ABSTRACT
Aproximadamente el 40% de los niños con sordera tienen añadido un trastorno del desarrollo o un problema médico importante, que puede retrasar la edad de diagnóstico de la hipoacusia y/o precisar de la intervención de otros profesionales. Esta situación se designa como «hipoacusia o sordera con discapacidad añadida» (DA+). El motivo por el que la población de niños con problemas auditivos es más propensa a asociar discapacidades añadidas radica en que los factores de riesgo para la hipoacusia se superponen con los de muchas otras discapacidades. Estos factores pueden influir en diversos aspectos del desarrollo, incluida la adquisición del lenguaje. Es importante comprobar que se recibe la adecuada atención, la efectividad de audífonos o implantes, así como de las estrategias de intervención logopédica, y la adherencia de la familia a sesiones y citas. Los desafíos que plantea la DA+ son su detección precoz, para permitir una temprana y adecuada intervención, y la necesidad de una colaboración transdisciplinar fluida entre todos los profesionales que han de intervenir, junto con la implicación de la familia. (AU)
Approximately 40% of children with deafness have an additional developmental disorder or major medical problem, which may delay the age of diagnosis of hearing loss and/or require intervention by other professionals. This situation is referred to as deafness with added disability (AD+). The reason why the population of hearing-impaired children is more likely to have associated added disabilities is that the risk factors for hearing impairment overlap with those for many other disabilities. These factors can influence various aspects of development, including language acquisition. It is important to check that appropriate care is received, the effectiveness of hearing aids or implants, as well speech therapy intervention strategies, and family adherence to sessions and appointments. The challenge posed by AD+ is early detection, to allow early and appropriate intervention, and the need for fluid transdisciplinary collaboration between all professionals involved, together with the involvement of the family. (AU)
Subject(s)
Humans , Child , eHealth Strategies , Deafness/therapy , Disabled Children , Early Medical Intervention , Interdisciplinary ResearchABSTRACT
Approximately 40% of children with deafness have an additional developmental disorder or major medical problem, which may delay the age of diagnosis of hearing loss and/or require intervention by other professionals. This situation is referred to as "deafness with added disability" (AD+). The reason why the population of hearing-impaired children is more likely to have associated added disabilities is that the risk factors for hearing impairment overlap with those for many other disabilities. These factors can influence various aspects of development, including language acquisition. It is important to check that appropriate care is received, the effectiveness of hearing aids or implants, as well speech therapy intervention strategies, and family adherence to sessions and appointments. The challenge posed by AD+ is early detection, to allow early and appropriate intervention, and the need for fluid transdisciplinary collaboration between all professionals involved, together with the involvement of the family.
Subject(s)
Deafness , Hearing Aids , Hearing Loss , Humans , Child , Deafness/complications , Hearing Loss/complications , Hearing Aids/adverse effectsABSTRACT
Ototoxicity is defined as the damage, reversible or irreversible, produced in the inner ear by various substances that are called ototoxic and that can cause hearing loss and/or an alteration of the vestibular system. Permanent hearing loss significantly affects quality of life and is especially important in children. The lack or delay in its detection is frequent, since it often progresses in an inconspicuous manner until it affects communication and overall development. This impact can be minimized by following a strategy of audiological monitoring of ototoxicity, which allows for its early detection and treatment. This document recommends that children who are going to be treated with cisplatin or aminoglycosides be monitored. This CODEPEH review and recommendation document focuses on the early detection, prophylaxis, otoprotection, monitoring and treatment of ototoxicity caused by aminoglycosides and platinum-based antineoplastics in the paediatric population.
