Screening

ABSTRACT

Most hearing screening programs have historically targeted children with moderate or more severe bilateral hearing loss. Children with unilateral or mild bilateral permanent hearing loss represent a substantial proportion of all children with hearing loss, and there are serious negative consequences for these children if they are not identified early and given appropriate help. Many children, particularly those with unilateral or mild bilateral hearing loss, acquire hearing loss after the newborn period. Although virtually all newborns are now screened for hearing loss before leaving the hospital, there are very few opportunities for periodic hearing screening after the newborn period. Effectively identifying those children who have late-onset loss or who are missed during newborn hearing screening will require modifying some of the procedures currently employed in hospital-based newborn hearing screening programs, as well as establishing better hearing screening procedures for early childhood and elementary school programs. Existing state Early Hearing Detection and Intervention systems are a resource for establishing and improving screening programs for infants and children with unilateral or mild bilateral hearing loss.

KEYWORDS

Unilateral hearing loss - mild bilateral hearing loss - screening

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1 NHANES analysis uses definitions of “slight” (16 to 25 dB HL) and “mild” (26 to 40 dB HL) for low-frequency hearing loss (pure-tone average 0.5, 1, and 2 kHz) and high-frequency hearing loss (pure-tone average 3, 4, and 6 kHz).

2 Recording epochs of 20 to 25 milliseconds are necessary for adequate ABR threshold detection measures in infants, especially when tonal stimuli are used.[45]

3 Bone-conduction testing should be completed if air-conduction thresholds are greater than 20 dB nHL.[45]