loss. RESULTS Demographics, pure-tone pass rates, and incidence of newly-diagnosed permanent hearing loss were similar across years. After intervention, overall pass rates increased from 92% to 95% (P = 0.0014), while only 0.7% remained unable to be tested (P<0.0001). 5% of children were unable to be tested by CPA screening but passed OAE testing, obviating further evaluation. Referral rate decreased from 8% to 5% (P = 0.0014), and follow-up improved from 36% to 91% (P<0.0001). Identification of pathology in children with follow-up increased from 19% to over 50%. Further, disparities in pass rates and ability to test seen in Year 1 were eliminated in Year 2. CONCLUSION AND RELEVANCE In a community setting, implementation of second-line OAE screening for CPA referrals reduced referral rates, increased identification of hearing loss, reduced outcome disparities, and improved follow-up rates. This study provides lessons in how to improve outcomes and reduce disparities in early-childhood hearing screening.
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Affiliation(s)
- Elizabeth Cedars
- University of California San Francisco, Department of Otolaryngology–Head and Neck Surgery, San Francisco, CA, United States of America
| | - Hayley Kriss
- San Francisco Department of Public Health, San Francisco, CA, United States of America
| | - Ann A. Lazar
- University of California San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA, United States of America
| | - Curtis Chan
- San Francisco Department of Public Health, San Francisco, CA, United States of America
| | - Dylan K. Chan
- University of California San Francisco, Department of Otolaryngology–Head and Neck Surgery, San Francisco, CA, United States of America
- * E-mail:
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Riga M, Korres G, Chouridis P, Naxakis S, Danielides V. Congenital cytomegalovirus infection inducing non-congenital sensorineural hearing loss during childhood; a systematic review. Int J Pediatr Otorhinolaryngol 2018; 115:156-164. [PMID: 30368378 DOI: 10.1016/j.ijporl.2018.10.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 10/02/2018] [Accepted: 10/03/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Congenital cytomegalovirus (CMV) infection is one of the most important risk factors for delayed onset and progressive hearing loss in children. However, the relevant literature is limited, heterogeneous and currently insufficient to provide guidance toward the effective monitoring of hearing acuity in these children. OBJECTIVES The aim of this study was to provide a systematic review focused on types of hearing loss that may escape diagnosis through universal neonatal hearing screening and/or present significant changes during childhood, such as progressive, fluctuating and late-onset hearing loss. DATA SOURCES A review of the present literature was conducted via the PubMed database of the US National Library of Medicine (www.pubmed.org) and Scopus database (www.scopus.com) with the search terms "late-onset hearing loss cytomegalovirus", "progressive hearing loss cytomegalovirus" and "fluctuating hearing loss cytomegalovirus". STUDY ELIGIBILITY CRITERIA Prospective or retrospective clinical studies were included if they presented a detailed audiological assessment, for a follow-up period of >2years. METHODS The prevalence and time of diagnosis of progressive, fluctuating and late-onset hearing loss were considered as primary outcomes. Results were recorded separately for symptomatic and asymptomatic children, when possible. RESULTS This analysis refers to a population of 181 children with CMV-induced hearing loss, who were diagnosed among 1089 with congenital CMV infection. The prevalence of CMV-induced hearing loss was significantly higher among symptomatic children (p < 0.0001), who were also significantly more likely to develop bilateral hearing loss (p = 0.001). There was not sufficient information on the prevalence, laterality, degree and time of diagnosis of progressive, fluctuating and late-onset hearing loss that could constitute the basis toward the report of specific follow-up guidelines. CONCLUSIONS Further studies are needed in order to understand and quantify the potential effects of congenital CMV infection in the inner ear and hearing acuity. The results presented in the relative studies should be very carefully evaluated and compared to each other, since they correspond to substantially different cohorts, study designs, and result elaboration. Infants with congenital CMV infection should be closely monitored, regarding their hearing acuity at least during their preschool years, although substantial changes in hearing thresholds have been reported as late as the 16th year of age. Parental counseling is of outmost importance in order to minimize the numbers of children lost to follow-up.