Subject(s)
Deafness , Hearing Loss , Ototoxicity , Aminoglycosides/adverse effects , Anti-Bacterial Agents/adverse effects , Child , Early Diagnosis , Hearing Loss/chemically induced , Hearing Loss/diagnosis , Hearing Loss/prevention & control , Humans , Ototoxicity/diagnosis , Ototoxicity/etiology , Ototoxicity/prevention & control , Quality of LifeABSTRACT
La ototoxicidad se define como el daño, reversible o irreversible, producido sobre el oído interno por diversas sustancias que se denominan ototóxicos y que causan una hipoacusia y/o una alteración del sistema vestibular.La hipoacusia permanente afecta significativamente a la calidad de vida y es especialmente importante en el caso de niños. Es frecuente la falta o el retraso en su detección, dado que muchas veces progresa de forma poco llamativa hasta que afecta a la comunicación y al desarrollo global. Este impacto puede minimizarse siguiendo una estrategia de monitorización audiológica de la ototoxicidad, que permita su detección y tratamiento precoz. Se recomienda implantar dicha monitorización en los niños que van a ser tratados con cisplatino o aminoglucósidos.Este documento de revisión y recomendaciones de la CODEPEH se enfoca a la detección precoz, la profilaxis, la otoprotección, el seguimiento y el tratamiento de la ototoxicidad por aminoglucósidos y antineoplásicos derivados del platino en la población pediátrica. (AU)
Ototoxicity is defined as the damage, reversible or irreversible, produced in the inner ear by various substances that are called ototoxic and that can cause hearing loss and/or an alteration of the vestibular system.Permanent hearing loss significantly affects quality of life and is especially important in children. The lack or delay in its detection is frequent, since it often progresses in an inconspicuous manner until it affects communication and overall development. This impact can be minimized by following a strategy of audiological monitoring of ototoxicity, which allows for its early detection and treatment. This document recommends that children who are going to be treated with cisplatin or aminoglycosides be monitored.This CODEPEH review and recommendation document focuses on the early detection, prophylaxis, otoprotection, monitoring and treatment of ototoxicity caused by aminoglycosides and platinum-based antineoplastics in the paediatric population. (AU)
Subject(s)
Humans , Cisplatin , Aminoglycosides , Disease Prevention , Hearing Loss , TherapeuticsABSTRACT
Programmes for early detection of congenital hearing loss have been successfully implemented mainly in developed countries, after overcoming some conceptual errors argued against their implementation and some criticism of their efficacy. However, some difficulties and weaknesses are still identified in these programmes: the detection of late-onset hearing loss and the percentage of children who did not pass the screening and did not complete the process of diagnosis and treatment, these being cases that are lost in the process. The purpose of this Document is to analyse these problems to determine areas for improvement and to emphasize one of the basic principles for the success of the programmes: continuous training for the interdisciplinary team. The result of the review process carried out by CODEPEH has been drafted as Recommendations for updating the Programmes with the evidence of the last decade, including advances in screening technology, the impact of the present knowledge on congenital infection by cytomegalovirus, genetic hearing loss research and control systems of lost to follow-up cases, treatment and follow up.
Subject(s)
Deafness , Hearing Loss, Sensorineural , Hearing Loss , Child , Cytomegalovirus , Hearing , Hearing Loss/diagnosis , HumansABSTRACT
Los programas de detección precoz de la hipoacusia congénita se han extendido de forma exitosa, especialmente en países desarrollados, superando los errores conceptuales argumentados contra su implantación o las críticas a su eficacia. No obstante, aún se identifican algunas dificultades y debilidades: la detección de la hipoacusia de desarrollo tardío y el porcentaje de niños que no pasaron el cribado y no completan el diagnóstico ni el tratamiento, siendo casos que se pierden en el proceso son algunas de ellas.El objetivo del presente documento es analizar estos problemas para determinar puntos de mejora e incidir en un principio básico del éxito de los programas: la formación continuada del equipo interdisciplinario.El resultado del trabajo de revisión llevado a cabo por la CODEPEH se plasma en la formulación de unas recomendaciones orientadas a actualizar los programas con las evidencias aparecidas en la última década, incorporando los progresos de la tecnología, los conocimientos actuales sobre la infección congénita por citomegalovirus y los estudios genéticos de la hipoacusia en los programas, así como los sistemas de control de la pérdida de casos en el proceso, el tratamiento y el seguimiento. (AU)
