Copyright 1999 The New York Times Company
The New
York Times
August 24, 1999, Tuesday, Late Edition -
Final
SECTION: Section F; Page 16; Column
1; Health & Fitness
LENGTH: 514 words
HEADLINE: Study Calls for Limits on Hearing Tests at
Birth
BYLINE: By ERIC NAGOURNEY
BODY:
A new study, running counter to the
nationwide move toward routinely testing all
newborns for hearing problems, argues for
testing only those infants known to be at risk.
Prompted in part by advocates for the disabled, who point to the
longstanding failure of doctors and parents to detect many cases of hearing loss
until a child is 2 or older, hospitals across the country have begun routinely
screening children shortly after birth. Some 20 states have passed laws
requiring the screening, and Congress is considering taking action.
The
new study, in the current issue of The American Journal of Otology, suggests,
however, that the effort is neither economical nor the best method to insure
that infants with hearing problems receive the appropriate care.
Instead, the authors said, hospitals should focus their resources on
newborns known to be at higher risk because of factors like family history, low
birth weight and herpes infection. They also urged that primary care physicians
and other people in contact with children be better trained to detect the signs
of deafness in those not considered at risk.
"I really believe that the
primary care physician has the key to this problem," said Dr. Paul R. Kileny, a
co-author of the report, who is director of audiology for the University of
Michigan Health System.
About 1 in 1,000 babies born in the United
States each year is deaf or has a serious hearing disorder, while perhaps 4 or 5
others have a less serious condition.
Left undiagnosed for too long, the
disorder can cause problems with language development, education and even social
skills. But with early detection, doctors can provide hearing aids for infants
just weeks old, and cochlear implants for children over 18 months.
After
studying more than 2,100 high-risk babies born at the University of Michigan
hospital in a 10-year period, researchers found that 6.4 percent were suffering
from at least some hearing loss.
The doctors used an auditory brain stem
response test, which measures brain activity in infants exposed to sounds. When
they calculated the cost of testing all of the high-risk infants, they found
that each diagnosis cost about $3,000 -- far less than if every newborn had been
tested.
Saving money, however, is not the only issue, said Dr. Kileny.
Because many cases of deafness have a delayed onset, he said, routine screening
of all newborns could give a false sense of security for infants who pass the
test but then develop problems later.
Dr. Kileny said he believed
universal screening was a fine ideal, but an impractical one. He and other
experts said this was nevertheless the trend in American medicine.
In
New York, Gov. George E. Pataki is reviewing a bill, approved by the
Legislature, that would require hospitals to screen all infants for hearing
problems or give them a referral.
"I think the train is down the track
for very good reasons," said Evelyn Cherow, director of audiology services for
the American Speech-Language-Hearing Association. Ms. Cherow's group has long
advocated universal screening.
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LOAD-DATE: August 24, 1999 
