Hearing and Vision Screening Program for newborns in Italy
Keywords:
Newborn, sensori-neural, hearing loss, red reflex testing, vision screeningAbstract
Background. The aims of this paper were to present data on the implementation and coverage of simultaneous Universal Neonatal Hearing and Vision Screening programmes and to evaluate the organization and management of these healthcare procedures in Italy.
Materials and Methods. Data were collected through a nationwide survey conducted in 2018. All maternity wards active in Italy in 2017 were included.
Results. Hearing screening. Overall 427,365 newborns out of 448,386 (95.3%) received the hearing screening test (first level) in 391 out of the 409 maternity hospitals (95.5%), with a national mean referral rate of 3.63% (SD ± 4.58). A statistically significant increase (p<0.034) of newborns sent to audiological examination was found in maternity hospitals with Neonatal Intensive Care Unit (NICU) with “TEOAE only” protocol (9.32% SD ± 7.57), compared to those with “TEOAE/AABR” (3.0% SD ± 3.29).
Vision screening. Overall 335,262 newborns out of 448,386 (74.7%) received vision screening (Red Reflex test) for vision impairment in 302 out of 409 maternity hospitals (73.8%), before nursery discharge. The mean referral rate, recorded in only 22 maternity hospitals out of 302 (7.2%), was 0.48% with a rate of lost to follow up of 0.75 %.
Conclusions. Our results show that implementation of simultaneous hearing and vision screening increased the coverage of both screening tests and is a new multi-disciplinary approach to sensorineural disability. The use of both ABR and TEOAE tests in the hearing screening decreases the number of newborns sent for audiological evaluation, with a notable reduction of costs.
The consideration that ocular problems are two to three times more common in deaf and hearing impaired children than their in hearing peers, confirms the importance of establishing guidelines for simultaneous hearing and vision screening, that favors the formation of a multi-disciplinary team (pediatrician, audiologist, ophthalmologist).
References
1. Day S. Normal and abnormal visual development. In: David T, ed. Pediatric ophthalmology. Section 1. Chapter 2. Oxford UK: Blackwell Science, 1997: 13-28.
2. Clark-Gambelunghe MB, Clark DA. Sensory development. Pediatr Clin North Am 2015; 62(2): 367-84. doi: 10.1016/j.pcl.2014.11.003.
3. Robinson K. Implications of developmental plasticity for the language acquisition of deaf children with cochlear implants. IntJPediatrOtorhinolaryngol1998; 46(1-2): 71-80. doi: 10.1016/s0165-5876(98)00125-6.
4. Olusanya BO, Davis AC, Wertlieb D, et al. Global Research on Developmental Disabilities Collaborators. Developmental disabilities among children younger than 5 years in 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Glob Health 2018; 6(10): e1100-21. http://dx.doi.org/10.1016/S2214109X(18)30309-7.
5. Dale N, Salt A. Early support developmental journal for children with visual impairment: the case for a new developmental framework for early intervention. Child Care Health Dev 2007; 33(6): 684-90. doi: 10.1111/j.1365-2214 .2007.00798.x.
6. Gilbert C, Rahi JS, Quinn GE. Visual impairment and blindness in children. In: Johnson GJ, Minassian D, Weale RA, West SK, eds. Epidemiology of Eye Disease. 2nd ed. London: Arnold Publishers, 2003: 260-86.
7. Sustainable development goals report 2018. New York: United Nations Department of Economic and Social Affairs, 2018. Available on: https:// unstats.un.org/sdgs/report/2018 [Last accessed: 2020, Oct 2].
8. Molloy CS, Anderson PJ, Anderson VA, Doyle LW. The long-term outcome of premature babies (gestation age <28 weeks) with and without severe retinopathy of prematurity. J Neuropsychol 2016; 10(2): 276-94.doi: 10.1111/jnp.12069. Epub 2015 Mar 24.
9. Erenberg A, Lemons J, Sia C, Trunkel D, Ziring P. Newborn and infant hearing loss: detection and intervention. American Academy of Pediatrics. Task Force on Newborn and Infant Hearing, 1998-1999. Pediatrics 1999; 103(2): 527-30. doi:
10.1542/peds.103.2.527.
10. National Institutes of Health Consensus Development Conference Statement. Early Identification of Hearing Impairment in Infants and Young Children. Int J Pediatr Otorhinolaryngol 1993; 27(3): 215-27.doi: 10.1016/0165-5876(93)90228-u.
11. Year 2007 position statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics 2007; 120(4): 898-921. doi: 10.1542/peds.2007-2333.
12. American Academy of Pediatrics. Section on Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus. American Association of certified Orthoptists. Red reflex examination in neonates, infants and children. Pediatrics 2008; 122(6): 1401-4. doi: 10.1542/ peds.2008-2624.
13. World Health Organization (WHO). Newborn and infant hearing screening. Current issues and guiding principles for action. Geneva: WHO, 2010. Available on: https://www.who. int/blindness/publications/Newborn_and_Infant_Hearing_Screening_ReRepo.pdf?ua=1 [Last accessed: 2020, Oct 3].
14. United Nations Convention on the Rights of Persons with Disabilities, 16 December 2006, A/RES/61/106.
15. Martini A, Marchisio P, Bubbico L, Trevisi P,
Perletti L. Permanent childhood hearing impairment: universal newborn hearing screening, PCHI management. Minerva Pediatr 2013; 65(2): 231-50. Italian. PMID: 23612271.
16. Bubbico L, Bartolucci MA, Broglio D. The newborn hearing screening in Italy. Ital J Pediatr 2005; 31: 290-2.
17. Bubbico L, Tognola G, Greco A, Grandori F. Universal Newborn Hearing Screening Programs in Italy: Survey of Year 2006. Acta Otolaryngol 2008; 128(12): 1329-36.doi: 10.1080/00016480802008165.
18. Bubbico L. Detecting permanent hearing loss in newborns. J Matern Fetal Neonatal Med 2012; 25(Suppl 4): 111-3. doi: 10.3109/14767058.2012.715031.
19. Bubbico L,Tognola G, Grandori F. Coverage and screening protocols in UNHS programmes in Italy in 2011: A nationwide survey. Hearing, Balance and Communication 2013; 11(3): 100102. doi: 10.3109/21695717.2013.820516.
20. Bubbico L,Tognola G, Grandori F.Evolution of Italian Universal Newborn Hearing Screening Programs Ann Ig 2017; 29(2): 116-22.doi: 10.7416/ai.2017.2138.
21. Guy R, Nicholson J, Pannu SS, Holden R. A clinical evaluation of ophthalmic assessment in children with sensori-neural deafness. Child Care Health Dev 2003; 29(5): 377-84. doi:
10.1046/j.1365-2214.2003.00355.x.
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