Programs for early detection of congenital hearing loss have been successfully implemented mainly in developed countries, after overcoming some conceptual errors argued against their implementation and some criticism of their efficacy. However, some difficulties and weaknesses are still identified in these programs: the detection of late-onset hearing loss and the percentage of children who did not pass the screening and did not complete the process of diagnosis and treatment, these being cases that are lost in the process.The purpose of this Document is to analyse these problems to determine areas for improvement and to emphasize one of the basic principles for the success of the programs: continuous training for the interdisciplinary team.The result of the review process carried out by CODEPEH has been drafted as Recommendations for updating the Programs with the evidence of the last decade, including advances in screening technology, the impact of the present knowledge on congenital infection by cytomegalovirus, genetic hearing loss research and control systems of lost to follow-up cases, treatment and follow up. (AU)
Subject(s)
Humans , Cytomegalovirus , Deafness , Hearing Loss, Sensorineural/diagnosis , PatientsABSTRACT
El objetivo del presente documento es contribuir a la mejora del manejo de la hipoacusia unilateral y de la hipoacusia asimétrica en la infancia. Las sorderas unilaterales afectan a uno por mil de los recién nacidos, aumentando su prevalencia con la edad, debido a los casos de aparición diferida o adquirida. Aunque se ha minimizado el impacto de estas sorderas sobre el desarrollo y los aprendizajes del niño, si no son tratadas provocan secuelas sobre el desarrollo del habla y del lenguaje, así como en el desarrollo global, afectando a la calidad de vida del niño y de su familia. El resultado del trabajo de revisión llevado a cabo se plasma en la formulación de unas recomendaciones orientadas a la mejora clínica diagnóstica y terapéutica de la hipoacusia unilateral y de la hipoacusia asimétrica
The aim of this document is to improve the management and the treatment of unilateral or asymmetrical hearing loss in children. One in one thousand newborn infants has unilateral hearing loss and this prevalence increases with age, due to cases of acquired and delayed-onset hearing loss. Although the impact on the development and learning processes of children of these kinds of hearing loss have usually been minimized, if they are not treated they will impact on language and speech development, as well as overall development, affecting the quality of life of the child and his/her family. The outcomes of the review are expressed as recommendations aimed at clinical diagnosis and therapeutic improvement for unilateral or asymmetrical hearing los
Subject(s)
Humans , Child , Hearing Loss, Unilateral/diagnosis , Hearing Loss, Unilateral/therapy , Quality of Life , Hearing Loss/complications , Child Development , Articulation Disorders/complications , Academic Performance , Cochlear Implants , Early DiagnosisABSTRACT
The aim of this document is to improve the management and the treatment of unilateral or asymmetrical hearing loss in children. One in one thousand newborn infants has unilateral hearing loss and this prevalence increases with age, due to cases of acquired and delayed-onset hearing loss. Although the impact on the development and learning processes of children of these kinds of hearing loss have usually been minimized, if they are not treated they will impact on language and speech development, as well as overall development, affecting the quality of life of the child and his/her family. The outcomes of the review are expressed as recommendations aimed at clinical diagnosis and therapeutic improvement for unilateral or asymmetrical hearing loss.
Subject(s)
Hearing Loss, Bilateral/diagnosis , Hearing Loss, Bilateral/therapy , Hearing Loss, Unilateral/diagnosis , Hearing Loss, Unilateral/therapy , Bone-Anchored Prosthesis , Brain/diagnostic imaging , Brain/physiology , Child , Child Behavior , Child Development , Cochlear Implants , Cognition , Early Diagnosis , Hearing Aids , Hearing Disorders/etiology , Hearing Loss, Bilateral/etiology , Hearing Loss, Unilateral/etiology , Humans , Interpersonal Relations , Learning , Quality of Life , Sound Localization , Speech Perception/physiologyABSTRACT
