why is newborn hearing screening important ? semiramis zizlavsky pre pito 8, sept 2,2013 jakarta
TRANSCRIPT
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
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)
0
5
10
15
20
25
30
35
Hearing loss Clef t lip or palate
Down syndrome
Limb defects Spina bifida Sickle cell anemia
PKU
Nu
mb
er
per
10,0
00
Congenital Condition Type
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
Automatic Auditory Brainstem Response (AABR)
PASS
REFER
Measures how the hearing nerve responds to sound
TIMING TO TEST
INTERVENTION
< 6 month HA CI
DIAGNOSIS (OAE,AABR/ABR)3 month RISK FACTORS
IDENTIFICATION (OAE)BEFORE DISCHARGE 2 days
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
Bayi baru lahir / 2 hr
OAEOAE PASS PASS REFER REFER
1 –3 BULANAuto ABR
atauclick 35 dB
1 –3 BULANAuto ABR
atauclick 35 dB
P R
3 bulanOtoskopi
TimpanometriOAE
Auto ABR
3 bulanOtoskopi
TimpanometriOAE
Auto ABR
P R
ABR Click & Tone B 500 Hzatau ASSR
Timpanometri High Frequeny
Pemantauan • Speech development• AudiologiTiap 3-6 bulan smp (anak bisa bicara) usia 3 th
Pemantauan • Speech development• AudiologiTiap 3-6 bulan smp (anak bisa bicara) usia 3 th
Habilitasi usia 6 bulanHabilitasi usia 6 bulan
Tidak perlu tindak lanjut
ALUR SKRINING BAYI BARU LAHIRALUR SKRINING BAYI BARU LAHIR
ABR Click + CochlearMicrophonicABR Tone B 500 Hz atau ASSRTimpanometri ( refleks akustik)
High Frequency
Faktor Risiko (-)Faktor
Risiko (-)
Neuropati AuditorikNeuropati Auditorik
Tuli SensorineuralTuli Sensorineural
Faktor Risiko (+)
Faktor Risiko (+)
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