Language Development for the New Generation of Children with Hearing Impairment

A new generation of children with hearing impairment (HI) has emerged due to the introduction of universal neonatal hearing screening, medical–surgical/technical and educational advances. Aim: Investigation of long-term development of vocabulary and social well-being of children with HI, including children with HI and additional disability. Method and Material: The project design was prospective, longitudinal, and comparative. Level of receptive vocabulary was compared to children with normal hearing, type of hearing technology, gender, additional disability, diagnosis of HI, level of social well-being, and start age for use of hearing technology. A total of 231 children participated. Intervention included early start of hearing technology and three years of auditory–verbal therapy (AVT) at the preschool level, followed by 3 years of AV guidance at the school level. Results: Children with HI scored within the norm for receptive vocabulary but were outperformed by the control group. Children with HI and a diagnosed additional disability scored lower than children without additional disability, in terms of parental assessments of social well-being. Children with additional disabilities showed positive progression in terms of receptive vocabulary development. Conclusions: New generations with HI possess the potential to succeed academically in accordance with individual abilities and become active participants in the working market.

Universal neonatal hearing screening program at a university hospital: an analysis using quality indicators

ABSTRACT Purpose: to assess the universal neonatal hearing screening program using quality indicators. Methods: the records of newborns who were submitted to the neonatal hearing screening in 2018 were analyzed, comparing the data with the first five quality indicators established by the national guideline for neonatal hearing screening attention: 1) rate of screening coverage (≥95%); 2) age at the screening in months (up to the first month of life); 3) rate of referrals for diagnosis (2% to 4%); 4) rate of attendance to diagnostic examination (≥90%); 5) age at confirmed diagnosis (up to the third month of life). The data were submitted to quantitative and descriptive statistical analysis. Results: the rate of coverage, age at screening, and the number of referrals for diagnosis met the indicators established by the national guideline. The rate of attendance to diagnostic examination fell short of the expected, and the age at confirmed diagnosis was verified in 70% of the cases. Conclusion: using the quality indicators furnished important data on the effectiveness of the neonatal hearing screening program and identified opportunities to improve the service, which can help identify hearing loss, early.

Universal neonatal hearing screening in a public hospital in Brazil: parents participation

Background The National Policy for Hearing Health Care in Brazil proposes that all newborns in the country undergo hearing screening in the first month of life.The Universal Neonatal Hearing Screening Program being extremely important for the early intervention of deafness. However, many parents/guardians do not return to the auditory retest, interrupting the neonatal protocol and making early auditory diagnosis impossible. Objective:To analyze the reasons for the non-attendance to retest of the Hearing Screening of a hospital in Curitiba. Methods This study was carried out in a Public Hospital, with live births from August 2017-May 2018. All the born were considered for the variables gender, risk for hearing loss, age at birth, results of Hearing Screening. Failed babies were analyzed, including the active search of those who did not attend the retest, through contact with parents/guardians to collect the reasons for faults. Results 2,531 infants were born, male had a prevalence of 1,275 (50.38%), term born 1,734(68.51%) and ICU stay as the most common risk indicator - 118(79.73%). 2,261(89.33%) infant passed on both ear; among those who failed only 94(40.0%) attended the retest. An active search was performed by phone, and 78(55.31%) could not establish contact, totaling 47(54.02%) mothers contacting. These motherś age was 19 to 24 years, 56.92% of whom had high school. The majority of those in charge are aware of the result of the test of the ear of their son (82.97%), was directed to test again (87.23%), were not able to answer the reason for not attending (27.65%) or had forgotten about this commitment (19.14%). Conclusions The data analyzed showed the lack of information that parents / guardians of the newborns give to the Hearing Screening, which compromises the integrality of health actions in newborns, making it necessary to seek other ways to ensure family adherence to the Program. Key messages Babies at risk of deafness need constant monitoring. Without parental participation, there is no success in health programs.

Territorial distribution and quality indicators of compulsory Neonatal Hearing Screening in Brazil after Law 12,303/2010

ABSTRACT Purpose: to survey the national literature after the universal neonatal hearing screening became compulsory, addressing aspects related to its territorial distribution, the screening procedures employed, and verify whether the internationally proposed quality indicators have been achieved. Methods: an integrative review of articles indexed in the BIREME, PubMed, and Scopus databases. Inclusion criteria: Articles in Portuguese and English published after Law 12,303/2010 was passed, whose theme was the neonatal hearing screening in Brazil. Exclusion criteria: Information from books and/or chapters, integrative review articles or reflexive articles, studies conducted in other countries, and studies approaching a specific subpopulation. The search strategy combined the following descriptors in Portuguese and English, respectively: “Triagem Neonatal”, “Perda auditiva”, “Recém-nascido”, “Brasil”, “Neonatal Screenings”, “Hearing Loss”, “Newborn”, “Brazil”. Results: of the 224 articles found, 26 were duplicates, 38 were books or book chapters, three were integrative reviews, 20 were studies conducted in other countries, and 120 were either reflexive articles or studies approaching a specific subpopulation. The final sample comprised 17 articles that addressed the proposed theme. Conclusion: the South and Southeast Regions of Brazil concentrated most of the programs, and the main technique employed was the evoked otoacoustic emissions. Two quality indicators were achieved: performance rates within the first month of life, and diagnosis referral rates. However, the coverage rates remained below the expectation, and there were still high retest referral rates, high nonattendance rates in the subsequent stages, low satisfactory retest result rates, and a large number of “fail” in the two screening stages.

Follow-up on the diagnostic level of children covered by the Universal Neonatal Hearing Screening Program in Poland, divided into voivodships

Introduction: Thanks to the Polish Universal Neonatal Hearing Screening Program (PUNHSP), All newborns in Poland undergo a free, screening hearing examination. Between 2006 and 2015, the average number of tested children per year was 373,477. According to the analysis of The Central Database(CDB), only 55.8% of the children attended the detailed hearing examinations at the second level of the Program. Aim: The aim of this study is to analyze the dates concerning the attendance of the children at the diagnostic level of PUNHSP in different regions of Poland. Materials and methods: To conduct an analysis of this fact and find out the reasons for the low attendance at the second level in 2015, a telephone survey questionnaire was developed for parents whose children had not registered for further consultation - 3,239 randomly selected parents. Results: The analysis revealed that the number of children examined at the second diagnostic level of the program is in fact much higher than the results of The Central Database show. The actual number is 83.6% as opposed to 55,8%. As a result of the telephone questionnaire, some inaccuracies in the input data to the CDB were detected. The main errors involved in the gathering of information for the CDB was the incorrect OAE test result and the lack of performed examination. Conclusion: In Poland, the worst results for the attendance to the diagnostic level (the results were a comparison of the questionnaire results compared to the CDB) was shown in Pomorskie, Lubelskie, Mazowieckie, and Podlaskie regions. In many cases, there was a large difference in reality to what the information in the CDB claimed. The improvement of clarity concerning the CDB application is important in order to minimize the possibility of malformation in the CDB.