La incidencia y prevalencia de la otitis media secretora infantil (OMS) son elevadas, sin embargo, existen evidencias de que solo una minoría de profesionales sigue las recomendaciones de las guías para su manejo clínico. Con objeto de mejorar el diagnóstico y el tratamiento de la OMS, para prevenir y/o reducir sus consecuencias sobre el desarrollo del niño, la Comisión para la Detección Precoz de la Hipoacusia (CODEPEH) ha realizado una amplia revisión de la literatura científica sobre la materia y ha elaborado un documento de recomendaciones para una correcta actitud clínica ante la OMS, abordando métodos diagnósticos y tratamiento médico y quirúrgico. Entre otros, no usar ninguna medicación, especialmente corticoides y antibióticos, siendo la espera vigilada la primera medida a tomar durante 3 meses. Si persiste la OMS, el otorrinolaringólogo valorará el tratamiento quirúrgico. En niños que presentan comorbilidades de diversa entidad, el impacto de la OMS es superior por lo que hay que actuar de forma inmediata, sin espera vigilada
The incidence and the prevalence rates of otitis media with effusion (OME) are high. However, there is evidence that only a minority of professionals follow the recommendations provided in clinical practice guidelines. For the purpose of improving diagnosis and treatment of OME in children to prevent and/or reduce its impact on children's development, the Commission for the Early Detection of Deafness (CODEPEH) has deeply reviewed the scientific literature on this field and has drafted a document of recommendations for a correct clinical reaction to of OME, including diagnosis and medical and surgical treatment methodology. Among others, medication, in particular antibiotics and corticoids, should not be prescribed and 3 months of watchful waiting should be the first adopted measure. If OME persists, an ENT doctor should assess the possibility of sugical treatment. The impact of OME in cases of children with a comorbidity is higher, so it requires immediate reaction, without watchful waiting
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Otitis Media with Effusion/diagnosis , Otitis Media with Effusion/therapy , Early Diagnosis , Hearing Loss/epidemiology , Risk Factors , Commission on Professional and Hospital Activities/standards , Health Knowledge, Attitudes, Practice , Neonatal Screening , Child Development/physiology , Otoscopy , Otitis Media with Effusion/drug therapyABSTRACT
The incidence and the prevalence rates of otitis media with effusion (OME) are high. However, there is evidence that only a minority of professionals follow the recommendations provided in clinical practice guidelines. For the purpose of improving diagnosis and treatment of OME in children to prevent and/or reduce its impact on children's development, the Commission for the Early Detection of Deafness (CODEPEH) has deeply reviewed the scientific literature on this field and has drafted a document of recommendations for a correct clinical reaction to of OME, including diagnosis and medical and surgical treatment methodology. Among others, medication, in particular antibiotics and corticoids, should not be prescribed and 3 months of watchful waiting should be the first adopted measure. If OME persists, an ENT doctor should assess the possibility of sugical treatment. The impact of OME in cases of children with a comorbidity is higher, so it requires immediate reaction, without watchful waiting.
Subject(s)
Otitis Media with Effusion/diagnosis , Otitis Media with Effusion/therapy , Acoustic Impedance Tests , Adenoidectomy/statistics & numerical data , Adrenal Cortex Hormones/therapeutic use , Anti-Bacterial Agents/therapeutic use , Audiometry , Child , Child Behavior Disorders/etiology , Child, Preschool , Cleft Palate/epidemiology , Comorbidity , Contraindications, Drug , Craniofacial Abnormalities/epidemiology , Developmental Disabilities/etiology , Down Syndrome/epidemiology , Hearing Loss/diagnosis , Hearing Loss/epidemiology , Hearing Loss/etiology , Hearing Loss/prevention & control , Humans , Infant , Infant, Newborn , Language Disorders/etiology , Middle Ear Ventilation/statistics & numerical data , Neonatal Screening , Otitis Media with Effusion/epidemiology , Otoscopy/methods , Risk Factors , Watchful WaitingABSTRACT
El importante avance en el campo de la genética molecular, fundamentalmente, así como en el diagnóstico por imagen, junto a la ausencia de un protocolo consensuado que oriente el proceso diagnóstico una vez confirmada la presencia de una sordera tras el cribado neonatal, motivan este nuevo trabajo de la Comisión para la Detección Precoz de la Hipoacusia Infantil (CODEPEH). El Documento de Recomendaciones sobre el diagnóstico etiológico de la sordera, que se basa en la más reciente evidencia científica, ofrece orientaciones de apoyo al profesional en la toma de decisiones que, en todo caso, deben llevarse a cabo sin entorpecer ni retrasar la intervención temprana. Identificar precozmente la causa de la hipoacusia aporta numerosas ventajas: evita molestias innecesarias a las familias, reduce el gasto sanitario derivado de la realización de numerosas pruebas y proporciona información pronóstica, que puede guiar la actuación terapéutica (AU)
