Universal Newborn Screening: A Case Study

Twenty-six percent of infants ears demonstrated hearing loss during the first year of life, and 78% of children’s ears demonstrated hearing loss during the study period. Of the children’s ears with hearing loss, 100% had a conductive component and 26% had an additional sensorineural component (mixed hearing loss…Common temporal bone findings included thickening and sclerosis of the

Conductive hearing loss is from one or more deformity with the outer, inner, or middle ear which impacts sound from transferring to the nerves 5. Conductive hearing loss is often corrected with surgery, drugs, or hearing aids. Sensorineural hearing loss affects the cochlea, which transfers the sounds vibrations to the nerves 5. Although hearing aids are typically used for conductive hearing loss, a profoundly deaf sensorineural patient needs to complete a 6-month trial with them before they are considered ineffective and referred on for further testing for cochlear implant candidacy 5. Sensorineural hearing loss is primarily due to a malfunctioning cochlea so doctors run a hearing test to see how many decibels can be picked up by the cochlea. For pediatric patients to qualify for implants they need to be considered profoundly deaf in both ears. The tone threshold for mild hearing loss is between 21 and 40 dBHL (decibels Hearing Level) and profound hearing loss is greater than 90 dBHL 5. Typically, a pediatric patient looking for cochlear implants will go through a battery of speech-recognition testing while simultaneously undergoing the audiological

A child’s speech and language development are highly effective from a young age of 5 and under (Dobie & Van Hemel, 2004). With early intervention, it is seen to be the most effective with children who receive it at a young age. There is not really any one type of intervention or services for people and families of the hearing impaired. However, it is reported that the earlies a deaf person receives treatment and services, the more potential they have to improve their speech, language, social development, and educational achievement. “Research strongly indicates that children with a hearing loss must receive early intervention as soon as possible if they are to learn the language skills necessary for reading and other academic subjects” (Hardman, Drew, & Egan,

Taylor and Emanuel (2013) conducted retrospective and prospective studies to assess the efficacy and offer suggestions to strengthen college hearing screening programs. Researchers assessed low return rates, addressed high ambient noise levels in therapy rooms, and considered the effects on results when excluding 6000 Hz. Retrospective records from 1999 to 2011 were analyzed at a university. A small percentage of students were referred for follow-up testing after failing their screening, yet only a third of the students returned for diagnostic testing. Students with hearing loss were not accurately identified due to the therapy rooms being poorly treated, resulting in unreliable findings. The prospective study included a smaller number of students who took part in a required screening and agreed to participate in a

The National Institutes of Health Consensus Statement (NIH, 1993) previously discussed the importance of implementing the two-stage, evoked otoacoustic emissions (EOAE) and auditory brainstem response (ABR) universal newborn hearing screening (UNHS) protocol. Bess and Paradise (1994) stated their objections towards the NIH study by presenting limitations, which included the practicability, effectiveness, cost, and harm-benefit ratio. Although there was an agreement between NIH and Bess and Paradise that early identification is important, Bess and Paradise are cautious in supporting NIH launching the UNHS protocol. The first notable limitation on the practicability of the NIH study takes into account hospital nurseries discharging within 24

Because of the amount of technology noise your child is exposed to, and the fact damaged hearing could affect their educational development, it is important you get their hearing checked annually between the ages of four and six. After six this can be scaled back to every second year until they reach middle teens.

at octave frequencies between 250 Hz and 4 kHz) was carried out and an average pure-tone

Remarkably one the most evidential successes of the last 51 years was the onset of the Newborn Screening process. According to the CDC, The Center for Disease Control, over “twelve thousand newborns per year are diagnosed with one of the twenty nine core conditions that are detected through newborn screening. This means that almost 1 out of every three hundred newborns screened is eventually diagnosed.” These screenings test for amino acid disorders, endocrine disorders, fatty acid and hemoglobin disorders as well as the newly added congenital heart disease disorders. “Newborn Screening helps to prevent certain treatable conditions. Babies with certain conditions need treatment in early infancy to prevent severe ill health. Newborn screening

The Weber and Rinne test are used to determine if hearing is normal or if conductive and sensorineural hearing loss are present. The Rinne test compares air and bone conduction hearing; the test consists of striking a 512 Hz tuning fork at the base of the mastoid bone (located behind the ear) (Lewis et al., 2011) and is a time interval test. Time interval is when bone conduction sound is heard longer than or equal to air conduction with conductive hearing loss and with sensorineural hearing loss the air conduction is heard longer than the bone conduction in the affected ear (Devitt, (n.d.). Since there are different types of hearing aids, external and internal this assessment is a valuable tool for the physician to determine what may be best for each specific patient. For the external hearing aids it has been determined by research printed in the American Journal of Audiology that fitting hearing aids bilateral instead of monaural will often result in better patient compliance (Lavie, Banai, Attias, & Karni, 2014). Bilateral fittings usually have a lesser risk of noncompliance and enhancing a better outcome for the patient. Nurses can provide referral sources for a patient who is in need of additional support services that nursing cannot provide. Such as when a patient fails a hearing screening and when hearing aids are not functioning or ill fitted. By collaborating with the others in the healthcare team there will be enhancement of the patient 's health and

Right now, I would not feel comfortable performing a hearing screening during a kindergarten round up. However, I would feel comfortable and prepared administering a hearing screening after I've practiced a few times. I have performed a hearing screening on classmates during undergrad and recently I observed my clinical supervisor administer a hearing screening during an

This part of your visit is critical as it will provide some critical details for the center’s staff to diagnose what could have caused hearing problems. There are other parts of the testing

Hearing screenings are just as important as a routine doctor’s check-up. The younger generation, such as college students, may not pay much attention to their hearing. Universities all over the country have made a point to provide hearing services to some of their students. Taylor & Emanuel’s article, Assessment of the Efficacy of a Hearing Screening Program for College Students, studies the effectiveness of a hearing screening program and proposes improvements that can be made to university hearing screening programs. This article discusses the importance of sensitivity and specificity when determining the effectiveness of a screening program. There were plenty of outside sources within this article, but a lot of these studies had insufficient

I think it is extremely interesting the newborn screening programs within the United States vary from state to state. In DC, newborns are screened for 52-55 genetic and metabolic disorders. In your state program screens for_______. The amount of test screened in not the only variation in the newborn screening programs. Informed consent, test result documentation, test results notification to parents or the healthcare provider vary as well from state to state. States screening “programs (45.1%) report only to physicians and require just their name (43.5%), an identification number (17.4%), a letter (26.1%), or a parent's signature (26.1%)… In 74.5% of programs, parents are notified but not asked for consent before collection of the sample; 19.6% neither notify parents nor obtain consent before screening” (Shlomit et al., 2002).

A hearing test is a test to check for hearing loss in one or both ears. A hearing screening is a quick and simple hearing test to see whether more in-depth tests are needed. If your child passes the screening, this means he or she does not have hearing loss. If the results of the screening show that there could be a problem, your child may need to see a hearing specialist (pediatric audiologist) for more detailed testing and evaluation.

Recently in the United States, there has been a drive at both the state and national level to provide universal screening for newborns to detect hearing loss. Although the idea of a universal screening in newborns is a new phenomenon, research has examined the impact of early intervention and screening for children with hearing loss. “Most professionals in the field feel strongly that early identification of hearing loss and early implementation of intervention enhances the child’s social, communicative, and academic development” (Calderon, 1998, p. 54). With that, the two studies used participants in the same early intervention program and mainly focused on the importance of the age of enrollment. Furthermore, the age of enrollment