Title: 'Limits of UNHS in Early Identification of Pedicatic Cochlear Implant Candidates'
Track: 1-EHDI Program Enhancement
Audience: Primary Audience: Audiologist
Secondary Audience: Early Intervention Provider
Tertiary Audeince: State Education Agency
Keyword(s): cochlear implantation, progressive hearing loss
Learning Objectives: 1.Understand the importance of early cochlear implantation to optimize hearing and language outcomes. 2. Identify risk factors and etiologies associated with progressive hearing loss. 3. Understand the limitations of UNHS in identifying implant candidates with delayed onset hearing loss.


This presentation will highlight the results of a recent study to determine whether universal newborn hearing screening (UNHS) has resulted in earlier age of diagnosis of hearing loss in children receiving cochlear implants and to determine how often implanted children had passed UNHS. An overview of causes of delayed onset of pediatric sensorineural hearing loss (SNHL) and of factors influencing cochlear implant outcomes will also be provided. The study was a retrospective case review of 417 pediatric implant recipients born before and after UNHS was mandated by law in Illinois. Children implanted at Children’s Memorial Hospital in Chicago between 1991 and 2008 were randomly selected for case review. Data analyzed included hearing screening status, age of initial diagnosis of SNHL hearing loss and severe to profound SNHL, and age at implantation. Data analysis revealed that implanted children born after legally mandated UNHS had a significantly younger age at diagnosis and implantation. However, younger age of diagnosis of SNHL was not achieved in those children who had passed UNHS, or were not screened. Approximately 30% of implanted children passed UNHS, regardless of etiology or presence or absence of known risk factor(s). The authors conclude that almost one third of our implanted children passed UNHS and were older at the time of initial diagnosis and implantation than their peers who failed UNHS. Delayed onset of SNHL limits our ability to achieve early diagnosis and implantation of a significant number of deaf children. This problem will not be solved by the current design of universal hearing screening programs.
Presentation(s): Not Available
Handouts: Not Available
Nancy M Young - Childrens Memorial Hospital
     Credentials: MD
     Other Affiliations: Northwestern University Feinberg School of Medicine; Northwestern University School of Communication
      Professor of Otolaryngology Head and Neck Surgery at Northwestern University Feinberg School of Medicine. Head of the Section of Otology & Neurotology within the Division of Pediatric Otolaryngology and Medical Director of the Audiology and Coclear Implant Programs at Children's Memorial Hospital in Chicago, Illinois. A Fellow of the Hugh Knowles Hearing Center of Northwestern University School of Communication in Evanston, Illinois. Course Director of the 13th Symposium on Cochlear Implants in Children, a multidisciplinary international comference-Chicago, July 2011. Dr Young completed a fellowship in Neurotology prior to dedicating her clinical practice to the pediatric population. Areas of special interest include diagnosis and management of hearing loss, surgical implants to address hearing loss, congenital and acquired cholesteatoma, and management of children with Ushers syndrome, auditory neuropathy spectrum disorder, Charge syndrome and post-meningitic deafness. Currently serves as Co-Chair of the State of Illinois Newborn Hearing Screening Advisory Committee.
Brian Reilly - Childrens Hospital Boston
     Credentials: MD, Fellow in Pediatric Otolaryngology, Children's Hospital Boston
      BIO: Brian Reilly completed his residency in Otolaryngology at Northwestern University's Feinberg School of Medicine. He is currently completing a fellowship at Children's Hospital Boston, Harvard Medical School
larissa burke - Children's Memorial Hospital
      BIO: Ms Burke is the research coordinator of the Children's Memorial Otology and Cochlear Implant Programs. She is completing an MPH program at UIC.