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Affiliation(s)
- Maria Riga
- Democritus University of Thrace, University Hospital of Evros, ENT Department, Dragana University Campus, 68100, Alexandroupolis, Greece.
| | - George Korres
- Central Manchester University Hospitals, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK.
| | - Pantelis Chouridis
- Democritus University of Thrace, University Hospital of Evros, ENT Department, Dragana University Campus, 68100, Alexandroupolis, Greece.
| | - Stephanos Naxakis
- University of Patras, University Hospital of Rio, ENT Department, 26504, Patras, Greece.
| | - Vasilios Danielides
- University of Patras, University Hospital of Rio, ENT Department, 26504, Patras, Greece.
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Fortnum H, Ukoumunne OC, Hyde C, Taylor RS, Ozolins M, Errington S, Zhelev Z, Pritchard C, Benton C, Moody J, Cocking L, Watson J, Roberts S. A programme of studies including assessment of diagnostic accuracy of school hearing screening tests and a cost-effectiveness model of school entry hearing screening programmes. Health Technol Assess 2018; 20:1-178. [PMID: 27169435 DOI: 10.3310/hta20360] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Identification of permanent hearing impairment at the earliest possible age is crucial to maximise the development of speech and language. Universal newborn hearing screening identifies the majority of the 1 in 1000 children born with a hearing impairment, but later onset can occur at any time and there is no optimum time for further screening. A universal but non-standardised school entry screening (SES) programme is in place in many parts of the UK but its value is questioned. OBJECTIVES To evaluate the diagnostic accuracy of hearing screening tests and the cost-effectiveness of the SES programme in the UK. DESIGN Systematic review, case-control diagnostic accuracy study, comparison of routinely collected data for services with and without a SES programme, parental questionnaires, observation of practical implementation and cost-effectiveness modelling. SETTING Second- and third-tier audiology services; community. PARTICIPANTS Children aged 4-6 years and their parents. MAIN OUTCOME MEASURES Diagnostic accuracy of two hearing screening devices, referral rate and source, yield, age at referral and cost per quality-adjusted life-year. RESULTS The review of diagnostic accuracy studies concluded that research to date demonstrates marked variability in the design, methodological quality and results. The pure-tone screen (PTS) (Amplivox, Eynsham, UK) and HearCheck (HC) screener (Siemens, Frimley, UK) devices had high sensitivity (PTS ≥ 89%, HC ≥ 83%) and specificity (PTS ≥ 78%, HC ≥ 83%) for identifying hearing impairment. The rate of referral for hearing problems was 36% lower with SES (Nottingham) relative to no SES (Cambridge) [rate ratio 0.64, 95% confidence interval (CI) 0.59 to 0.69; p < 0.001]. The yield of confirmed cases did not differ between areas with and without SES (rate ratio 0.82, 95% CI 0.63 to 1.06; p = 0.12). The mean age of referral did not differ between areas with and without SES for all referrals but children with confirmed hearing impairment were older at referral in the site with SES (mean age difference 0.47 years, 95% CI 0.24 to 0.70 years; p < 0.001). Parental responses revealed that the consequences to the family of the referral process are minor. A SES programme is unlikely to be cost-effective and, using base-case assumptions, is dominated by a no screening strategy. A SES programme could be cost-effective if there are fewer referrals associated with SES programmes or if referrals occur more quickly with SES programmes. CONCLUSIONS A SES programme using the PTS or HC screener is unlikely to be effective in increasing the identified number of cases with hearing impairment and lowering the average age at identification and is therefore unlikely to represent good value for money. This finding is, however, critically dependent on the results of the observational study comparing Nottingham and Cambridge, which has limitations. The following are suggested: systematic reviews of the accuracy of devices used to measure hearing at school entry; characterisation and measurement of the cost-effectiveness of different approaches to the ad-hoc referral system; examination of programme specificity as opposed to test specificity; further observational comparative studies of different programmes; and opportunistic trials of withdrawal of SES programmes. TRIAL REGISTRATION Current Controlled Trials ISRCTN61668996. FUNDING This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 36. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Heather Fortnum
