Conventional Hearing Impairment- Screening. Flashcards
Why should we screen for anything?
- may be a Serious Problem
- might have an asymptomatic phase (don’t know there’s a problem)
- Treatment available to help
- Outcome better when treated early
- The test is easily available and acceptable (no harm to baby, v quick)
Why should we screen for congenital hearing impairment?
- serious effects on speech and language (pathways for speech & hearing won’t develop)
- Average age at diagnosis 2-3 years
- Hearing aids are effective
- Speech acquisition is better when aided at a younger age.
- Tests are non-invasive.
How had kids been screened traditionally?
- Universal behavioural tests in infants- distraction test by health visitor at 8 months
- Targeted objective tests for high risk neonates- evoked response audiometry within 6 weeks.
Who is considered high risk?
- If babies have a 1st degree relative with sensorineural deafness
- Bacterial Meningitis
- SCBU (special care baby unit) graduates.
Was targeted screening enough?
No- it only picked up 30-50% of deaf kids.
The health visitor ______ test can be effective but the results were often poor- _______ of deaf children were missed by the tests.
Distraction
50%.
What does the health visitor distraction test require?
- Good Technique
- Equipment
- Quiet Environment
- Cooperative child.
Because lots of deaf children were missed by traditional screening, what changed?
There is now universal neonatal screening. (all babies screened).
In other places automated response cradles and otoacoustic emissions are used for screening. In Scotland, what’s used to screen babies?
Evoked Response Audiometry (ERA)
What does otoacoustic emission (OAE) test?
It tests the cochlea, but not the whole pathway.
What screening tells us the whole pathway?
Evoked Response Audiometry (ERA).
What is another name for Evoked Response Audiometry?
Automated ABR.
If a baby fails the automated ABR, what happens?
They undergo a further diagnostic test called Diagnostic ABR.
What does UNHS stand for?
Universal Neonatal Hearing Screening.
After diagnosis, where must babies go?
Community follow up clinics.
Those at most risk of the disease are also the ones…
least likely to attend for screening.
With the new screening, the prevalence hasn’t changed but…
They are picking up more children with hearing impairment.
Congenital deafness satisfies requirements for a ________ programme.
Screening.
The old screening system….
failed many children.
What screening is the future?
UNHS.
Even with UNHS, what is still required?
Constant Vigilance.
After diagnosis what is essential?
For good support to be in place.