Important progress in the fields of molecular genetics (principally) and diagnostic imaging, together with the lack of a consensus protocol for guiding the diagnostic process after confirming deafness by neonatal screening, have led to this new work document drafted by the Spanish Commission for the Early Detection of Child Deafness (Spanish acronym: CODEPEH). This 2015 Recommendations Document, which is based on the most recent scientific evidence, provides guidance to professionals to support them in making decisions regarding aetiological diagnosis. Such diagnosis should be performed without delay and without impeding early intervention. Early identification of the causes of deafness offers many advantages: it prevents unnecessary trouble for the families, reduces health system expenses caused by performing different tests, and provides prognostic information that may guide therapeutic actions (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Deafness/diagnosis , Deafness/etiology , Hearing Loss/diagnosis , Hearing Loss/etiology , Infections/complications , Infections/etiology , Vestibular Aqueduct/pathology , Vestibular Aqueduct , Deafness/genetics , Deafness/physiopathology , Medical History Taking/methods , Medical History Taking/standards , Toxoplasmosis/complications , Toxoplasmosis/etiology , AlgorithmsABSTRACT
Important progress in the fields of molecular genetics (principally) and diagnostic imaging, together with the lack of a consensus protocol for guiding the diagnostic process after confirming deafness by neonatal screening, have led to this new work document drafted by the Spanish Commission for the Early Detection of Child Deafness (Spanish acronym: CODEPEH). This 2015 Recommendations Document, which is based on the most recent scientific evidence, provides guidance to professionals to support them in making decisions regarding aetiological diagnosis. Such diagnosis should be performed without delay and without impeding early intervention. Early identification of the causes of deafness offers many advantages: it prevents unnecessary trouble for the families, reduces health system expenses caused by performing different tests, and provides prognostic information that may guide therapeutic actions.
Subject(s)
Deafness/etiology , Diagnostic Techniques, Otological , Age of Onset , Child , Child, Preschool , Deafness/congenital , Deafness/epidemiology , Deafness/genetics , Diagnostic Techniques, Otological/standards , Ear/abnormalities , Early Diagnosis , Female , Hearing Loss/congenital , Hearing Loss/epidemiology , Hearing Loss/etiology , Hearing Loss/genetics , Hearing Tests , Humans , Infant , Infant, Newborn , Physical Examination , Pregnancy , Pregnancy Complications, Infectious , Virus Diseases/complications , Virus Diseases/diagnosisABSTRACT
La literatura científica más reciente señala el diagnóstico precoz de la sordera como elemento fundamental para definir el pronóstico educativo y de inclusión del niño sordo, pues permite aprovechar el periodo crítico de su desarrollo (0-4 años). Existen diferencias altamente significativas entre las personas sordas estimuladas tempranamente y las que han recibido esta atención específica de forma más tardía y/o inadecuada. La identificación temprana de los trastornos diferidos requiere de una especial atención y conocimientos entre todos los profesionales que atienden a los niños durante su infancia. Se trata de diseñar programas y de planificar acciones adicionales más allá del cribado neonatal para asegurar que todos los niños con una hipoacusia significativa sean detectados pronto. Con este propósito, la Comisión para la Detección Precoz de la Hipoacusia (CODEPEH) quiere poner de relieve la necesidad de un seguimiento continuado sobre la salud auditiva de los niños. Y establece para ello las recomendaciones contenidas en el presente Documento
The latest scientific literature considers early diagnosis of deafness as key element to define the educational prognosis and inclusion of the deaf child, as advantage can be taken in the critical period of development (0-4 years). Highly significant differences exist between those deaf persons who have been stimulated early and those who have received late or inappropriate intervention. Early identification of late-onset disorders requires special attention and knowledge of all childcare professionals. Programs and additional actions beyond neonatal screening should be designed and planned in order to ensure that every child with a significant hearing loss is detected early. For this purpose, the Committee for the Early Detection of Deafness (CODEPEH) would like to highlight the need for continuous monitoring on the hearing health of children. And, for this reason, CODEPEH drafts the recommendations included in the present document
