Diagnóstico e intervención temprana de los trastornos de la audición: una experiencia cubana de 20 años / Early detection and intervention of hearing impairment in Cuba: outcome after 20 years

Introduction. Infant hearing loss is a highly prevalent disorder which untreated can severely disrupt normal brain development. As a result there is a significant delay in language acquisition as well as many cognitive and emotional problems in the child. Over the last decades important advances have occurred in the available technology for early detection and assessment of hearing impairment. Therefore many countries worldwide have become aware of the need for hearing screening programs. The optimal protocols depending on the local conditions of health care as well as the availability of technological and human resources. Aim. To summarize the results obtained over the last 20 years by an ongoing hearing screening protocol. Development. Data on the coverage program, sensitivity and specificity, age of identification of hearing losses, diagnostic and intervention stages will be summarized and discussed. Also the long terms effects of early detection on the child cognitive and language development are analyzed. Finally, the possible role of a new technique based on the recording of multiple auditory steady state potentials with Cuban equipment (AUDIX system) was evaluated within this context. Conclusions. The Cuban targeting multiple high risk hearing screening program is a useful alternative to early detection of hearing losses. The average detection age of hearing loss was 10 months during the period of optimal functioning. Cognitive, emotional and linguistic development are improved by early detection and intervention. The multiple auditory steady state responses can provide valuable audiometric information within a screening context (AU)

Introducción. Los trastornos de la audición presentan una alta prevalencia en la población infantil con graves consecuencias para la comunicación, y para el desarrollo cognitivo y emocional del niño. En los últimos años se han generado importantes avances en las tecnologías disponibles para la detección temprana de las pérdidas auditivas, lo cual ha permitido la creación de programas de cribado auditivo en numerosos países según sus propias características organizativas y tecnológicas. Objetivo. Se describe y fundamenta el modelo adoptado por el programa cubano de cribado auditivo, con múltiples grupos de riesgo, en funcionamiento desde 1983. Desarrollo. Se presentan datos acerca de la prevalencia de los trastornos auditivos, edad media de detección, cobertura del cribado, programas de estimulación temprana utilizados y sus efectos sobre el desarrollo cognitivo y progreso escolar del niño. Finalmente, se discuten los resultados de la introducción de una nueva tecnología diagnóstica para la evaluación objetiva de la audición en toda la gama de frecuencias audibles, basada en el registro de potenciales evocados auditivos de estado estable (PEAee) mediante el sistema cubano AUDIX. Conclusiones. El modelo cubano de cribado auditivo puede considerarse una alternativa válida para la detección temprana de trastornos auditivos en condiciones de limitados recursos. Durante su período de funcionamiento óptimo logró reducir a 10 meses la edad media de detección. El grupo de niños identificados e intervenidos tempranamente logró un mejor desarrollo cognitivo, afectivo y lingüístico. El uso de los PEAee a múltiples frecuencias en un protocolo de cribado auditivo puede aportar valiosa información audiométrica (AU)

[Early detection and intervention of hearing impairment in Cuba: outcome after 20 years]. / Diagnóstico e intervención temprana de los trastornos de la audición: una experiencia cubana de 20 años

INTRODUCTION: Infant hearing loss is a highly prevalent disorder which untreated can severely disrupt normal brain development. As a result there is a significant delay in language acquisition as well as many cognitive and emotional problems in the child. Over the last decades important advances have occurred in the available technology for early detection and assessment of hearing impairment. Therefore many countries worldwide have become aware of the need for hearing screening programs. The optimal protocols depending on the local conditions of health care as well as the availability of technological and human resources. AIM: To summarize the results obtained over the last 20 years by an ongoing hearing screening protocol. DEVELOPMENT: Data on the coverage program, sensitivity and specificity, age of identification of hearing losses, diagnostic and intervention stages will be summarized and discussed. Also the long terms effects of early detection on the child cognitive and language development are analyzed. Finally, the possible role of a new technique based on the recording of multiple auditory steady state potentials with Cuban equipment (AUDIX system) was evaluated within this context. CONCLUSIONS: The Cuban targeting multiple high risk hearing screening program is a useful alternative to early detection of hearing losses. The average detection age of hearing loss was 10 months during the period of optimal functioning. Cognitive, emotional and linguistic development are improved by early detection and intervention. The multiple auditory steady state responses can provide valuable audiometric information within a screening context.