Page 3485 - Week 11 - Wednesday, 15 November 2006
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hearing screening program, hearing screening was extended to Calvary Private Hospital and John James Memorial Hospital. A budget of $201,000 was allocated in 2004-05 for the implementation of this second program phase, with a recurrent funding allocation of $130,000 for subsequent years.
The ACT has adopted the auditory brainstream response, or ABR, method for screening newborns. This method replaces tests such as the distraction test of the past that attempted to determine hearing impairment by, as an example, making noises to the side of the child to see if they turned to the source of the noise. Of course, all of us who have any experience with children—this extends to teenagers and young adults too—know that just because they do not respond to you does not mean they cannot hear you.
The new ABR screening tests no longer rely on outside stimulus. The tests are undertaken by auditory technicians and provide for pass or fail outcomes. If a child fails the ABR test, they are referred to a diagnostic evaluation for hearing impairment. The referral provides details on hearing thresholds and determines actual levels of hearing impairment. The testing not only determines whether a child has hearing impairment but it can also determine if a child has impairment in both ears or just one.
Children with impairment in just one ear, known as unilateral deafness, are provided with regular follow-up sessions, as some of them will develop bilateral deafness—that is deafness in both ears—later on. In addition, some children with congenital hearing problems may not present with hearing loss in the first few days and weeks after birth. So, despite the great benefits of the newborn hearing screening program, there remains the need to monitor children’s progress even after a hearing screening pass in the neonatal period.
The field of newborn hearing screening is still in its infancy. The NHMRC has noted that the study into this area suggests that there may be additional risk factors that could assist in highlighting children who need special attention. Some factors that may be related to hearing impairment in infants might include admission to neonatal intensive care units; infections caught during the first weeks and months of life; face, head or skull abnormalities; a birth weight of less than 1.5 kilos; birth asphyxia; chromosomal abnormalities; jaundice; a family history of permanent childhood hearing impairment; and some medicinal compounds.
As more study is undertaken, the link between these and other causes of hearing impairment will become clearer and enable additional treatments and interventions. In terms of permanent childhood hearing impairment, the NHMRC has recommended that there is fair evidence to recommend universal neonatal hearing screening.
At this stage, according to the NHMRC, there is insufficient evidence to make a recommendation for or against genetic screening. The NHMRC has also found insufficient evidence to make a recommendation for or against school entry screening. I remember that when I attended Ainslie primary school, we were offered school-based hearing screening at the school and also as school excursions to the institute of anatomy, where hearing tests were provided.
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