Transcript Why is newborn hearing screening important

Why is newborn
hearing screening
important ?
Semiramis Zizlavsky
Pre PITO 8, Sept 2,2013 Jakarta
INTRODUCTION
• Babies : develop speech and language from
the time they are born.
• Listening and interacting with sounds and
voices around them.
• Baby is born with hearing loss: speech and
language development can be delayed.
• Hearing screening testing : highly accurate.
earlier identification and treatment of infants
-
What is newborn hearing screening
Why hearing screening is important ?
Principles of Screening
Target
Risk Factors
Benefit of Hearing Screening
Risk of Newborn Hearing Screening
Timing to test
How to do ?
Important to thinks
What is newborn hearing screening ?
Newborn hearing screening……..
programs are designed to identify
hearing loss in infants shortly after
birth
• Prevalence ; 2-3 per 1000 newborn will
have HL
Indonesia : 1-3 per 1000
1/1000 WBN
10/1000 NICU
Why is early identification of hearing
loss important
• Hearing loss is the most common birth
condition
• Previous methods for detecting hearing loss
have been ineffective (behavioral
observation)
• Undetected hearing loss can delay
speech, language, social and academic
development
Incidence of Congenital Conditions (Per 10,000)
35
Number per 10,000
30
25
20
15
10
5
0
Hearing loss
Clef t lip or
palate
Down
syndrome
Limb def ects Spina bifida
Congenital Condition Type
Sickle cell
anemia
PKU
Principles of Principles
of
Screening
Screening
Quick
Cheap
Not Invasive
Accurate,
reproducible
Target
Universal
Hearing
Screening
All
Babies
Targeted
Hearing
Screening
Risk
Factors
RISK FACTORS (JCIH 2000)
0-28 day
-NICU > 48 hours
-Syndrome
-Family history
-Craniofacial anomalies
-In utero infection
29 days- 2 years
-Parental/caregiverconcern
-Family history
-Syndrome
-Postnatal infection
-In-utero infection
-Hyperbilirubinemia
-Neurogenerative disorders
-Head trauma
Benefits of Newborn Screening
• IDENTIFICATION
• EARLY INTERVENTION
• REDUCED MORBIDITY
• FAMILY PLANNING
Risk of Newborn Hearing Screening
• Parent anxiety (false positive )
• Missed diagnosis ( false negative)
• Unanticipated outcome
- range of reactions
- maternal feelings of guilt
- financial problem
- cultural sensitivity
HOW TO DO ?
• One
• Two step
Hearing Screening Techniques
AABR
OAE
OAE +
AABR
ABR
OAE
Otoacoustic Emmision (OAE)
PASS
REFER
Measures sound waves produced in the inner ear
Automatic Auditory Brainstem Response (AABR)
PASS
REFER
Measures how the hearing nerve responds to sound
TIMING TO TEST
IDENTIFICATION (OAE)
BEFORE DISCHARGE
2 days
DIAGNOSIS (OAE,AABR/ABR)
3 month
RISK FACTORS
INTERVENTION
< 6 month
HA
CI
BIRTH: Hospital-based Screening
• OAE,AABR,ABR
• Re-Screen before discharge :possible
• Hearing screen pass : not guarantee (risk
factors ?)
• Re-screening if : - any failure / incomplete
- unilateral
• Parents refuse screening : documentation
Before one month of Age
• Outpatient re-screening : - failed
- missed
- incomplete
• Unilateral failure : audiology evaluation
Early re-screening :
-Earlier diagnosis
- Minimizes parental anxiety
Before Three Month of Age
Audiology evaluation
DIAGNOSIS
If HL is confirmed
(Information, amplification & communication)
Before Six months of Age
• Continue early intervention : WHY ???
• Other evaluations :
- genetics
- ophthalmology
- pediatrics
Syndrome ?
- neurology
- cardiology
- nephrology
HTA Hearing Screening
ALUR SKRINING BAYI BARU LAHIR
Bayi baru lahir / 2 hr
OAE
PASS
Faktor
Risiko (-)
P
Tidak perlu
tindak lanjut
1 –3 BULAN
Auto ABR
atau
click 35 dB
REFER
Faktor
Risiko (+)
P
R
ABR Click + CochlearMicrophonic
ABR Tone B 500 Hz atau ASSR
Timpanometri ( refleks akustik)
High Frequency
Pemantauan
•Speech development
•Audiologi
Tiap 3-6 bulan smp (anak bisa
bicara) usia 3 th
3 bulan
Otoskopi
Timpanometri
OAE
Auto ABR
R
ABR Click & Tone B 500 Hz
atau ASSR
Timpanometri High Frequeny
Neuropati
Auditorik
Tuli Sensorineural
Habilitasi usia 6 bulan
Conclusion
☺Screening is part of a system of
follow-up, diagnosis, treatment and
evaluation.
☺Timely and appropriate intervention
have lasting effects on outcomes.
☺ Family involvement : important
THANK YOU