- National Institute for Health Research, Nottingham Hearing Biomedical Research Unit, Hearing and Otology Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Obioha C Ukoumunne
- National Institute for Health Research, Collaborations for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Chris Hyde
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - Rod S Taylor
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - Mara Ozolins
- National Institute for Health Research, Nottingham Hearing Biomedical Research Unit, Hearing and Otology Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Sam Errington
- National Institute for Health Research, Nottingham Hearing Biomedical Research Unit, Hearing and Otology Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Zhivko Zhelev
- National Institute for Health Research, Collaborations for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | | | - Claire Benton
- Nottingham Audiology Services, Nottingham University Hospitals, Nottingham, UK
| | - Joanne Moody
- Cambridgeshire Community Services, Community Child Health, Ida Darwin Hospital, Fulbourn, Cambridge, UK
| | - Laura Cocking
- Peninsula Clinical Trials Unit, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
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Vos B, Senterre C, Boutsen M, Lagasse R, Levêque A. Improving early audiological intervention via newborn hearing screening in Belgium. BMC Health Serv Res 2018; 18:56. [PMID: 29378570 PMCID: PMC5789748 DOI: 10.1186/s12913-018-2878-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 01/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Newborn hearing screening programs aim to lower the ages at audiological intervention among hearing-impaired children. In Wallonia and Brussels (Belgium), audiological intervention data are not collected in the screening program, and the ages at initiating audiological care have never been assessed. This study aimed to assess the evolution in the ages at initiating audiological intervention in the context of a newborn hearing screening program implementation. METHODS This population-based descriptive study used data from the Belgian healthcare billing database. The main outcomes were the children's ages at the initial audiological assessment, hearing-aid fitting, and cochlear implantation. Results were compared to the same outcomes from another Belgian regional program (Flanders) that was implemented one decade earlier. Annual birth cohorts from 2006 to 2011 were included in the study. RESULTS In Wallonia-Brussels, the median ages for all outcomes tended to decrease over time but remained higher than in Flanders for each birth cohort. For all outcomes except the hearing-aid fitting, differences in median ages between the two regions became less pronounced during the study period. In 2006, < 23% of the children from Wallonia-Brussels received any audiological care before the age of 12 months and these proportions were approximately 2-fold greater in the subsequent birth cohorts. For all outcomes, early care (< 12 months) was typically delivered less frequently in Wallonia-Brussels, compared to the delivery in Flanders. These region-specific differences exhibited a decreasing trend over time, and statistically significant differences were less common in the later birth cohorts. CONCLUSIONS We conclude that the hearing screening program in Wallonia and Brussels promoted earlier audiological intervention among hearing-impaired children. However, milestones recommended by experts for an early intervention were not totally encountered. We also recommend collecting audiological intervention data as part of this program, which can facilitate more accurate and regular program evaluation.
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Affiliation(s)
- Bénédicte Vos
- Research Center Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Route de Lennik 808, 1070, Brussels, Belgium. .,Research Center Health Policy and Systems-International Health, School of Public Health, Université libre de Bruxelles (ULB), Route de Lennik 808, 1070, Brussels, Belgium. .,Centre d'Epidémiologie Périnatale (CEpiP), Newborn Hearing Screening Program Agency, Route de Lennik 808, 1070, Brussels, Belgium.