Subject(s)
Humans , Infant , Child, Preschool , Hearing Loss/diagnosis , Hearing Loss/pathology , Neonatal Screening/instrumentation , Early Diagnosis , Hearing TestsABSTRACT
La literatura científica más reciente señala el diagnóstico precoz de la sordera como elemento fundamental para definir el pronóstico educativo y de inclusión del niño sordo, pues permite aprovechar el periodo crítico de su desarrollo (0-4 años). Existen diferencias altamente significativas entre las personas sordas estimuladas tempranamente y las que han recibido esta atención específica de forma más tardía y/o inadecuada. La identificación temprana de los trastornos diferidos requiere de una especial atención y conocimientos entre todos los profesionales que atienden a los niños durante su infancia. Se trata de diseñar programas y de planificar acciones adicionales más allá del cribado neonatal para asegurar que todos los niños con una hipoacusia significativa sean detectados pronto. Con este propósito, la CODEPEH quiere poner de relieve la necesidad de un seguimiento continuado de la salud auditiva de los niños, estableciendo para ello las recomendaciones contenidas en el presente documento (AU)
The latest scientific literature considers early diagnosis of deafness as the key element to define the educational and inclusive prognosis of the deaf child, because it allows taking advantage of the critical period of development (0-4 years). Highly significant differences exist between deaf people who have been stimulated early and those who have received late or improper intervention. Early identification of late-onset disorders requires special attention and knowledge on the part of every childcare professional. Programs and additional actions beyond neonatal screening should be designed and planed to ensure that every child with a significant hearing loss is detected early. For this purpose, the CODEPEH would like to highlight the need for continuous monitoring of children's auditory health. Consequently, CODEPEH has drafted the recommendations included in the present document (AU)
Subject(s)
Male , Female , Infant, Newborn , Infant , Child, Preschool , Humans , Hearing Loss/diagnosis , Hearing Loss/epidemiology , Hearing Loss/genetics , Cytomegalovirus Infections/epidemiology , Evoked Potentials, Auditory, Brain Stem/physiology , Epidemiological Monitoring/trends , Early Diagnosis , Neonatal Screening , Child Health , Hearing Loss, Sensorineural/diagnosis , Risk Factors , Acoustic Impedance Tests , Audiometry/methods , Cochlear Implants , Health of the Disabled , Spain/epidemiologyABSTRACT
The latest scientific literature considers early diagnosis of deafness as key element to define the educational prognosis and inclusion of the deaf child, as advantage can be taken in the critical period of development (0-4 years). Highly significant differences exist between those deaf persons who have been stimulated early and those who have received late or inappropriate intervention. Early identification of late-onset disorders requires special attention and knowledge of all childcare professionals. Programs and additional actions beyond neonatal screening should be designed and planned in order to ensure that every child with a significant hearing loss is detected early. For this purpose, the Committee for the Early Detection of Deafness (CODEPEH) would like to highlight the need for continuous monitoring on the hearing health of children. And, for this reason, CODEPEH drafts the recommendations included in the present document.
Subject(s)
Hearing Loss/diagnosis , Child, Preschool , Early Diagnosis , Hearing Tests , Humans , InfantABSTRACT
The latest scientific literature considers early diagnosis of deafness as the key element to define the educational and inclusive prognosis of the deaf child, because it allows taking advantage of the critical period of development (0-4 years). Highly significant differences exist between deaf people who have been stimulated early and those who have received late or improper intervention. Early identification of late-onset disorders requires special attention and knowledge on the part of every childcare professional. Programs and additional actions beyond neonatal screening should be designed and planed to ensure that every child with a significant hearing loss is detected early. For this purpose, the CODEPEH would like to highlight the need for continuous monitoring of children's auditory health. Consequently, CODEPEH has drafted the recommendations included in the present document.
