Hearing Screening in Newborn

When Mishi (name changed) was born her parents were extra cautious for her hearing as her elder sister now 4 years old has cochlear implantation done.

They visited audiologist for hearing evaluation. Their worst fears was confirmed, Mishi now 6 months has severe to profound hearing loss and is fitted with hearing aids. But there is hope, as she is young she will most probably lead normal life like her elder sister which was intervened early and appropriately.

On the other hand khushi is 3 and ½ years old, pediatrician immediately referred her to audiologist for delayed speech, thanks to increasing awareness in Navi Mumbai. But even after confirmation of hearing loss, they are not willing for intervention as her father thinks she will start talking with time.

 

Importance of assessing hearing in a new-born child:

Two out of every 100 children under 6 years of age have permanent moderate deafness and 1-4 out of every 1,000 newborns have significant hearing loss.

Birth to 3 years are critical for speech and language development and if child does not hear the sound, he can not speak, even a mild or one sided hearing loss can affect speech language skills, academic & intellectual skills, and it affects individual for the rest of his life.

“American Academy of Pediatrics recommends new born hearing screening and periodic hearing testing for first three years of life. Joint Committee on Infant Hearing (JCIH, 1994) recommends that all infants with hearing loss should be identified by 3 months of age, and should be fitted with hearing aids or cochlear implant and receive services to help them learn to listen and speak by 6 months of age.

 

Importance of OAE hearing screening:

Newborns, infants and children below 5 years are difficult to diagnose by routine tests. Traditional subjective methods of behavioral observation to ringing bells and hand clapping are not fully reliable as child may respond to some sound because of residual hearing or they may take cues from visual prompts, at the same time child with normal hearing may not respond.

Prior to Objective tests such as OAE, infants with hearing loss typically remained unidentified until 2 ½ years of age. – far too late for optimal language development.

Advances in technology make it possible to assess the hearing of infants even while they are asleep.

 

Method for hearing screening Otoacoustic Emission (OAE):  

A small probe is placed in the child’s ear canal. This probe delivers a low-volume sound stimulus into the ear, which travels from middle ear to inner ear. If hearing is good this sound will bounce back as echo generated by outer hair cells of cochlea (called OAE)  and is measured with a microphone.

In approximately 30 seconds, the result is displayed on the screening unit as a “pass” or “refer.”

It is very important to remember that fail OAE  does not mean child have haring loss it just indicates that further  tests are required for full hearing evaluation. (BERA and ASSR test).

 

Newborn hearing screening in India:

 In developed countries like US it is mandatory to check hearing of each and every newborn within 48 hours of birth. But currently there are no mandatory rules or regulations for Newborn Hearing Screening in India and hence the identification of hearing loss is mostly at later ages.

 

Conclusion:

OAE screening is proved to be reliable method of screening. If hearing screening is made mandatory for the newborns at the time of birth or within the first month of life many more cases of hearing & speech impairment could be avoided.

Hearing impairment must be corrected before the child reaches six months of age. Late intervention of the hearing loss will yield very poor results as the plasticity of the brain reduces drastically as the child grows older. Undetected hearing loss is big obstacle to educational achievement and socialization.

Mother’s instinct should never be ignored and probable hearing loss in the child should be subjected to audio logical assessment.  It should not be ignored withIt shall improve in the next few years” or ‘child did not hear because he was busy playing or watching television’.

For more information about OAE screening visit hearing screening protocol at Audicco

or mail at info@audicco.com

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