| | - Christelle Senterre
- Research Center Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Route de Lennik 808, 1070, Brussels, Belgium
| | - Michel Boutsen
- Agence InterMutualiste (IMA), Avenue de Tervueren, 188/A, 1150, Brussels, Belgium
| | - Raphaël Lagasse
- Research Center Health Policy and Systems-International Health, School of Public Health, Université libre de Bruxelles (ULB), Route de Lennik 808, 1070, Brussels, Belgium
| | - Alain Levêque
- Research Center Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Route de Lennik 808, 1070, Brussels, Belgium.,Research Center Health Policy and Systems-International Health, School of Public Health, Université libre de Bruxelles (ULB), Route de Lennik 808, 1070, Brussels, Belgium.,Centre d'Epidémiologie Périnatale (CEpiP), Newborn Hearing Screening Program Agency, Route de Lennik 808, 1070, Brussels, Belgium
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Lin PH, Hsu CJ, Lin YH, Lin YH, Lee HY, Wu CC, Liu TC. Etiologic and Audiologic Characteristics of Patients With Pediatric-Onset Unilateral and Asymmetric Sensorineural Hearing Loss. JAMA Otolaryngol Head Neck Surg 2017; 143:912-919. [PMID: 28687817 DOI: 10.1001/jamaoto.2017.0945] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Pediatric-onset unilateral and asymmetric sensorineural hearing loss (SNHL) is a common condition, but in most patients, the cause remains unclear; thus, determination of the hearing outlook is difficult. Objective To analyze the etiologic and audiologic characteristics of pediatric-onset unilateral and asymmetric SNHL. Design, Setting, and Participants In this retrospective cohort study performed from January 1, 2008, through December 31, 2016, patients at a tertiary referral center who were diagnosed with pediatric-onset unilateral or asymmetric SNHL were divided into 3 groups according to their hearing levels: unilateral hearing loss with scaled-out levels (UHL-SO), unilateral hearing loss with residual hearing (UHL-RH), and asymmetric hearing loss (AHL). Main Outcomes and Measures Basic demographic data, family and medical histories, audiologic results, imaging findings, and genetic results were ascertained and compared among patients of the 3 groups. Results A total of 133 patients (mean [SD] age, 9.1 [10.9] years; 63 [47.4%] male and 70 [52.6%] female), including 50 with UHL-SO, 42 with UHL-RH, and 41 with AHL, were enrolled for analyses. Of 50 patients with UHL-SO, 49 (98.0%) had stable hearing levels with time, whereas 10 of 42 patients with UHL-RH (23.8%) and 18 of 41 patients with AHL (43.9%) revealed progressive or fluctuating hearing loss. Inner ear malformations detected with temporal bone high-resolution computed tomography, particularly cochlear aperture stenosis, were detected at higher rates in patients with UHL-SO (9 of 31 [29.0%]) and UHL-RH (6 of 24 [25.0%]) than in those with AHL (1 of 30 [3.3%]). In contrast, screening for mutations in 3 common deafness genes-GJB2, SLC26A4, and MTRNR1-achieved definite diagnosis in a higher percentage of patients with AHL (10 of 37 [27.0%]) than patients with UHL-SO (0 of 33) and UHL-RH (1 of 25 [4.0%]). Conclusions and Relevance The UHL-SO and UHL-RH conditions share a common or similar etiopathogenesis different from that of AHL. Imaging studies and genetic testing might be prioritized during the respective general etiologic workups for patients with UHL and AHL. Regular hearing checkups are warranted for patients with UHL and AHL because a certain proportion of patients might sustain progression in SNHL.
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Affiliation(s)
- Pei-Hsuan Lin
- Department of Otolaryngology, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Chuan-Jen Hsu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Otolaryngology, Taichung Tzu-Chi Hospital, Taichung, Taiwan
| | - Yi-Hsin Lin
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Molecular Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yin-Hung Lin
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Medical Genomics and Proteomics, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hui-Yu Lee
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chen-Chi Wu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Tien-Chen Liu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
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Abstract
BACKGROUND Newborn hearing screening has to be considered the first step of a program for the identification, diagnosis, treatment and habilitation/rehabilitation of children with hearing impairment. MAIN PART In Tuscany Region of Italy, the universal newborn hearing screening is mandatory since november 2007. The first guidelines for the execution of the screening have been released in June 2008; then many other Italian regions partially or totally adopted these guidelines. On the basis of the experience from 2008 and according to the recent evidences in the scientific literature, a new screening protocol was released in Tuscany region. The new protocol is an evolution of the previous one. Some issues reported in the previous protocol and in the Joint Committee on Infant Hearing statement published in 2007 were revised, such as the risk factors for auditory neuropathy and for late onset, progressive or acquired hearing loss. The new updated guidelines were submitted to the Sanitary Regional Council and then they have been approved in August 2016. The updated screening protocol is mainly aimed to identify newborns with a congenital moderate-to-profound hearing loss, but it also provides indications for the audiological follow-up of children with risk's factor for progressive or late onset hearing loss; further it provides indications for the audiological surveillance of children at risk for acquired hearing impairment. Then, in the new guidelines the role of the family paediatrician in the newborn hearing screening and audiological follow-up and surveillance is underscored. Finally the new guidelines provide indications for the treatment with hearing aids and cochlear implant, in accordance with the recent Italian Health Technology Assessment (HTA) guidelines. CONCLUSIONS In the paper we report the modality of execution of the universal newborn hearing screening in the Tuscany Region, according to the recently updated protocol. The main features of the protocol and the critical issues are discussed.
