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Semiramis Zizlavsky Pre PITO 8, Sept 2,2013 Jakarta

Semiramis Zizlavsky Pre PITO 8, Sept 2,2013 Jakarta. Why is newborn hearing screening important ?. INTRODUCTION. Babies : develop speech and language from the time they are born. Listening and interacting with sounds and voices around them.

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Semiramis Zizlavsky Pre PITO 8, Sept 2,2013 Jakarta

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  1. Semiramis ZizlavskyPre PITO 8, Sept 2,2013 Jakarta Why is newborn hearing screening important ?

  2. INTRODUCTION • Babies : develop speech and language from the time they are born. • Listening and interacting with sounds and voices around them. • Baby is born with hearing loss: speech and language development can be delayed. • Hearing screening testing : highly accurate. earlier identification and treatment of infants

  3. - What is newborn hearing screening • Why hearing screening is important ? • Principles of Screening • Target • Risk Factors • Benefit of Hearing Screening • Risk of Newborn Hearing Screening • Timing to test • How to do ? • Important to thinks

  4. What is newborn hearing screening ? Newborn hearing screening…….. programs are designed to identify hearing loss in infants shortly after birth

  5. Prevalence ; 2-3 per 1000 newborn will have HL Indonesia : 1-3 per 1000 1/1000 WBN 10/1000 NICU

  6. Why is early identification of hearing loss important • Hearing loss is the most common birth condition • Previous methods for detecting hearing loss have been ineffective (behavioral observation) • Undetected hearing loss can delay speech, language, social and academic development

  7. Incidence of Congenital Conditions (Per 10,000)

  8. Principles of Principles ofScreening Screening

  9. Target

  10. RISK FACTORS (JCIH 2000) 0-28 day -NICU > 48 hours -Syndrome -Family history -Craniofacial anomalies -In utero infection 29 days- 2 years -Parental/caregiverconcern -Family history -Syndrome -Postnatal infection -In-utero infection -Hyperbilirubinemia -Neurogenerative disorders -Head trauma

  11. Benefits of Newborn Screening

  12. Risk of Newborn Hearing Screening • Parent anxiety (false positive ) • Missed diagnosis ( false negative) • Unanticipated outcome - range of reactions - maternal feelings of guilt - financial problem - cultural sensitivity

  13. HOW TO DO ? • One • Two step

  14. Hearing Screening Techniques

  15. ABR OAE

  16. Otoacoustic Emmision (OAE) Measures sound waves produced in the inner ear PASS REFER

  17. Automatic Auditory Brainstem Response (AABR) PASS REFER Measures how the hearing nerve responds to sound

  18. TIMING TO TEST

  19. BIRTH: Hospital-based Screening • OAE,AABR,ABR • Re-Screen before discharge :possible • Hearing screen pass : not guarantee (risk factors ?) • Re-screening if : - any failure / incomplete - unilateral • Parents refuse screening : documentation

  20. Before one month of Age • Outpatient re-screening : - failed - missed - incomplete • Unilateral failure : audiology evaluation • Early re-screening : • Earlier diagnosis • Minimizes parental anxiety

  21. Before Three Month of Age Audiology evaluation DIAGNOSIS If HL is confirmed (Information, amplification & communication)

  22. Before Six months of Age • Continue early intervention : WHY ??? • Other evaluations : - genetics - ophthalmology - pediatrics Syndrome ? - neurology - cardiology - nephrology

  23. ALUR SKRINING BAYI BARU LAHIR Bayibarulahir / 2 hr PASS OAE REFER Faktor Risiko (-) FaktorRisiko (+) 3 bulan Otoskopi Timpanometri OAE Auto ABR 1 –3 BULAN Auto ABR atau click 35 dB R P R P ABR Click & Tone B 500 Hz atau ASSR Timpanometri High Frequeny ABR Click + CochlearMicrophonic ABR Tone B 500 Hz atau ASSR Timpanometri ( refleks akustik) High Frequency Tidakperlutindaklanjut NeuropatiAuditorik TuliSensorineural • Pemantauan • Speech development • Audiologi • Tiap 3-6 bulansmp (anakbisabicara) usia 3 th Habilitasiusia 6 bulan HTA Hearing Screening

  24. Conclusion ☺Screening is part of a system of follow-up, diagnosis, treatment and evaluation. ☺Timely and appropriate intervention have lasting effects on outcomes. ☺ Family involvement : important

  25. THANK YOU

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