**Chapter 7**

Provisional chapter

#### **Hearing Screening around the World** Hearing Screening around the World

Piotr Henryk Skarżyński and Maciej Ludwikowski Piotr Henryk Skarżyński and Maciej Ludwikowski

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.73535

#### Abstract

Newborn hearing screening programs for congenital disorders and chronic diseases are expanding worldwide, and children are identified at the earliest possible stage. However, the practice is limited or absent in much of the developing world, such as Africa. Recent epidemiological studies show significant increase of hearing impairments in school-age children (around 20 in 100). Hearing disorders disturb the child's perception of sound, as well as the development of speech which in consequence negatively affects the child relations in society. The early detection of hearing impairments in children enables the effective implementation of medical and rehabilitation procedures or preventive treatment. According to the guidelines of the European Scientific Consensus on Hearing, the detection and treatment of hearing disorders in early school-age children are of the highest importance. That idea was one of the priorities during Polish Presidency of the Council of the European Union (the second half of 2011). The Institute team, in collaboration with numerous national centers, has laid the groundwork for screening programs and developed methods, procedures, and devices for carrying them out. In addition, the Institute was the coordinator and producer of many programs. Based on this, two screening models have been created—newborn and school-age children.

DOI: 10.5772/intechopen.73535

Keywords: hearing screening, hearing impairment, school-age children

#### 1. Introduction

Nowadays, audiology and otolaryngology, which are included in preventive medicine, have many possibilities to assist patients with hearing impairment. However, in order to make full use of these opportunities, hearing disorders or damage should be detected in the early stages. Hence, screening programs for early detection of hearing defects are of great importance. In an optimal healthcare system, hearing screening should be conducted not only during the

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, © 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

distribution, and eproduction in any medium, provided the original work is properly cited.

neonatal or infancy but also in the subsequent years of the child's life. In this way, both congenital and acquired hearing defects can be detected.

8. Ototoxic (damaging to the auditory system) drugs

ing screening in school-age children is very important [15].

3. The impact of hearing loss on child's development

equivalent to their peers by the time they enter kindergarten.

chological distress [18].

Acquired hearing loss is a hearing loss which appears after birth, at any time in one's life, as a result of a disease, a condition, or an injury. In fact, the most common cause of hearing loss in young children is otitis media. Fluctuating conductive hearing loss nearly always occurs with all types of otitis media [14]. Symptoms, severity, frequency, and length of the condition vary. At one extreme is a single short period of thin, clear, no infected fluid without any pain or fever but with a slight decrease in hearing ability. At the other extreme are repeated bouts with infection, thick "glue-like" fluid, and possible complications such as permanent hearing loss. Therefore, a hear-

Hearing Screening around the World http://dx.doi.org/10.5772/intechopen.73535 115

It is recommended that hearing loss in infants be identified, and when possible treated, prior to 6 months of age. This recommendation is based on studies that have shown that children identified with hearing loss prior to 6 months of age have a better chance of developing skills

Following the guidelines for hearing screening, hearing deficits in children can interfere with

Failure to identify children with congenital or acquired hearing impairment can lead to lifelong consequences including deficits in speech and language abilities, cognition delays [16], poor academic performance [17], insufficient psychosocial skills, underemployment, and psy-

Classroom is an auditory verbal environment where precise transmission and reception of speech is critical for effective learning to occur [19]. For instance, being able to hear all sounds is fundamental when learning to read. The behavioral effects of hearing impairment are frequently subtle and look similar to those of children who experience attention-deficit disorders, learning disabilities, language, and cognitive delays. Commonly cited behaviors include the following [20]: difficulty attending to spoken or other auditory information; often requests repetition; tired easily when listening; gives not suitable answer; avoids contacts with peers; difficulty with reading skills and written language; and easily frustrated. Children with mild unilateral hearing impairment can cause difficulties in sound-source location and problem with speech perception in background noise. In addition, problem associated with the loss of binaural summation and sound localization is delays in speech-language development and school achievements. Lack of binaural hearing may decrease accidental learning due to background noise interferes with overheard speech. Therefore, only such early identification results in early intervention via hearing aids, cochlear implants, and various assistive listening devices. The intervention allows

for speech and language development and academic achievements to remain on target.

What is important, there are many factors that affect the speech and language acquisition, academic achievements of each child. Level of hearing loss (mild, moderate, severe, or

normal speech and language development, communication, and the ability to learn.

Timely intervention is an important component of Early Hearing Detection and Intervention (EHDI) screening program. In Poland, neonatal screening program (NHS) is carried out. The first projects were performed over 25 years ago [1]. The result of the Polish EHDI/NHS program shows that the prevalence of congenital hearing impairment ranges from 2 to 7 per 1000 births [2]. The National Institute on Deafness and Other Communication Disorders (NIDCD) adduces that 6–7/1000 children have permanent hearing loss in addition to the 3/1000 likely to be diagnosed in short period after birth [3]. From the official database of the National Health & Nutrition Evaluation Studies (NHANES) for screened children who are 6–19 years, it is indicated that approximated 3/1000 prevalence of permanent hearing loss in infants can be expected to increase to 9–10/1000 children in the school-age population.

In years 2007–2016, the Institute of Physiology and Pathology of Hearing screened over million pupils from class I to VI primary school in Poland and approximately~ million children around the world [4]. This experience provided an opportunity to screen a significant number of school-age children and also created the international infrastructure for screening which makes it a suitable solution for place even in remote rural areas.