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Exploring reasons for late identification of children with early-onset hearing loss. Int J Pediatr Otorhinolaryngol 2017; 100:160-167. [PMID: 28802365 DOI: 10.1016/j.ijporl.2017.06.039] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 06/26/2017] [Accepted: 06/30/2017] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Several studies have shown that early identification of childhood hearing loss leads to better language outcomes. However, delays in the confirmation of hearing loss persist even in the presence of well-established universal newborn hearing screening programs (UNHS). The objective of this population-based study was to document the proportion of children who experienced delayed confirmation of congenital and early onset hearing loss in a UNHS program in one region of Canada. The study also sought to determine the reasons for delayed confirmation of hearing loss in children. METHODS Population level data related to age of first assessment, age of identification and clinical characteristics were collected prospectively for all children identified through the UNHS program. We documented the number of children who experienced delay (defined as more than 3 months) from initial audiologic assessment to confirmation of hearing loss. A detailed chart review was subsequently performed to examine the reasons for delay to confirmation. RESULTS Of 418 children identified from 2003 to 2013, 182 (43.5%) presented with congenital or early onset hearing loss, of whom 30 (16.5%) experienced more than 3 months delay from initial audiologic assessment to confirmation of their hearing disorder. The median age of first assessment and confirmation of hearing loss for these 30 children was 3.7 months (IQR: 2.0, 7.6) and 13.8 months (IQR: 9.7, 26.1) respectively. Close examination of the factors related to delay to confirmation revealed that for the overwhelming majority of children, a constellation of factors contributed to late diagnosis. Several children (n = 22; 73.3%) presented with developmental/medical issues, 15 of whom also had middle ear dysfunction at assessment, and 9 of whom had documented family follow-up concerns. For the remaining eight children, additional reasons included ongoing middle ear dysfunction for five children, complicated by family follow-up concerns (n = 3) and mild hearing loss (n = 1) and the remaining three children had isolated reasons related to family follow-up (n = 1) or mild hearing loss (n = 2). CONCLUSION Despite the progress made in the early detection of pediatric hearing loss since UNHS, a substantial number of children referred for early assessment can experience late confirmation and intervention. In particular, infants with developmental and/or medical issues including middle ear disorders are at particular risk for longer time to confirmation of hearing loss.
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Halliday LF, Tuomainen O, Rosen S. Language Development and Impairment in Children With Mild to Moderate Sensorineural Hearing Loss. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:1551-1567. [PMID: 28547010 DOI: 10.1044/2016_jslhr-l-16-0297] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 10/03/2016] [Indexed: 06/07/2023]
Abstract
PURPOSE The goal of this study was to examine language development and factors related to language impairments in children with mild to moderate sensorineural hearing loss (MMHL). METHOD Ninety children, aged 8-16 years (46 children with MMHL; 44 aged-matched controls), were administered a battery of standardized language assessments, including measures of phonological processing, receptive and expressive vocabulary and grammar, word and nonword reading, and parental report of communication skills. Group differences were examined after controlling for nonverbal ability. RESULTS Children with MMHL performed as well as controls on receptive vocabulary and word and nonword reading. They also performed within normal limits, albeit significantly worse than controls, on expressive vocabulary, and on receptive and expressive grammar, and worse than both controls and standardized norms on phonological processing and parental report of communication skills. However, there was considerable variation in performance, with 26% showing evidence of clinically significant oral or written language impairments. Poor performance was not linked to severity of hearing loss nor age of diagnosis. Rather, outcomes were related to nonverbal ability, maternal education, and presence/absence of family history of language problems. CONCLUSIONS Clinically significant language impairments are not an inevitable consequence of MMHL. Risk factors appear to include lower maternal education and family history of language problems, whereas nonverbal ability may constitute a protective factor.
