IM this article to a friend!

May 10, 2007

Study shows early testing, followup can save children's hearing

From: Salt Lake Tribune, UT - May 10, 2007

Youth screening and follow-up are crucial to help kids fulfill potential, data show

By Heather May
The Salt Lake Tribune

Almost all American newborns have their hearing tested. But of the babies who show signs of hearing loss, one-third don't get follow-up tests - putting them at risk for language, social and learning delays, according to data released Wednesday.

The figure alarms Karl White, director of the Utah State University-based National Center for Hearing Assessment and Management. The Logan center tracks newborn screening for the federal government and crunched the numbers.

"There's good research showing the earlier these babies get intervention, the better they will do," White said.

Most children whose hearing loss is caught early and who receive help - such as hearing aids or cochlear implants, listening and speech training - will catch up to their peers and won't need special eduÂcation services, he said.

The nation has made great strides in screening newborns - 95 percent are tested, up from 3 percent in 1989. And there are signs of success with follow-ups, too. It used to be that just half of babies received diagnostic evaluations; now, two-thirds do.

When babies show difficulty with the initial screening - typically done in hospitals with a machine that measures the acoustic sounds emitted from the baby's hair cells - they should be referred for further testing.

The Centers for Disease Control and Prevention recommends that follow-up take place by 3 months of age, though White recommends by 1 month for healthy babies.

In the diagnostic test, babies listen to clicks or tones though earphones. Electrodes measure how the sound travels from the ear to the brain to see if the nerve is functioning.

In Utah, where screening is mandated, 98 percent of newborns are tested, said Rich Harward, director of the screening program for the state.

Of the 54,000 babies born last year in Utah, about 300 needed a diagnostic hearing test and apparently didn't get one. The state is trying to track them down through its birth certificate database.

"Of that 300, there will be a number who will have permanent hearing loss. Those are the ones we're really concerned about," Harward said.

White said pediatric audiologists, who perform the diagnosis, can be hard to find. And physicians may be ill-informed, advising their patients that children cannot be tested until they are older.

"Pediatricians might say, 'Why don't we wait and see?' That's exactly the wrong thing to do now, but it was the right thing to do 25 years ago," White said.

Parents can be culpable, too. Wanting to believe their children have normal hearing, they may seize on signals that everything is OK, like a baby being startled by a slamming door, White said. But they could miss more subtle signs of moderate hearing loss, he explained.

He recommends parents be vigilant. Faye Mitsunaga, an audiologist at Mountain West Hearing Center in Salt Lake County, agrees.

"You want to try to follow up with the child as soon as possible," she said. "There is that critical period for speech and language development."

To get on track for language development, children need early interventions. Today's deaf adults, who didn't get them, read at a fourth-grade level on average, White noted.

His data show that 23 percent of children with hearing loss aren't enrolled in programs by the time they are 6 months old, a goal set by the federal government.

Taunya Paxton knows how difficult it can be to play catch up when a child gets a late diagnosis. Doctors now believe her son, Chance, lost his hearing at 13 months from a virus. But it wasn't discovered until he was almost 3, when his parents noticed his vocabulary was lagging.

Now 7, Chance has cochlear implants and his vocabulary is similar to a 5 1/2 -year-old's. He is in the mainstream kindergarten class at Orem Elementary and attends extra language classes taught by the Utah Schools for the Deaf and Blind.

"We're closing the gap," Paxton said.

Since Chance had passed the initial newborn screening test, "We were completely blown out of the water that Chance was deaf," she added. "It's something you need to be diligent about and watching and making sure they're hitting their milestones."

© 2007, The Salt Lake Tribune.