Chapter 1 Lecture 2 5/2/2015 Hearing disorders in children/ Hala AlOmari1.

Hearing disorders in children/ Hala AlOmari

1

Hearing disorders in children

Chapter 1 Lecture 25/2/2015


2

Three classes or levels of need for audiological healthcare can be considered

1. Population- at this level the actions needed to reduce the need for intervention

2. Sub-population of children in each age cohort. For example, children on at risk register, or who have failed primary screen

3. Individual/ family the considerations of need at this class is difficult.

Audiological health needs for children


3

The aim here is to reach the whole birth cohort living in a certain district for example immunisation

Education to promote good auditory health or normal auditory and communicative development.

The combination of surveillance and screening at critical times

1. Population


4

There could be several sub-populations of children at each age cohort.

The need here may be a very prompt and efficient auditory assessment of the child.

Advice why the assessment is necessary and explanation of the results of each assessment needed.

For the sub-population whose hearing is impaired one of the major provisions will be hearing aid.

2. Sub-population


5

What are the needs? What place or priority should they have in a

properly constructed audiological health service configured to give maximum benefit to society?

One of the major needs for an adult with an acquired hearing impairment is to be able to hear and communicate with other people.

providing a service to meet that need is by supplying an appropriate rehabilitative package

3. Individual/ family


6

If we are to consider a child’s need, is it appropriate to use the adult service provision?

The need of the child will depend on- The age of confirmation of the hearing

impairment- The severity of the hearing impairment- The need of a very young child is very

different than that of an adult.



7

The hearing impaired child needs help to develop the skills necessary to learn to communicate with other people.

The society has to purchase a service that aims at the population level to eliminate the causes of deafness in children via appropriate vaccinations, education and preventive programmes.

At a sub-population level the aim is to identify the hearing impaired child as early and as efficiently as possible

At an individual level to provide appropriate forms or rehabilitation for the child and its family at different stages of development.



8


9

e.g. What proportion of 3 yr olds have a hearing loss?

What % age of 3 yr olds have a profound hearing loss

What % age of 3 yr olds have moderate permanent hearing loss

What % age of 3 yr olds have a moderate hearing loss

What % age of 3 yr olds have glue ear

Consideration for prevalence studies


10

type of impairment◦ conductive/SNHL

age at onset◦ Congenital/late onset/acquired

aetiology◦ genetic/ meningitis

degree of impairment◦ mild/moderate/severe/profound

Prevalence data


11

Average of 0.25, 0.5, 1, 2 & 4 kHz

◦ mild <40 dB HL

◦ moderate 41 –70 dB HL

◦ severe 71 – 95 dB HL

◦ profound >95 dB HL

Recommended classification of severity (BSA, Brit J Audiol 1988; 22: 123)


12

Population base e.g. geographical, clinic based

Assigning children to categories◦ Young/difficult to assess◦ Audiological certainty◦ Conductive overlay

Prevalence


13

Prevalence


14

Significant hearing loss occurs in 1 to 2 per 1000 newborns

2 per 1000 young children Nearly all children develop transient hearing

loss related to middle ear infections during the period from birth to 11 years of age

* based on a study by Fortnum and Davis (1997) carried out in UK-Trent region for children born in the period between (1985-1993)

Prevalance


15

◦Squint 3-7 per 1000◦Hypothyroidism 0.2 per thousand◦Congenital heart disease (CHD) 5.5 per 1000

◦Phenylketonuria (PKU) 0.5-1.0 per 10000

◦Down syndrome 1 per 600*http://en.wikipedia.org/wiki/Phenylketonuria

The prevalence of hearing loss in comparison to other health issues

Aetiology

•genetic 40%•prenatal (e.g., TORCH) 4%•perinatal (e.g., NICU) 7%•postnatal (e.g., meningitis) 6%•Craniofacial abnormality CFA 1%•missing 41%

TORCHToxoplasmosisOther (e.g., syphilis)Rubella (German measles)Cytomegalovirus (CMV)Herpes


17

40 % of children with PCHI have additional disability – cognitive deficit 13.9%– visual 10%– systematic disorder 13%– cerebral dysfunction 11.3%– neuromotor 7.6%– named syndrome 13.6%

Permanent Childhood Hearing Impairment (PCHI) – usually defined as better ear hearing level of 40 dB or more, includes sensorineural and permanent conductive loss, at present tend to exclude mild and unilateral loss

Additional disabilities

Chapter 1 Lecture 2 5/2/2015 Hearing disorders in children/ Hala AlOmari1.

Documents

Transcript of Chapter 1 Lecture 2 5/2/2015 Hearing disorders in children/ Hala AlOmari1.