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Affiliation(s)
- Lorna F Halliday
- Division of Psychology and Language Sciences, University College London (UCL), United Kingdom
| | - Outi Tuomainen
- Division of Psychology and Language Sciences, University College London (UCL), United Kingdom
| | - Stuart Rosen
- Division of Psychology and Language Sciences, University College London (UCL), United Kingdom
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Saki N, Bayat A, Hoseinabadi R, Nikakhlagh S, Karimi M, Dashti R. Universal newborn hearing screening in southwestern Iran. Int J Pediatr Otorhinolaryngol 2017; 97:89-92. [PMID: 28483258 DOI: 10.1016/j.ijporl.2017.03.038] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 03/27/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The implementation of Neonatal Hearing Screening (NHS) program is still at the preliminary stage particularly in developing countries despite the burden of permanent congenital and early-onset hearing impairment. The purpose of this study was to report results for universal newborn NHS in a cohort of children born in the southwestern region of Iran, as part of a national screening program set up by the Iranian National Health System. METHODS During this cross-sectional study, which took place between March 2013 and April 2016, healthy newborns were screened using transient evoked otoacoustic emissions (TEOAEs) and automated auditory brainstem responses (AABRs) methods at several points in time as early as possible after birth. Screening followed a two-stage strategy and newborns referred after the second-stage screening were scheduled for diagnostic evaluation. RESULTS A total of 92,521 newborns were screened in the urban (n = 67,780) and rural (n = 24,741) regions. Hearing impairment was confirmed in 223 (2.41 per 1000) newborns. One hundred forty-one (1.52 per 1000) of these newborns were affected bilaterally. More than 87% of these infants (195/223) showed a sensorineural hearing loss, while the defect was found to be conductive in 12 cases (P < 0.001). Of the 223 cases with hearing loss, 28 (12.5%) infants had auditory neuropathy. The majority of the infants, in both urban and rural regions, showed severe hearing impairment. We did not observe any significant difference among the incidences associated with gender (p = 0.29). CONCLUSION Our results demonstrated that universal newborn hearing screening program is an adequate program for southwestern of Iran with high coverage, low referral rate, and good follow-up rate.
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Affiliation(s)
- Nader Saki
- Hearing Research Center, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Arash Bayat
- Hearing Research Center, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Reza Hoseinabadi
- Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | - Soheila Nikakhlagh
- Hearing Research Center, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Majid Karimi
- Department of Audiology, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran.
| | - Rezvan Dashti
- Musculoskeletal Research Center, School of Rehabilitation, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Rohlfs AK, Friedhoff J, Bohnert A, Breitfuss A, Hess M, Müller F, Strauch A, Röhrs M, Wiesner T. Unilateral hearing loss in children: a retrospective study and a review of the current literature. Eur J Pediatr 2017; 176:475-486. [PMID: 28132094 DOI: 10.1007/s00431-016-2827-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 12/04/2016] [Accepted: 12/12/2016] [Indexed: 12/21/2022]
Abstract
UNLABELLED Despite the introduction of universal newborn hearing screening (UNHS), unilateral hearing loss (UHL) is sometimes recognized late. This diagnostic delay has adverse repercussions, given the importance of binaural hearing for the development of normal auditory processing. It is incorrect to maintain that unilateral hearing is the minimum requirement for adequate speech development and that hearing aid provision is consequently unnecessary. In our retrospective study, hearing aid provision resulted in improved directional and selective hearing (quiet and noisy environments) and, compared with their chronically ill counterparts, the children in our study displayed superior health-related quality of life (HRQoL) scores in all areas. On the basis of the results, the authors conclude that even mild hearing losses (from an auditory threshold of 30 to 40 dB) should have the opportunity for hearing aid provision. A selective literature review was conducted in PubMed and textbooks and with reference to national and international guidelines. Early diagnosis and treatment of UHL have a positive effect on verbal-cognitive, linguistic, communicative, and socio-emotional development, as demonstrated by neurophysiological studies. Among the treatment modalities with differing effects on the quality of binaural hearing, cochlear implants are now used increasingly in children with hearing loss bordering on deafness. CONCLUSION Published evidence and clinical experience support early diagnosis and treatment. Wherever feasible, hearing aid provision before or at the end of the first year of life is recommended for children with UHL. What is Known: • Almost 30 years ago, poor academic performance was reported in children with unilateral hearing loss (UHL). • Despite improvements in treatment options, it is traditionally held that unilateral hearing is the minimum requirement for adequate speech development and hearing aid provision is unnecessary. What is New: • Academic and behavioral deficits in children with UHL may be mediated by deficiencies in the default mode network. • Published evidence supports the recommendation for hearing aid provision before or at the end of the first year of life in children with UHL.