Subject(s)
Deafness , Hearing Aids , Deafness/diagnosis , Early Medical Intervention , Hearing Loss , Humans , Infant, Newborn , Neonatal ScreeningABSTRACT
En la última década hemos asistido a un rápido y tremendo progreso en el desarrollo de los sistemas de diagnóstico y tratamiento precoz de la hipoacusia infantil dentro de programas de salud pública. El porcentaje de niños cribados anualmente en España se ha incrementado significativamente al haberse extendido los programas de atención al déficit auditivo infantil a todas las autonomías. Históricamente, los indicadores de alto riesgo han sido empleados para la identificación de los niños que debían ser evaluados audiológicamente por vivir en áreas remotas donde los programas de cribado no existían, para ayudar a identificar aquellos niños que, aunque hayan pasado el cribado, siguen presentando riesgo de desarrollar una hipoacusia diferida y para identificar los niños que presentan hipoacusias permanentes leves no detectadas en el cribado. En esta revisión se analizan los indicadores de riesgo de hipoacusia y se identifican los factores que se asocian a sus formas de presentación diferida. La recomendación establecida es que se lleve a cabo al menos una revisión audiológica entre los 24 y los 30 meses de edad en los niños con un indicador de bajo riesgo. Sin embargo, para aquellos que presenten factores de alto riesgo como la infección por citomegalovirus o antecedentes familiares de hipoacusia es apropiado realizar un seguimiento más frecuente y temprano. Para todos los niños, incluidos los que carecen de indicadores de riesgo, se debería comprobar su desarrollo global con una herramienta validada a los 8, 18, 24 y 30 meses de edad o antes si existe preocupación de los padres o cuidadores(AU)
In the last decade, tremendous progress has been made very rapidly in the development of Early Hearing Detection and Intervention (EHDI) systems as a major public health initiative. The percentage of infants screened annually in Spain has increased significantly since the EHDI systems have expanded to all autonomic regions. Historically, high risk indicators have been used for the identification of infants who should receive audio logical evaluation but who live in geographic locations where universal hearing screening is not yet available, to help identify infants who pass neonatal screening but are at risk of developing delayed-onset hearing loss and to identify infants who may have passed neonatal screening but have mild forms of permanent hearing loss. In this review, the standard risk factors for hearing loss are analysed and the risk factors known to be associated with late onset or progressive hearing loss are identified. The recommendation for infants with a risk factor that may be considered as low risk is to perform at least one audiology assessment by 24-30 months. In contrast, for an infant with risk factors known to be associated with late onset or progressive hearing loss (such as cytomegalovirus infection or family history), early and more frequent assessment is appropriate. All infants should have an objective standardised screening of global development with a validated assessment tool at 9, 18 and 24-30 months of age or at any time if the health care professional or the family is concerned(AU)
Subject(s)
Humans , Male , Female , Infant , Hearing Loss, Sensorineural/epidemiology , Early Diagnosis , Mass Screening/methods , Risk FactorsABSTRACT
In the last decade, tremendous progress has been made very rapidly in the development of Early Hearing Detection and Intervention (EHDI) systems as a major public health initiative. The percentage of infants screened annually in Spain has increased significantly since the EHDI systems have expanded to all autonomic regions. Historically, high risk indicators have been used for the identification of infants who should receive audiological evaluation but who live in geographic locations where universal hearing screening is not yet available, to help identify infants who pass neonatal screening but are at risk of developing delayed-onset hearing loss and to identify infants who may have passed neonatal screening but have mild forms of permanent hearing loss. In this review, the standard risk factors for hearing loss are analysed and the risk factors known to be associated with late onset or progressive hearing loss are identified. The recommendation for infants with a risk factor that may be considered as low risk is to perform at least one audiology assessment by 24-30 months. In contrast, for an infant with risk factors known to be associated with late onset or progressive hearing loss (such as cytomegalovirus infection or family history), early and more frequent assessment is appropriate. All infants should have an objective standardised screening of global development with a validated assessment tool at 9, 18 and 24-30 months of age or at any time if the health care professional or the family is concerned.
