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普遍新生儿听力筛查对0至3岁听力损失儿童早期干预项目的影响。

Effects of universal newborn hearing screening on an early intervention program for children with hearing loss, birth to 3 yr of age.

作者信息

Halpin Kathy S, Smith Kay Y, Widen Judith E, Chertoff Mark E

机构信息

Hartley Family Center, University of Kansas Medical Center, Kansas City, USA.

出版信息

J Am Acad Audiol. 2010 Mar;21(3):169-75. doi: 10.3766/jaaa.21.3.5.

Abstract

BACKGROUND

Universal Newborn Hearing Screening (UNHS) was introduced in Kansas in 1999. Prior to UNHS a small percentage of newborns were screened for and identified with hearing loss.

PURPOSE

The purpose of this study was to determine the effects of UNHS on a local early intervention (EI) program for young children with hearing loss.

RESEARCH DESIGN

This was a retrospective study based on the chart review of children enrolled in the EI program during target years before and after the establishment of UNHS.

STUDY SAMPLE

Charts for 145 children were reviewed.

DATA COLLECTION AND ANALYSIS

The chart review targeted the following aspects of the EI program: caseload size, percentage of caseload identified by UNHS, age of diagnosis, age of enrollment in EI, degree of hearing loss, etiology of hearing loss, late onset of hearing loss, age of hearing aid fit, percentage of children fit with hearing aids by 6 mo, percentage of children with profound hearing loss with cochlear implants, and percentage of children with additional disabilities.

RESULTS

Changes in the EI program that occurred after UNHS were increases in caseload size, percentage of caseload identified by UNHS, percentage of children fit with hearing aids by 6 mo of age, and percentage of children with profound hearing loss with cochlear implants. There were decreases in age of diagnosis, age of enrollment in EI, and age of hearing aid fit. Before UNHS, the majority of children had severe and profound hearing loss; after UNHS there were more children with mild and moderate hearing loss. The percentage of known etiology and late-onset hearing loss was approximately the same before and after UNHS, as was the percentage of children with additional disabilities.

CONCLUSION

UNHS had a positive impact on caseload size, age of diagnosis, age of enrollment in EI, and age of hearing aid fit. The percentage of the caseload identified in the newborn period was about 25% before UNHS and over 80% after its implementation. After UNHS, the EI caseload included as many children with mild and moderate hearing loss as with severe and profound loss. By the last reporting year in the study (academic year 2005-2006) all children with profound hearing losses had cochlear implants.

摘要

背景

1999年堪萨斯州引入了新生儿听力普遍筛查(UNHS)。在实施UNHS之前,只有一小部分新生儿接受了听力损失筛查并被确诊。

目的

本研究的目的是确定UNHS对当地针对听力损失幼儿的早期干预(EI)项目的影响。

研究设计

这是一项回顾性研究,基于对UNHS设立前后目标年份参加EI项目儿童的病历审查。

研究样本

审查了145名儿童的病历。

数据收集与分析

病历审查针对EI项目的以下方面:病例数量、UNHS确诊的病例比例、诊断年龄、进入EI项目的年龄、听力损失程度、听力损失病因、迟发性听力损失、佩戴助听器的年龄、6个月时佩戴助听器的儿童比例、重度听力损失儿童接受人工耳蜗植入的比例以及患有其他残疾的儿童比例。

结果

UNHS实施后,EI项目出现的变化包括病例数量增加、UNHS确诊的病例比例增加、6个月大时佩戴助听器的儿童比例增加以及重度听力损失儿童接受人工耳蜗植入的比例增加。诊断年龄、进入EI项目的年龄以及佩戴助听器的年龄有所降低。在UNHS之前,大多数儿童患有重度和极重度听力损失;UNHS之后,患有轻度和中度听力损失的儿童增多。UNHS前后已知病因和迟发性听力损失的比例大致相同,患有其他残疾的儿童比例也是如此。

结论

UNHS对病例数量、诊断年龄、进入EI项目的年龄以及佩戴助听器的年龄产生了积极影响。在UNHS之前,新生儿期确诊的病例比例约为25%,实施后超过80%。UNHS之后,EI项目中的病例包括许多轻度和中度听力损失的儿童以及重度和极重度听力损失的儿童。到研究的最后报告年份(2005 - 2006学年),所有重度听力损失儿童都接受了人工耳蜗植入。

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