In the article, we will consider what audiological screening of newborns is.
Any newborn child still in the maternity hospital must undergo a comprehensive examination of certain specialists and a number of important tests. Such measures are necessary in order to exclude the presence of any pathologies in the child. Quite recently, it has become mandatory to conduct audiological screening according to order No. 108 “On standards for dispensary observation of children.”
The concept and components of screening
In the first days after birth, the baby should be observed by a neonatologist who conducts a comprehensive neonatological examination. This is necessary to detect hereditary pathological changes in the baby’s body, as well as to identify abnormalities in the very early stages of a child’s development. The sooner any abnormalities are found, the more effective the therapy will be.
The mass examination of newborns includes the following diagnostic steps:
- Examination by such narrow medical specialists as an orthopedist, surgeon, ophthalmologist, neurologist.
- Ultrasound screening.
- Audiological screening.
- Neonatological screening (laboratory examination of blood samples).
A blood test is a fairly common procedure, while audiological screening often alarms the parents of a newborn baby. However, this procedure is very simple and should not provoke any concerns.
By audioscreening is meant an examination that allows you to detect pathological changes in the organs of hearing using a special medical device.
Reasons for the need
The procedure for audiological screening must be taken very seriously, since hearing impairment in children is best amenable to therapy in the first six months after birth. It is the ability to hear and distinguish sounds in the future that allows you to recognize speech and learn to speak. If pathologies are detected untimely, this can lead to the development of complete deafness in the child. In this regard, the indicated examination and the results obtained in its course should not be neglected.
How often do you need to spend?
The rules establish that audiological screening is necessary twice: three to four days after the birth of the baby, and then 1-1.5 months after birth. In some cases, when the results of the first scan are good, re-examination is not required. Of greatest importance is the study of hearing in children born prematurely, as well as those with somatic diseases. This is due to the fact that premature babies are very likely to develop auditory neuropathy and other hearing impairments.
Order of conduct
The examination is carried out for the first time three to four days after the birth of the baby, it is absolutely painless, non-invasive, harmless to the baby. In addition, there are no contraindications to such a hearing examination. Using a small device for audiological screening, a neonatologist automatically registers the otoacoustic emission. The device looks like a small probe equipped with a highly sensitive microphone and a small phone.
It is advisable to conduct a study between feedings of the baby when he is calm or asleep. To calm the baby, you can give a dummy, but during screening it must be removed from the mouth - sucking will create additional noise, which will affect the result of the study. To get the most accurate results, screening should be done in absolute silence.
The obturator, or microphone (a special small probe equipped with an earmold), the doctor introduces the child into the external auditory canal. A device is attached to the probe that performs several functions: it delivers sound pulses of different frequencies and registers otoacoustic emission (sound generated by cochlear hair cells — auditory system receptors). The device sends two signals of different frequencies to the child’s ear in series, while the device detects the response of the receptors to this sound. Each ear is tested by a doctor in turn.
Varieties
Specialists distinguish several types of audiological screening:
- UAE (screening otoacoustic emission). It is a general study, a standard diagnosis of the baby’s hearing in a maternity hospital.
- Clinical UAE. It is a more detailed examination conducted by an audiologist. Such a study is prescribed for children in whom the primary UAE was negative.
- VSWP (fixation of short lateral auditory evoked potentials). This technique is an alternative to the UAE. In the course of CVS, you can get more accurate results than in the UAE.
- ASSR test. It is an objective computer audiometry. This technique is often prescribed as an adjunct to VSWP if the child by that time has any abnormalities in the hearing aid. Computer audiometry makes it possible to visually assess hearing thresholds at different frequencies.
Evaluation of the results
Results of audiological screening are immediately displayed on the monitor of the device. The result of Refer indicates that during the test there were no fluctuations in the hair cells, which in turn indicates hearing impairment. If a similar result is obtained, the child is sent for further examination to an audiologist. However, parents should remember that such a result does not confirm that the child has hearing loss or another problem.
It often happens that re-examination of children who have already undergone audiological screening gives a positive result, that is, the presence of pathology is not confirmed. Different experts explain this situation in different ways. Often, the first study gives a negative result due to the fact that maternal masses have not yet completely left the ear passages of the baby. Re-examination is shown 1-1.5 months after the first. Upon receipt of a repeated negative result, the child is sent for further examination with subsequent treatment.
If audiological screening twice gives a negative result, the child is shown an examination by an otolaryngologist, who will give a referral for an extended examination in an audiological center. It is better to do this before the baby is 3 months old.
Risk factors
Specialists identify several risk factors for pathological changes in hearing and hearing loss in newborns:
- Rhesus conflict.
- Asphyxia of the baby during childbirth.
- Postponed pregnancy.
- Prematurity, underweight in a baby at birth.
- Diseases of an infectious, viral nature, transferred by the mother during the bearing of the child.
- Frequent toxicosis during pregnancy.
- Burdened heredity is a complete absence or hearing impairment noted in close relatives.
Children at risk are shown a mandatory in-depth examination by an audiologist, as they are most susceptible to the development of hearing pathologies.