Early hearing screening as part of prevention of speech impairment (part 2)
This is the so-called Principle 1-3-6, according to which:
Auditory screening is carried out for all children, optimally until they are discharged from the hospital, maximum – until they reach 1 month.
If auditory disorders, extensive audio diagnostics, i.e., determination of the nature and degree of hearing impairment, are detected during the screening, the child is reached 3 months of age.
Hearing replacement (correction of auditory impairment) is carried out for children with diagnosed irreversible auditory impairment no later than they reach 6 months of age.
Various objective methods of hearing assessment have been created and put into clinical practice that can be used to diagnose hearing impairment in young children who are not able to adequately assess their feelings. Such methods include the method of recording otoacoustic emission. It can be used both as a screening and in the differential diagnosis of hearing impairment in combination with other methods.
Audiological screening of newborns is carried out using an apparatus that automatically interprets the results of the study. The result may be the following conclusion: “passed, the SAAE is within the normal range” (“pass”) or “failed, the SAAE is not registered, send” (“refer” [9:10 AM, 5/27/2019] Tatyana Brook). VOAE can not be registered only on one ear or on both. If VOE is absent, this is evidence of damage to the middle ear (the so-called conductive hearing loss) or internal (sensorineural hearing loss), which has a degree from mild abnormality to complete deafness. VOAE may also not be recorded with temporary hearing impairment in children with an inflammatory process in the nasopharynx. The type of disorder and the degree of hearing loss can only be determined by conducting a comprehensive examination in a specialized clinic, using a number of subjective and objective methods. Portable devices designed for hearing screening, for example, OtoRead (Interacoustics, Denmark) and AccuScreen (GN Otometrics A / S, Denmark), can be used to register VOAE.
If a child has been diagnosed with hearing loss as a result of a comprehensive examination, the rehabilitation program should be started at the age of 2 to 4 months, but no later than 6 months.
The program offered by the Clinical Neurology Center in St. Petersburg includes:
necessary treatment (conservative, and if necessary, surgical);
the help of teachers and psychologists;
auditory prosthetics (this refers to the selection and tuning of the hearing aid);
carrying out cochlear implantation after a child reaches 10-18 months.
In the absence of comprehensive assistance in children with hearing impairment, a developmental delay will be inevitable, since without normal hearing the development of not only speech but also thinking is impaired. Early auditory prosthetics for children with identified hearing loss, as well as timely cochlear implantation for deafness, are prevention of the development of dumbness and other speech disorders, providing the opportunity for the correct development of intelligence. This can only be achieved if a child suffering from congenital hearing loss receives an auditory prosthetics on time, in 2–4 months. The exceptions are children with deep prematurity who receive hearing prosthetics at the age of 6–10 months, as well as children with auditory neuropathy, who usually have an auditory prosthetics after 12 months.
Cochlear implantation is an surgical intervention during which electrodes are implanted into the inner ear, namely, into the cochlea of a child, which convert the sound wave into a weak electrical impulse and transmit it further to the auditory nerve, which allows the child to perceive sounds.