Conventional Hearing Impairment- Screening.

Question 1

Why should we screen for anything?

Answer 1

• 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)

Question 2

Why should we screen for congenital hearing impairment?

Answer 2

• 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.

Question 3

How had kids been screened traditionally?

Answer 3

• 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.

Question 4

Who is considered high risk?

Answer 4

• If babies have a 1st degree relative with sensorineural deafness
• Bacterial Meningitis
• SCBU (special care baby unit) graduates.

Question 5

Was targeted screening enough?

Answer 5

No- it only picked up 30-50% of deaf kids.

Question 6

The health visitor ______ test can be effective but the results were often poor- _______ of deaf children were missed by the tests.

Answer 6

Distraction

50%.

Question 7

What does the health visitor distraction test require?

Answer 7

• Good Technique
• Equipment
• Quiet Environment
• Cooperative child.

Question 8

Because lots of deaf children were missed by traditional screening, what changed?

Answer 8

There is now universal neonatal screening. (all babies screened).

Question 9

In other places automated response cradles and otoacoustic emissions are used for screening. In Scotland, what’s used to screen babies?

Answer 9

Evoked Response Audiometry (ERA)

Question 10

What does otoacoustic emission (OAE) test?

Answer 10

It tests the cochlea, but not the whole pathway.

Question 11

What screening tells us the whole pathway?

Answer 11

Evoked Response Audiometry (ERA).

Question 12

What is another name for Evoked Response Audiometry?

Answer 12

Automated ABR.

Question 13

If a baby fails the automated ABR, what happens?

Answer 13

They undergo a further diagnostic test called Diagnostic ABR.

Question 14

What does UNHS stand for?

Answer 14

Universal Neonatal Hearing Screening.

Question 15

After diagnosis, where must babies go?

Answer 15

Community follow up clinics.

Question 16

Those at most risk of the disease are also the ones…

Answer 16

least likely to attend for screening.

Question 17

With the new screening, the prevalence hasn’t changed but…

Answer 17

They are picking up more children with hearing impairment.

Question 18

Congenital deafness satisfies requirements for a ________ programme.

Answer 18

Screening.

Question 19

The old screening system….

Answer 19

failed many children.

Question 20

What screening is the future?

Answer 20

UNHS.

Question 21

Even with UNHS, what is still required?

Answer 21

Constant Vigilance.

Question 22

After diagnosis what is essential?

Answer 22

For good support to be in place.