AAP updates guidance on hearing assessment
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Key takeaways:
- The AAP updated guidelines on hearing assessments for the first time in more than a decade.
- Children who are deaf or hard of hearing face increased risk for permanent language acquisition deficits.
The AAP announced new guidance on hearing assessments in infants, children and adolescents, according to an updated clinical report published in Pediatrics.
The AAP Committee on Practice and Ambulatory Medicine and Section on Otolaryngology-Head and Neck Surgery spearheaded the recommendations, which replace recommendations made in 2009.
“Improvements were needed in several aspects including the terminology, risk assessment and an improved hearing assessment algorithm,” Charles M. Bower, MD, FAAP, pediatric otolaryngologist at UAMS Health and lead author of the report, told Healio. “The updated draft was produced after literature review and expert input, then reviewed by all interested parties for accuracy and appropriateness. This was a multiyear project.”
According to the report, children who are deaf or hard of hearing face increased risk for permanent language acquisition deficits. For those children who are not identified through newborn screening, risk assessment and ongoing surveillance should continue during the neurocognitive period through age 5 years. Further guideline recommendations include objective, evidence-based risk assessment for changes in hearing thresholds for all children and prompt screenings when there is clinical or caregiver concern of hearing changes.
“This guideline is oriented toward [primary care physicians] and pediatricians, but is relevant to all providers caring for children and adolescents,” Bower said. “Providers should do a regular risk assessment for hearing, and perform scheduled objective hearing screens for hearing. Prompt referral for management as indicated based on hearing screening is important to optimize language, cognitive and socioemotional development. Parents and patients should seek medical attention and prompt hearing screening if there is concern regarding hearing.”
The report also includes possible genetic causes of hearing changes, a hearing assessment algorithm for primary care pediatricians, a table of risk factors and a chart detailing hearing screening technologies for a primary care setting.
The importance of intervention, support and follow-up is also discussed in the report.
“The primary concern for a child who is newly identified as deaf or hard of hearing is access to language,” Bower said. “Because the neurocritical period for language acquisition is birth to 5 years, children who become [deaf or hard of hearing] under the age of 5 years are at risk for language deprivation.”
The clinical report terminology also reflects AAP Words Matter guidance by removing deficit-framing terminology and recognizing children who are deaf or hard of hearing are “equal, health and whole as they are.”
Reference:
- Hearing assessment update offers 7 recommendations, expands medical home guidance. https://publications.aap.org/aapnews/news/25437/Hearing-assessment-update-offers-7-recommendations?searchresult=1. Published Aug. 28, 2023. Accessed Sept. 6, 2023.
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