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Affiliation(s)
- Anna-Katharina Rohlfs
- Department of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Martinistrasse, 52 20246, Hamburg, Germany.
| | - Johannes Friedhoff
- Department of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Martinistrasse, 52 20246, Hamburg, Germany
| | - Andrea Bohnert
- Department for ENT and Communication Disorders, University Medical Center of the Johannes Gutenberg University, Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Achim Breitfuss
- Department of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Martinistrasse, 52 20246, Hamburg, Germany
| | - Markus Hess
- Department of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Martinistrasse, 52 20246, Hamburg, Germany
| | - Frank Müller
- Department of Voice, Speech and Hearing Disorders, University Medical Center Hamburg-Eppendorf, Martinistrasse, 52 20246, Hamburg, Germany
| | - Anke Strauch
- KIND Hörgeräte, Erdkampsweg, 55 22335, Hamburg, Germany
| | - Marianne Röhrs
- Community Practice for Otorhinolaryngology, Phoniatrics and Pediatric Audiology, Pestalozzistraße, 24 22305, Hamburg, Germany
| | - Thomas Wiesner
- Department of Phoniatrics and Pediatric Audiology, Werner Otto Institut, Bodelschwinghstrasse, 23 22337, Hamburg, Germany
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Yun C, Wang Z, Gao J, He P, Guo C, Chen G, Zheng X. Prevalence and Social Risk Factors for Hearing Impairment in Chinese Children-A National Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14010088. [PMID: 28106811 PMCID: PMC5295338 DOI: 10.3390/ijerph14010088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 01/11/2017] [Accepted: 01/12/2017] [Indexed: 11/20/2022]
Abstract
Hearing impairment may affect children’s communication skills, social development, and educational achievement. Little is known about the prevalence of hearing impairment among Chinese children. Data were taken from the 2006 second China National Survey on Disability (CNSD). Hearing impairment was defined as moderate (41–60 dB HL), severe (61–80 dB HL), profound (81–90 dB HL), or complete (>91 dB HL). Logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CI). A weighted number of 567,915 hearing impairment children were identified, yielding a prevalence of 17.49 per 10,000 people (95% CI: 16.90–18.08), with prevention or treatment options possible for 64.6% of hearing impairment children. The main causes of hearing impairment were hereditary, tympanitis, and drug intoxication. Illiteracy in one or both parents (mother: OR = 1.388, 95% CI: 1.125–1.714, p < 0.0001; father: OR = 1.537, 95% CI: 1.152–2.049, p < 0.0001 relative to no school or primary school), annual family income lower than national average (OR = 1.323, 95% CI: 1.044–1.675, p = 0.0203, relative to higher than national average), household size larger than three people (OR = 1.432, 95% CI: 1.164–1.762, p = 0.0007, relative to smaller than three people) and single-mother family (OR = 2.056, 95% CI: 1.390–3.042, p = 0.0176, relative to intact family) were the independence risk factors for hearing impairment among Chinese children. Lower annual family income, male children, larger household size, single-mother family, and lower levels of maternal and paternal education were independent risk factors for hearing impairment for Chinese children. Further studies on hearing impairment prevention and the relationship between parental social factors and the risk of hearing impairment are needed.
