Care of kids with hearing loss inadequate

Big deficits in newborn screening programme
  • Deborah Condon

A new study has revealed ‘significant deficits' in the newborn hearing screening programme, which was rolled out nationally in 2014.

According to the findings, ‘the current medical management of infants and children with permanent childhood hearing loss (PCHL) in Ireland is inadequate and puts our most vulnerable at risk'.

The Universal Neonatal Hearing Screening Programme (UNHS) aims to detect hearing loss as early as possible, so that intervention services can be offered. The early detection and treatment of hearing loss has been shown to significantly improve a child's long-term outcomes.

On average, 5,000 babies are screened every month. Around 3% of these will not pass the screening and will be referred on for diagnostic assessment. One to two babies in every 1,000 will be diagnosed with a hearing loss in one or both ears.

All infants identified with PCHL should have a paediatric assessment performed. The researchers set out to assess these services and to inform service development.

According to the HSE, the UNHS aims to screen babies by one month of age. If problems are detected, they should undergo diagnostic audiology assessments by three months of age, and appropriate intervention and medical services should begin by six months of age.

However, the study found that when a problem was detected, there was major variance in relation to waiting times for assessment.

The average waiting time to see an infant identified with a hearing loss was 14 weeks, although this ranged from two to 52 weeks overall.

The researchers identified 33 paediatricians who are involved in the assessment of infants with PCHL. However, they found that just 18% of these had received specific training in this area, while just 21% felt that they saw enough children with PCHL to retain their clinical expertise.

Furthermore, almost half said that they had limited access to tertiary advice and second opinions for complex cases.

The researchers said that UNHS is well established in Ireland, and is appropriately funded and resourced with specially trained screeners and audiologists. However, they said that there are ‘significant deficits in the paediatric component' of the programme.

This survey indicates significant deficits in the availability of appropriately trained paediatricians to assess and manage infants in a timely fashion, which is in contrast to the equity and quality of the UNHS screening component.

"Identified gaps include inadequate training, deficiencies in infrastructural local support and limited access to tertiary support i.e. genetics, ENT and infectious diseases services," they noted.

The researchers pointed out that as a result of this study, an integrated care pathway for children with PCHL ‘is in development'.

"The development of a more effective regional approach is proposed, which would be provided by adequately trained, resourced and locally and regionally supported paediatricians with expertise in child development, knowledge of disability service structures and all relevant aspects of the assessment of children with permanent hearing loss using a nationally agreed standardised assessment process," they said.

The study was carried out by researchers from Tallaght University Hospital, Cavan General Hospital, St Luke's General Hospital in Kilkenny, Trinity College Dublin and the Royal College of Surgeons in Ireland.

The findings are published in the Irish Medical Journal.

 


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