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- Hearing Loss, March-April,
1999
- There are psychosocial, linguistic, and
educational advantages for children who receive appropriate
management for their hearing condition at an early age (Ross,
l998). Studies completed over ten years ago have shown that the
English language and auditory skill development is superior for
these children compared to those whose hearing loss is detected
and managed at a later date (Watkins, 1987; White & White,
l987; Levitt, McGarr, & Geffner, l987).
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- In the most recent study of this type
(Yoshinaga-Itano, Sedey, Coulter, & Mehl, l998), the earlier
results have been corroborated. It was found that children whose
hearing losses were identified before six months of age
demonstrated significantly better language scores than children
whose losses were detected later. Early management can also spare
parents the years of agonizing uncertainty and feelings of
helplessness that often occur when there is a delay in the
detection of their child's hearing loss. In short, there are
compelling reasons for the necessity to detect hearing loss in
children at an early age, with no apparent dissenting
voices.
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- Until recent years, however, there has not
been an efficient and cost-effective way of identifying hearing
loss in newborn infants on a universal scale. Previous efforts
often resulted in too many normally hearing children "failing," or
too many children with hearing loss "passing." In the last several
years, technical developments have made it possible to efficiently
set up a nationwide newborn infant hearing screening program that
is both accurate and relatively inexpensive. Existing models in
several states clearly demonstrate that infant hearing screening
programs using the otoacoustic emission (OAE) phenomenon can
reliably and accurately identify the presence of a hearing
loss.
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- These programs are administered by
audiologists, and conducted by medical technicians and nurses
under the supervision of an audiologist. Children who fail the
hearing screening at least twice are referred to an audiologist
for an auditory brainstem response (ABR) test. The results of this
test can accurately estimate the degree and general configuration
of a child's hearing loss in each ear. Once these measurements are
made, and after an otolaryngological examination is conducted to
consider the medical implications of the hearing loss, it is then
necessary to provide for a comprehensive management program for
the infant and his/her family by qualified early intervention
specialists, state health agencies, the state educational system,
and consumer and parent organizations. Such a program would
include the selection and fitting of an appropriate amplification
device or determining whether or not a child is a cochlear implant
candidate. Indeed, and this should be stressed, without such a
management program the process would be incomplete.
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- Thus, a model universal newborn hearing
screening program would include the following components: hearing
screening, diagnostic audiological testing, a medical examination,
and a habilitation process that is a component of, and flows from,
the identification and diagnostic procedures.
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- SHHH supports the passage of legislation
to mandate a Universal Newborn Hearing Screening program.
Furthermore, we recommend that such legislation directly or
indirectly address the necessity for a linked non-medical
habilitation component.
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- References
- Levitt, H., McGarr, N.S. & Geffner, D.
(l987). Development of language and communication skills in
Hearing-Impaired Children, ASHA Monograph #26, Washington, D.C.
American Speech-Language-Hearing Association.
- Ross, M. (l998). Implications of delay in
the detection and management of deafness. Educational Audiology
Review, 15(4) 10-15.
Watkins, S. (l987). Long term effect of
home intervention with
hearing-impaired children. American
Annals of the Deaf, 132, 267-275.
- White, S. J. & White, R.E.C. (l987).
The effects of hearing status of the family and age of
intervention on receptive and expressive oral language skills in
hearing-impaired infants. In Levitt, McGarr & Geffner (Eds.),
Hearing-Impaired Children, ASHA Monograph #26, American
Speech-Language-Hearing Association.
- Yoshinaga-Itana, C., Sedey, A. L.,
Coulter, D. K., & Mehl, A. L.
(l998). Language of early-
and later-identified children with hearing loss. Pediatrics,
102(5), 1161-1171. |
