Читать книгу Early Detection and Intervention in Audiology - Группа авторов - Страница 25

Amisha Kanji

Early detection of hearing impairment through newborn hearing screening (NHS) is the initial step to any early hearing detection and intervention (EHDI) programme. Universal newborn hearing screening (UNHS) is considered the gold standard worldwide. However, this approach may not initially be feasible for some developing contexts where contextual challenges to implementation exist. Targeted newborn hearing screening (TNHS) is a possible interim approach that may be implemented in such contexts. This chapter first discusses the different approaches to early detection of hearing impairment in South Africa, followed by the recommended approach for this context. The chapter concludes by suggesting possible solutions and recommendations for early detection of hearing impairment in South Africa and other low and middle-income (LAMI) countries that may not yet have early detection programmes in place.

Early detection of hearing impairment is conducted through NHS, and is usually followed by a comprehensive diagnostic audiological evaluation should a refer result be obtained from the screening. NHS has been used for over a century. Investigation of early detection of hearing impairment began in the 1800s with the use of subjective evaluation in the form of behavioural responses. It has now progressed to the use of objective measures in the form of otoacoustic emissions (OAEs) and the auditory brainstem response (Mencher & DeVoe, 2001), which are employed in NHS programmes globally. Similarly, risk-based hearing screening, commonly referred to as TNHS, was the first approach to early detection in the 1950s and 1960s, with the introduction of the high-risk register (HRR) to identify newborns and infants presenting with risk criteria for permanent congenital and early onset hearing impairment who require NHS (Mencher & DeVoe, 2001). Identification of infants at risk for permanent congenital and early onset hearing impairment based on established risk factors on the HRR was recommended by the Joint Committee on Infant Hearing (JCIH) in 1973. The use of this approach for early detection of hearing impairment gradually progressed toward the introduction of UNHS in 2000, which entails the screening of all newborns (JCIH, 2000, 2007).