Hearing Screening

Question 1

What are the principles of screening?

Answer 1

Disorder
Procedure
Treatement

Question 2

Principle of screening- Disorder

Answer 2

• • • must cause substantial mortality, morbidity, or suffering
• • • frequent enough to warrant screening or consequences of late identification serious
• • • must be able to be screened for
• • • must have treatment/management option available
• • • must be recognisable at an early age
• • • natural history of condition must be known

Question 3

Principles of screening - procedure

Answer 3

acceptable - acceptable to the population
accessible
agreement on whom to treat as effected individuals
available
early treatment must be more effective than later
easy to comply
effective
facilities available
low in cost
practical
reliable
safe
simple
valid

Question 4

principles of screening - treatment

Answer 4

Australian Hearing
Genetic assessment
ENT assessment
Early intervention

Question 5

What are the ASHA vs. SWISH guidelines for children with risk factors?

Answer 5

ASHA - hearing should be monitored at least every 6 months until 3years and at regular intervals after that depending on risk factor

SWISH - recommended to follow-up with VROA

Question 6

Efficacy of screening programs

Answer 6

coverage and referral rates
- - - 95% screened, 2.7%lost to follow-up between 1st and 2nd screen

breakdown of hearing loss
- - - Conductive mild 31%; SNHL moderate 23%; Permanent mild 15%

does early detection really help?
effects on age of identification
effects on parents

Question 7

Does early detection help?

Answer 7

Yoshinago-Itano et al found children whose HL were found before 6months of age demonstrated significantly better language scores than children identified after 6 months

Fitzpatrick - age of intervention didn’t effect results but degree of loss did

Question 8

Effects on Parents

Answer 8

False positive

• • • adversely effect relationship with child
• • • feelings of resentment and confusion when child is found to be normal
• • • lingering doubts

False Negative
- - - inappropriate confidence delays identification

True Positive

• • • emotional stress
• • • effects on bonding
• • • effects on future reproductive decisions

Question 9

Telling the news for toddlers vs. newborns

Answer 9

newborns

• • • no suspicions of hearing loss so difficulty in accepting the diagnosis
• • • no sense of relief. commonly shock/denial
• • • parents do not feel guilty. Commonly feel anger

Toddlers

• • • parents may have had suspicions
• • • not something else - relief
• • • parents often feel guilt it wasn’t diganosed earlier