Hearing impairment in children: regional epidemiologic studies

Abstract

The aim of the study is a comparative analysis of medical and social indicators of audiological care for children with hearing impairments in two regions of the Russian Federation and the development of recommendations for its improvement. Methodology. The study was carried out on the basis of children’s audiology centers in St. Petersburg and Novosibirsk. At the first stage, the organization of audiological care for children in the region and the results of audiological screening were analyzed: coverage, frequency of detection of hearing loss. At the second stage, we analyzed the data from outpatient records of children with hearing impairments registered in audiology centers. The age at which the diagnosis was made, the age of primary hearing aid, the type of hearing aid, and the type of educational organization attended by the child were assessed. At the third stage, a screening examination of hearing was carried out in primary school students of a comprehensive school using otoscopy, tympanometry, registration of otoacoustic emission, and tone threshold audiometry. Results. The analysis showed that all components of medical care in the regions comply with international recommendations. Despite this, less than 10% of children with hearing impairment receive it in accordance with the time standard for early care «1-3-6», which involves the detection of hearing impairment at the age of 1 month, diagnosis of hearing impairment at 3 months, at 6 months - hearing aids and psychological and pedagogical assistance to a child and his family. The main reasons for the late diagnosis of hearing impairments in children and, as a consequence, the late start of their rehabilitation have been established: not all children go through the 1st stage of universal audiological screening of newborns, some children with a positive result of the 1st stage of screening do not enter the 2nd stage for diagnostic examination of hearing; children with auditory neuropathy and hearing loss of various etiologies that occur after birth «drop out» from the current audiological screening procedure. Conclusion. A system of measures is proposed to solve the problem of early detection of hearing impairments in children: 1) control of the 1st stage of audiological screening of newborns and the transfer of information about children to be examined at the 2nd stage to the audiology center; 2) the introduction of additional audiological screenings for children at the age of 1 year and upon admission to school; 3) increasing the awareness of pediatricians, neurologists and the population about the causes, diagnosis and rehabilitation of hearing impairment in children; 4) actions aimed at preventing the occurrence of hearing impairment in children (vaccination, treatment of otitis media, hearing hygiene, etc.).