In this article, we will look at what constitutes audiological screening of newborns.
Any newborn child still in the maternity hospital must undergo a comprehensive examination by certain specialists and a number of important tests. Such measures are necessary in order to exclude the presence of any pathologies in the child. Quite recently, it has become mandatory to conduct audiological screening by order No. 108 “On the standards of dispensary observation of children.”
The concept and components of screening
In the first days after birth, the child should be observed by a neonatologist who conducts a comprehensive neonatological examination. This is necessary to detect hereditary pathological changes in the baby's body, as well as to detect anomalies at the earliest stages of the child's development. The sooner any disorders are detected, the more effective the therapy will be.
The following diagnostic steps are included in mass screening of newborns:
- Examination by such narrow medical specialists as an orthopedist, surgeon, ophthalmologist, neurologist.
- Ultrasound screening.
- Audiological screening.
- Neonatology screening (laboratory testing of blood samples).
Blood testing is a fairly common procedure, while audiological screening often worries parents of a newborn baby. However, this procedure is very simple and should not give rise to any concerns.
Audio screening is an examination that allows you to detect pathological changes in the hearing organs using a special medical device.
Reasons for the need
Audiologic screening should be taken seriously, as hearing loss in children is best treated in the first six months after birth. It is the ability to hear and distinguish sounds in the future that allows you to recognize speech and learn to speak. If the pathologies are not detected in time, then this can lead to the development of complete deafness in the child. In this regard, this survey and the results obtained during it should not be neglected.
How often should I do it?
The regulations state that audiological screening is required twice: three to four days after the birth of the child, and then 1-1.5 months after the birth. In some cases, when the results of the firstscans are good, re-examination is not required. Of greatest importance is the study of hearing in children born prematurely, as well as those with somatic diseases. This is due to the fact that premature babies are very likely to develop auditory neuropathy and other hearing impairments.
Proceedings
Examination is carried out for the first time three or four days after the birth of the baby, it is absolutely painless, non-invasive, harmless to the child. In addition, there are no contraindications to such a hearing test. The neonatologist uses a small audiological screening device to automatically record otoacoustic emissions. The device looks like a small probe, equipped with a highly sensitive microphone and a small phone.
It is advisable to conduct a study between feedings of the child, when he is calm or sleeping. To calm the baby, you can give a pacifier, but during screening it must be removed from the mouth - sucking will create additional noise, which will affect the result of the study. For the most accurate results, screening should be done in complete silence.
An obturator, or a microphone (a special small probe equipped with an ear plug), the doctor inserts into the child's external auditory canal. A device is attached to the probe, which performs several functions: it delivers sound pulses of different frequencies, and registers otoacoustic emission (sound generated by hair cellscochlea - receptors of the auditory system). The device sends two successive signals to the child's ear with different frequencies, while the device registers the reaction of receptors to this sound. Each ear is tested by the doctor in turn.
Varieties
Specialists distinguish between several types of audiological screening:
- OAE (screening otoacoustic emission). It is a general study, a standard diagnosis of a baby's hearing in a maternity hospital.
- Clinical UAE. It is a more detailed examination conducted by an audiologist. Assign such a study to children whose primary OAE was negative.
- KSEP (fixation of short-lateral auditory evoked potentials). This technique is an alternative to the UAE. You can get more accurate results during ABR than with UAE.
- ASSR test. It is an objective computer audiometry. This technique is often prescribed as an adjunct to the ABR if the child has any abnormalities in the hearing aid by that time. Computer audiometry makes it possible to visually assess hearing thresholds at different frequencies.
Evaluation of results
The results of audiological screening are immediately displayed on the monitor of the device. The Refer result indicates that during the test no fluctuations of hair cells were detected, which in turn indicates a hearing impairment. If receiveda similar result, the child is sent for further examination to an audiologist. However, parents should be aware that this result is not proof that the child has a hearing loss or other problem.
It often happens that re-examination of children who have already undergone audiological screening gives a positive result, that is, the presence of pathology is not confirmed. Different experts explain this situation in different ways. Often, the first study gives a negative result due to the fact that the birth masses have not yet completely left the baby’s ear passages. A re-examination is indicated 1-1.5 months after the first. Upon receipt of a repeated negative result, the child is referred for further examination with subsequent treatment.
If the audiological screening is negative twice, the child is shown an examination by an otolaryngologist, who will give a referral for an extended examination at the audiology center. It is best to do this before the baby is 3 months old.
Risk factors
Specialists identify several risk factors for pathological changes in hearing and hearing loss in newborns:
- Rhesus conflict.
- Asphyxiation of the baby during childbirth.
- Postterm pregnancy.
- Prematurity, underweight in a baby at birth.
- Diseases of an infectious, viral nature, suffered by the mother during childbearing.
- Frequent toxicosis during pregnancy.
- Weightedheredity - the complete absence or hearing impairment noted in close relatives.
Children at risk are shown a mandatory deep examination by an audiologist, as they are most susceptible to the development of hearing pathologies.