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Affiliation(s)
- Chunfeng Yun
- Institute of Population Research, Peking University, Beijing 100871, China.
| | - Zhenjie Wang
- Institute of Population Research, Peking University, Beijing 100871, China.
| | - Jiamin Gao
- Institute of Population Research, Peking University, Beijing 100871, China.
| | - Ping He
- Institute of Population Research, Peking University, Beijing 100871, China.
| | - Chao Guo
- Institute of Population Research, Peking University, Beijing 100871, China.
| | - Gong Chen
- Institute of Population Research, Peking University, Beijing 100871, China.
| | - Xiaoying Zheng
- Institute of Population Research, Peking University, Beijing 100871, China.
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Niclasen J, Obel C, Guldager C, Pleinert S, Dammeyer J. Associations between childhood hearing loss and behavioural and academic difficulties: A Danish cohort study. Int J Pediatr Otorhinolaryngol 2016; 90:91-98. [PMID: 27729161 DOI: 10.1016/j.ijporl.2016.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 09/03/2016] [Accepted: 09/03/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Negative associations between hearing loss (HL) and behavioural and academic difficulties have been reported. However, most studies are based on small clinical samples. The aim of the present study was to investigate such associations using data from a large-scale non-clinical Danish birth cohort controlling for a large number of relevant confounding factors. METHODS The study applied data from the Aarhus Birth Cohort's 10-12-year-old follow-up (N = 7599). Associations between parent-reported HL on the one hand, and parent- and teacher-reported behavioural difficulties measured by the Strengths and Difficulties Questionnaire (SDQ) and parent-reported academic difficulties on the other hand, were investigated. RESULTS After controlling for relevant confounding factors, significant associations were observed between parent-reported HL and parent- and teacher-reported Externalising scores, and academic difficulties. CONCLUSIONS Childhood HL is associated with behavioural and academic difficulties. Parent reported HL in a non-clinical cohort is indicative for academic and behavioural difficulties.
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Affiliation(s)
- Janni Niclasen
- Center for Collaborative Health, Aarhus University, Høegh-Guldbergs Gade 6B, 8000 Aarhus C, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark.
| | - Carsten Obel
- Center for Collaborative Health, Aarhus University, Høegh-Guldbergs Gade 6B, 8000 Aarhus C, Denmark
| | - Christian Guldager
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark
| | - Simone Pleinert
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark
| | - Jesper Dammeyer
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark
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Abstract
OBJECTIVES Early cochlear implantation has been widely promoted for children who derive inadequate benefit from conventional acoustic amplification. Universal newborn hearing screening has led to earlier identification and intervention, including cochlear implantation in much of the world. The purpose of this study was to examine age and time to cochlear implantation and to understand the factors that affected late cochlear implantation in children who received cochlear implants. DESIGN In this population-based study, data were examined for all children who underwent cochlear implant surgery in one region of Canada from 2002 to 2013. Clinical characteristics were collected prospectively as part of a larger project examining outcomes from newborn hearing screening. For this study, audiologic details including age and severity of hearing loss at diagnosis, age at cochlear implant candidacy, and age at cochlear implantation were documented. Additional detailed medical chart information was extracted to identify the factors associated with late implantation for children who received cochlear implants more than 12 months after confirmation of hearing loss. RESULTS The median age of diagnosis of permanent hearing loss for 187 children was 12.6 (interquartile range: 5.5, 21.7) months, and the age of cochlear implantation over the 12-year period was highly variable with a median age of 36.2 (interquartile range: 21.4, 71.3) months. A total of 118 (63.1%) received their first implant more than 12 months after confirmation of hearing loss. Detailed analysis of clinical profiles for these 118 children revealed that late implantation could be accounted for primarily by progressive hearing loss (52.5%), complex medical conditions (16.9%), family indecision (9.3%), geographical location (5.9%), and other miscellaneous known (6.8%) and unknown factors (8.5%). CONCLUSIONS This study confirms that despite the trend toward earlier implantation, a substantial number of children can be expected to receive their first cochlear implant well beyond their first birthday because they do not meet audiologic criteria of severe to profound hearing loss for cochlear implantation at the time of identification of permanent hearing loss. This study underscores the importance of carefully monitoring all children with permanent hearing loss to ensure that optimal intervention including cochlear implantation occurs in a timely manner.
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