Neonatal Audiological Screening

Epidemiological significance and consequences

The problem of hearing impairment in pediatric practice is extremely acute. In the Russian Federation, about 1.3 million children and adolescents suffer from various hearing impairments, and unfortunately, there is a clear upward trend in this figure. Statistics show that even with a completely normal course of pregnancy and childbirth, there is one deaf newborn per 1,000 physiological births.

Congenital and early-onset hearing loss is a leading cause of severe neuropsychiatric disability in children. This is due to the development of a pathological cascade triggered by auditory sensory deprivation:

1. Impaired auditory reception — the primary link where the brain does not receive adequate acoustic stimuli.
2. Impaired speech development — due to the lack of auditory feedback, the child cannot form speech normally.
3. Impaired intellectual and personality development — the logical outcome of a lack of full communication and verbal thinking.

It is important to understand that not only complete deafness, but even a mild degree of hearing loss inevitably provokes a delay in speech development, creates serious difficulties in further learning and communication, and also leads to behavioral deviations.

Risk factors for auditory analyzer damage

For targeted monitoring and the formation of high-risk groups, pediatricians and neonatologists identify a number of key factors contributing to damage to the auditory system of the fetus and newborn. These include:

• Burdened family history (presence of relatives with congenital or early-onset hearing loss).
• Intrauterine developmental anomalies (malformations of the maxillofacial region and ear structures).
• Intrauterine hypoxia, leading to ischemic damage to sensitive nerve cells.
• Congenital infections with teratogenic and neurotoxic effects.
• Prematurity (morphofunctional immaturity of auditory analyzer structures).
• Birth asphyxia (intrapartum oxygen deprivation of the brain).

Screening algorithm and patient routing

The logic of the screening program is strictly structured from the initial detection stage to the proper routing of the patient. The main goal of this measure is the earliest possible detection of hearing pathologies. This is necessary for the timely initiation of comprehensive rehabilitation, which necessarily includes medical, deaf-educational, psychological, and social aspects.

Timing and methods: Primary screening is performed in the first days of the child's life directly in the maternity hospital. The main objective method used is hardware recording of otoacoustic emissions — a quick and painless procedure.

Routing in case of deviations from the norm:

• If the newborn was discharged from the hospital early (before the test could be performed) or if questionable results were obtained during the study, the screening is not canceled. It is postponed to the outpatient stage and carried out at the local pediatric clinic.
• Upon confirmation of negative test results and a justified need for further in-depth examination, the patient is mandatorily referred to specialized medical professionals — otorhinolaryngologist-audiologists.

Class and exam questions

What else to study on this topic

• Comprehensive medical rehabilitation of children with hearing loss
• Deaf-educational support and speech development
• Psychological and social aspects of adaptation
• Principles of operation of the device for recording otoacoustic emissions

Other topics in «Chapter 2. Neonatology»

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.