Abstracts

Screening for Hearing Loss in Early Childhood Programs
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Abstract: This study assessed the feasibility of doing hearing screening in Migrant, American Indian and Early Head Start programs using otoacoustic emissions (OAE) technology. Staff members were trained to screen 0–3-year-old children for hearing loss using handheld OAE equipment and a multi-step screening and referral protocol. Of the 3486 children screened as a part of the study, 77% passed an OAE screening at the first step, 18% more passed an OAE screening at the second step, and 5% were ultimately referred for medical or audiological follow-up. Eighty children were identified as having a hearing loss or disorder of the outer, middle or inner ear requiring treatment. Of these 80, six had permanent bilateral or unilateral hearing loss. Although the protocol suggested that the multi-step screening procedure should be completed within a 4-week time period or less, analysis of the data showed that for children requiring more than an initial OAE screening, the length of time over which the screening was completed ranged from 7 to 12 weeks. The median time required to complete a single OAE screening session was 4 minutes per child. The results demonstrate that OAE screening of young children using this protocol is practical and effective. The implications for conducting periodic hearing screening throughout early childhood are discussed.

Updating Hearing Screening Practices in Early Childhood Settings
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Abstract: Each day in the life of a young child with an undetected hearing loss is a day without full access to language.  When hearing loss goes undetected, the resulting language deficits can become overwhelming obstacles to literacy, educational achievement, socialization, and school readiness.  Several programs such as Head Start, Early and Periodic Screening, Diagnosis and Treatment (EPSDT), and Part C of the Individuals with Disabilities Education Act are responsible for providing hearing screening to many young children nationwide.  These programs have typically had to rely on subjective hearing screening methods.   Otoacoustic emissions (OAE) technology, used widely in hospital-based newborn screening programs, is beginning to be recognized as a more practical and effective alternative when screening children birth to three years of age.   Successful OAE screening in early childhood settings is dependent on consultation from an experienced pediatric audiologist,  selection of appropriate equipment, adherence to an appropriate screening and follow-up protocol,  and access to training and follow-up technical assistance.  When these elements are present, children with a wide range of hearing health conditions can be identified in a timely manner.

Using Otoacoustic Emissions to Screen for Hearing Loss in Early Childhood Care Settings
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Abstract:  Until recently, no objective tool has been available to help health and early childhood education providers screen young children for hearing loss. The aim of this study was to screen underserved children <= 3 years of age for hearing loss using Otoacoustic Emissions (OAE) technology and to systematically document multi-step screening and diagnostic outcomes.  A total of 4519 children, <= 3 years of age in 4 states were screened by trained lay screeners using portable OAE equipment set to deliver stimuli and measurement levels sensitive to mild hearing loss as low as 25 decibels (dB) hearing level. The screening and follow-up protocol specified that children not passing the multi-step OAE screening be evaluated by local physicians and hearing specialists.  Of the 4519 children screened as a part of the study, 257 (6%) ultimately required medical or audiological follow-up. One hundred and seven children were identified as having a hearing loss or disorder of the outer, middle or inner ear requiring treatment or monitoring. Of these 107 children, 5 had permanent bilateral and 2 had permanent unilateral hearing loss. The 7 children with permanent hearing loss included 4 who had passed newborn screening, 2 who were not screened at birth and 1 who did not receive follow-up services after referring from newborn screening.  OAE screening, using a multi-step protocol, was found to be a feasible and accurate practice for identifying a wide range of hearing-health conditions warranting monitoring and treatment among children <= 3 years of age in early childhood care programs. Future studies are needed to: 1) further examine barriers to effective OAE screening in early childhood care settings, and 2) explore the value of extending early childhood OAE hearing screening into health care clinics and settings where young children receive routine care.