Newborn Hearing Screening Programme NHSP

Question 1

What is screening?

Answer 1

This checks for satisfactory hearing when babies are born to ensure that babies get treatment and early ingtervention. find babies that have severe HL to see before it affects speech.This helps identify a smaller population who are likely to have the target condition.

Question 2

what are the 10 principles for screening:

Answer 2

1. condition should be an important health problem
2. treatment available
3. facilities for diagnosis
4. should be recognisable latent or early symptomatic phases (early recognition)
5. test or examination available for the condition
6. Should be acceptable for the population
7. Natural history of the condition should be adequately understood
8. Agreed policy on who to treat
9. total cost of finding a case should be economically balanced in relation to a medical condition
10. case finding should be a continuous process

Question 3

what are difficulties with false negative and false positive results from a screening service?

Answer 3

false negative: when they pass the screening but they have a HL. and false post is when the condition says that a patient has a condition when they don’t, which can lead to a waste of resources and a waste of time.

Question 4

potential harm for screening

Answer 4

• potential for psychological distress in parents as they are worried
• parental concerns if a child has a positive screen results
• information giving is key
• stress levels are lower if parents understand the implications of the screening at each stage of the screening process.

Question 5

what is the NICU protocol for screening?

Answer 5

1. identify the eligible population and gain consent.
2. if declined, provide checklist and inform GP/HV.
3. If given, perform OAE’s and AABR’s.
4. if all clear then discharge
5. if no AOAE + clear AABR then monitor risk factors and refer at 7-9months if risks.
6. no response you refer for audiological assessment within 44 weeks age.

if testing. newborn you have the same protocol but you perform AOAE, if not then you do AABR.

Question 6

OAE’s

Answer 6

to interpret you look at the coloured bars. Right is red. The grey is the background noise affecting the test. Ignore the grey. You want to know if they are big enough and the green ticks. You need at least 2 or three ticks. 2 for newborn hearing screening is 2 and for diagnostic you need 3. Look at numbers and see if their SNR is bigger than 6 for clear response. Reasons for not getting OAE’s – glue ear, fluid, ear, wax, infection, hearing loss. Clear repones – you do not care about background Nosie if it matches the SNR 6. For unclear repones, you need the background noise to be as lower than -5 and does not meet clear repones, it is inconclusive (means electrical interference). Cheel the third graph. If you have glue ear to fluid do tymp and otoscopy first. Check stimulus, usually sound is clicking sound that is 80db, so loud stimulus

Question 7

ABR

Answer 7

frequency specific testing. Concentrate on 4kHz because that si the most important for speech and determine problems. 45R, 45 is your deibles and R is right ear. Looking for peak around 8-10ms and trough is after that. The peak is wave 5 and that is the reponse that we are looking for – this si the most prominent wave as it produces the most amount of energy. You can also look for 10 and 8. . 8m’s for ave 5. And SN 10 is the dip. CR means clear reponse. AR means absent reponse. INC means inconclusive. Always ta the end of traces and labelled. You do loud sound sforsta nd then if they apss you drop it down. 45db THEN QUIETER, lowest is 35 db. There are correction factor involved, you can play 35db, BUT 30 Db is what reaches the eardrum.