Updating the nationwide methodology for hearing screening of newborns in the Czech Republic

Summary

Screening programs examining neonatal hearing serve to detect hearing defects, as a prerequisite for hearing rehabilitation, communication skills, and the enhancement of speech development.

There are two methods through which neonatal hearing screening is carried out – the transiently evoked otoacoustic emissions (TEOAE) or the automatic BERA (AABR, automated auditory brainstem response). Positive screening means the discovery of a hearing defect (permanent hearing loss), and negative screening (normal TEOAE or the AABR results) means the absence of a hearing defect. The procedural aim is to update and adjust the neonatal hearing screening, which is determined by the Bulletin of the Ministry of Health of the Czech Republic No. 7/2012.

Neonatal screening is performed at three levels: at neonatological site, at the ENT (phoniatric) rescreening site and at the ENT regional centre. The activities at each level are accurately and concretely identified including the issue of billing the performance to health insurance companies and informed consent to personal data protection (GDPR).

The correct functioning of screening for hearing loss is based on the simple organization of the screening, patient examination comfort, medical recovery from it, and its economic viability. The schedule for neonatal hearing screening and rehabilitation recommends the following steps: 1. screening of a newborn’s hearing on the second or third day after delivery by a neonatological nurse using otoacoustic emissions, alternatively AABR for newborns at risk; 2. hearing rescreening in the third to sixth week of child`s age at the ENT rescreening site; 3. completion of hearing impairment diagnostics within three to sixth months of age at the ENT regional centre. The failure to follow the procedure above is a threat to the hearing and speech development of the child with severe permanent hearing impairment. The collaboration of ENT doctors with neonatologists and paediatricians allows for creating conditions under which the functional nationwide hearing screening of newborns can be established throughout the Czech Republic.

Keywords:

neonatal hearing screening – permanent hearing loss – otoacoustic emissions