Subject(s)
Hearing Loss, Sensorineural/epidemiology , Age of Onset , Appointments and Schedules , Audiometry , Child, Preschool , Craniocerebral Trauma/epidemiology , Craniofacial Abnormalities/epidemiology , Disease Progression , Drug-Related Side Effects and Adverse Reactions/epidemiology , Early Diagnosis , Female , Fetal Diseases/epidemiology , Genetic Diseases, Inborn/epidemiology , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/etiology , Humans , Infant , Infant, Newborn , Infant, Newborn, Diseases/epidemiology , Male , Mass Screening/standards , Neonatal Screening/standards , Neurodegenerative Diseases/epidemiology , Otitis Media with Effusion/epidemiology , Practice Guidelines as Topic , Risk FactorsABSTRACT
Actualmente, el cribado auditivo neonatal se lleva a cabo de forma rutinaria en muchos de los sistemas de salud autonómicos en España. A pesar de la importante expansión del cribado de la hipoacusia desde 2000, su viabilidad y los beneficios de la identificación e intervención tempranas, aún existen importantes retos. En este artículo, la CODEPEH actualiza las recomendaciones que se consideran importantes para el futuro desarrollo de los sistemas de detección e intervención precoz en los siguientes puntos: 1. Protocolos de cribado: se recomienda seguir distintos protocolos para los niños ingresados en cuidados intensivos neonatales y los procedentes de maternidad. 2. Evaluación audiológica: se precisa contar con profesionales con experiencia en evaluación de recién nacidos y niños pequeños para completar tanto el diagnóstico como para la selección y adaptación de audioprótesis. 3. Evaluación médica: los factores de riesgo para la hipoacusia neonatal y adquirida se recogen en una única lista en lugar de estar agrupados por el momento de su aparición. Un protocolo de diagnóstico paso a paso es más eficiente y de coste efectivo que efectuar todas las pruebas simultáneamente. 4. Intervención temprana y seguimiento: todos los profesionales que atienden a niños con hipoacusia deberían contar con un entrenamiento especializado y experiencia en la audición, el habla y el lenguaje. Debe realizarse un control periódico del desarrollo de las habilidades auditivas, si existen sospechas paternas y del estado del oído medio. 5. Control de calidad: la gestión de la información como parte integral del sistema es importante para monitorizar y mejorar la calidad del servicio (AU)
Newborn hearing screening is currently performed routinely in many regional health-care systems in Spain. Despite the remarkable expansion in newborn hearing screening since 2000, its feasibility and the benefits of early identification and intervention, many major challenges still remain. In this article, the Committee for the Early Detection of Hearing Loss (Comisión para la Detección Precoz de la Hipoacusia, CODEPEH) updates the recommendations that are considered important for the future development of early hearing detection and intervention (EDHI) systems in the following points: 1. Screening protocols: Separate protocols are recommended for NICU (Neonatal Intensive Care Units) and well-infant nurseries. 2. Diagnostic audiology evaluation. Professionals with skills and expertise in evaluating newborn and young infants should provide diagnosis, selection and fitting of amplification devices. 3. Medical evaluation. Risk factors for congenital and acquired hearing loss have been combined in a single list rather than grouped by time of onset. A stepwise diagnostic paradigm is diagnostically more efficient and cost-effective than a simultaneous testing approach. 4. Early intervention and surveillance. All individuals providing services to infants with hearing loss should have specialized training and expertise in the development of audition, speech and language. Regular surveillance should be performed on developmental milestones, auditory skills, parental concerns, and middle ear status. 5. Quality control. Data management as part of an integrated system is important to monitor and improve the quality of EDHI services (AU)
Subject(s)
Humans , Male , Female , Hearing Loss/complications , Hearing Loss/epidemiology , Commission on Professional and Hospital Activities/trends , Early Diagnosis , Auditory Perceptual Disorders/epidemiology , Hearing/physiology , Hearing Disorders/epidemiology , Hearing Loss/prevention & control , Hearing Disorders/prevention & control , Mass Screening/methods , Quality ControlABSTRACT
Newborn hearing screening is currently performed routinely in many regional health-care systems in Spain. Despite the remarkable expansion in newborn hearing screening since 2000, its feasibility and the benefits of early identification and intervention, many major challenges still remain. In this article, the Committee for the Early Detection of Hearing Loss (Comisión para la Detección Precoz de la Hipoacusia, CODEPEH) updates the recommendations that are considered important for the future development of early hearing detection and intervention (EDHI) systems in the following points: 1. Screening protocols: Separate protocols are recommended for NICU (Neonatal Intensive Care Units) and well-infant nurseries. 2. Diagnostic audiology evaluation. Professionals with skills and expertise in evaluating newborn and young infants should provide diagnosis, selection and fitting of amplification devices. 3. Medical evaluation. Risk factors for congenital and acquired hearing loss have been combined in a single list rather than grouped by time of onset. A stepwise diagnostic paradigm is diagnostically more efficient and cost-effective than a simultaneous testing approach. 4. Early intervention and surveillance. All individuals providing services to infants with hearing loss should have specialized training and expertise in the development of audition, speech and language. Regular surveillance should be performed on developmental milestones, auditory skills, parental concerns, and middle ear status. 5. Quality control. Data management as part of an integrated system is important to monitor and improve the quality of EDHI services.
