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Case 1
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Hearing screening showed that one ear failed, and hearing was diagnosed as unilateral severe hearing loss. But this child responds to sound. Therefore, some parents tend to ignore this result and even choose to give up hearing diagnosis and follow-up.
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Analysis
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The main reason why parents make the above choices is that they lack of understanding of the relevant listening knowledge and hearing screening, do not realize the importance of hearing screening and the severity of unilateral hearing loss. According to a study in the United States, children with unilateral hearing loss have lower scores in comprehensive language test and oral expression than those with normal hearing, regardless of the severity of their hearing loss. Moreover, with the increase of age, if no intervention is taken, the defects of speech expression will be further highlighted.
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Countermeasures
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For the children whose screening results show that they have failed in one side, parents must cooperate with further diagnosis, determine the cause of hearing loss, determine the type of hearing loss, and then carry out follow-up and early intervention (such as receiving language training) under the guidance of professionals.
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Case 2
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The results show that “low frequency is good, high frequency is not good”
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Case
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Some children’s hearing screening failed, hearing was diagnosed as high-frequency hearing loss, and low-frequency voice response. This test result corresponds to the real life: the child only responds to some low and thick sounds, but does not respond to some sharp and thin sounds. Parents who encounter this situation often don’t think that there is a problem with their children’s hearing, but that this problem will subside with their children’s age.
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Analysis
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Obviously, the child has hearing impairment. If no intervention is taken, the child will have problems such as unclear speech or not understanding the meaning of the other person’s speech as he grows older. In addition, the parents mentioned in the case are obviously lack of understanding of relevant listening knowledge and careful observation of children’s listening development.
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Countermeasures
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Parents should implement early intervention measures under the guidance of professionals, wear hearing aids and receive language training.
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Case 3
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“Pass” may also have hearing impairment
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Case
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Clinical manifestations: some children show “pass” in hearing screening, but with the passage of time, their hearing level will fluctuate and decline, and even show obvious hearing impairment.
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Analysis
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At present, the otoacoustic emission and automatic auditory brainstem response used in most newborn hearing screening is a very effective hearing screening technology and method, but hearing testing should be a comprehensive evaluation process.
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For example, the possibility of auditory neuropathy cannot be completely ruled out when otoacoustic emission of hearing screening shows “pass” and automatic auditory brainstem response shows “fail”. If only otoacoustic emission is used for hearing screening, even if the test results show “pass”, we should be alert to the existence of auditory neuropathy, because it may be missed at this time.
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Some studies have shown that in infants with auditory neuropathy, the maximum output of auditory brainstem response has no response, 60% – 70% of which can record otoacoustic emission, that is to say, otoacoustic emission screening can show “pass”.
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Secondly, not all hereditary deafness occurs at birth, some of which occur in childhood or even in adults. Therefore, although some infants have passed hearing screening, infants with high-risk factors of hearing impairment, such as family history of deafness, hypoxia at birth, jaundice, etc., may have delayed hearing Loss, only follow-up can be found early.
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Countermeasures
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For newborns, especially those with high risk factors, even if they pass the screening, they should be followed up every six months within three years. Continuous audiological and medical observation, as well as communication skill development monitoring. In order to find out the possible hearing impairment in children early.
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Case 4
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Failure to pass does not necessarily mean hearing impairment
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Case
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Clinical manifestations: some children pass the primary screening or even re screening.
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Analysis
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If the newborn fails the hearing screening, sometimes it is because the instrument of hearing screening is relatively sensitive, and some external factors will affect the test results. It is not that the newborn really has hearing problems, such as secretion in the external or middle ear of the newborn, the newborn moves more severely during the examination, the newborn does not breathe well due to the nasal obstruction, and the surrounding environment has noise, etc., which may lead to new hearing problems The hearing screening of newborn children failed.
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Countermeasures
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During the period of waiting for re screening and hearing diagnosis, parents should not be too worried. During this period, the most important thing to pay attention to is to try to avoid the newborn’s cold, fever and milk choking, reduce the nasal obstruction, and reduce the chance of middle ear effusion. At the same time, for the children with middle ear effusion, hearing diagnosis may show hearing damage, but with the growth of children’s age, middle ear effusion will be absorbed or discharged, at this time, the children’s hearing will be improved.
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Therefore, it is more important to carry out professional diagnosis and follow-up work in the later period for newborns who fail to pass the hearing screening, so as to take measures as early as possible.
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Case 5
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Parents did not take early intervention measures after diagnosis
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Case
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It will be found in clinic that even if some newborns are confirmed to have hearing loss, parents will not take any intervention measures.
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Analysis
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This is related to the parents’ concept and understanding of deafness. On the one hand, parents hope that their children’s hearing will be better as they grow older. On the other hand, parents often can’t accept the fact that children wear hearing aids at a very young age. In parents’ concept, children wearing hearing aids are not recognized by the society.
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Therefore, some parents will choose to intervene when their children are old. At this time, the best intervention age is often missed.
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Countermeasures
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We should strengthen the propaganda of the concept of prevention and treatment of deafness among parents so that parents can realize the importance of early detection and early intervention. Raise the level of parents’ awareness. On this basis, we should also conduct psychological counseling for parents to help them change their ideas, because parents’ psychological conditions will
Link：Hearing knowledge | early prevention of hearing in newborn
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