concise history taking

Question 1

Necessary Sections for History Taking in Paediatric Audiology

Answer 1

1- Newborn Hearing Screening Results:
- Did the child pass their newborn hearing screening? If not, what follow-up actions were taken?

2- Hearing Concerns:
- Ask parents about their concerns regarding the child’s hearing.
- Assess how the child responds to sounds at home and in other environments (e.g., school or nursery).
- Any reports of ringing or buzzing noises in their ears?

3- Communication Skills:
- How does the child currently communicate? (e.g., verbal, non-verbal, signing).

4- ENT Symptoms:
- History of tonsil issues, grommets, or other ENT-related conditions.

5- Vision History:
- Can the child see well enough to engage in tests such as play audiometry?
- Assess for any syndromes or conditions linked to vision issues (e.g., early onset glaucoma).

6- Onset, Duration, and Progress of Symptoms:
- When did the symptoms begin, and how have they progressed over time?

7- Balance and Dizziness:
- Does the child experience balance problems, dizziness, or unsteadiness?

8- Tinnitus and Hyperacusis:
- Are there any issues with ringing in the ears or sensitivity to sound?

9- General Health and Medical History:
- Recent or recurrent illnesses, including ear infections.
- Use of ototoxic medications, history of head injury, meningitis, or chronic conditions like diabetes.
- Has the child been seen by ENT or other specialists?

10- Pregnancy and Birth History:
- Was the child born full-term?
- Were there complications during pregnancy or delivery?
- NICU or SCBU admission, jaundice, sepsis, or any other postnatal issues.

11- Speech and Language Development:
- Parental concerns about speech and language.
- History of speech and language therapy.
- Milestones in vocabulary and language development.

12- Developmental History:
- Assess general developmental milestones (sitting, crawling, walking).
- Any concerns about delays in development?

13- Educational and Social Context:
- School progression, behavior, and interaction with peers.
- Does the child require additional support in school?

14- Family History of Hearing Loss (HL):
- Any family members with hearing loss?
- Was the hearing loss investigated, and what was the cause?

15- Social and Environmental Factors:
- Interaction with other children, play habits, and behavior.
- Observations of parental interaction and engagement.

Question 2

Contraindications to be considered during history taking

Answer 2

1- Age-Appropriate Testing:
Avoid tests unsuitable for the child’s age or developmental level (e.g., too complex for young children).

2 - Medical Instability:
Postpone testing if the child is acutely unwell or unstable.

3 - Physical or Emotional Distress:
*Avoid procedures that may cause significant distress without adequate support or preparation.

4 - Allergies or Adverse Reactions:
*Consider potential contraindications for medications or imaging contrast agents.

5 - Parent/Guardian Consent:
*Ensure parents are informed and give consent for all investigations.

6 - Inappropriate Test Conditions:
*Ensure the environment is suitable for testing (e.g., quiet room for audiological assessments).