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EDITORIALS: Shirley Russ Measuring the prevalence of permanent childhood hearing impairment BMJ 2001; 323: 525-526 [Full text]

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Impaired Hearing

Paula Molyneux   (11 September 2001)

The need for population-based prevalence data on permanent childhood hearing impairment

Helen Bailey   (22 September 2001)

Impaired Hearing 11 September 2001
Paula Molyneux, Administrator Send response to journal: Re: Impaired Hearing	As a parent of a child with a hearing problem, I would like to know what is going to be done especially regarding education in mainstream schools, when they are faced with SATs testing and so on. Do the goverment not understand that this must be taken into consideration and give teachers more training when dealing with children with this problem. I have been told that my child will not listen in class or he fidgets to much and is easily distracted, but when i have approched them and asked what they have done, the usuall response is that the child was kept in at playtime. I have also tried to find out why after failing a hearing test at 8 months old he was not recalled, only to be told "I dont have the answer to that question". I have tried to find out if the problem started during birth when the cord was round my sons neck, and oxygen was needed for 20 minutes, or was it the ear infection at 6 weeks old, but I am very conceren that my local health authority will not give me any answers. He is the one who has been called names and other children his age say he is stupid because he can not read as well as others, and that his speach was very slow and quite often unable to understand what he was saying. Or is it the fact that he thinks he is dumb because he kept falling of his bike and needed stabilizers when others didn't. What does it take to make, not just the child but teachers and others alike to take note, of this problem. I would be intrested to find out more though as to where i can go for help to get the answers to my questions, as he is now developing other problems e.g. being able to concentrate for periods of time before getting restless. He is now 8 years old and has already had a couple of operations to his eardrums, he is missing out as he has been told he is not allowed to go swimming, this concerns me a great deal as we live near water, and no doubt the torment will start again when he is a teenager and he is unable to swim. I am now begining to think that the goverment is only concerned with targets & figures, not about peoples health and state of mind. At the end of the day not everybody can be perfect but a lot more understanding and teaching would go a long long way. P Molyneux
The need for population-based prevalence data on permanent childhood hearing impairment 22 September 2001
Helen Bailey, Coordinator, Western Australian Newborn Hearing Screening Programme TVW Telethon Institute for Child Health Research, University of Western Australia Send response to journal: Re: The need for population-based prevalence data on permanent childhood hearing impairment	To the editors We read with interest the paper by Fortnum et al (1) on the prevalence of permanent childhood hearing impairment and the accompanying editorial by Russ(2). Professor Russ stressed the need for adequate evaluation of new universal newborn hearing screening programmes and the need for population-based prevalence data. Since February 2000, a pilot newborn hearing screening programme has been implemented in Western Australia. Currently all babies born at the five largest hospitals in Perth, or admitted to the neonatal unit at the major children’s hospital are offered screening. These babies account for about 45% of the 25,000 babies born in Western Australia each year. Western Australia is a very large state geographically, but many services are centralised. For example, all the state’s level two and three neonatal nurseries are in hospitals in the Perth metropolitan area and are included in the pilot programme. However, there are many rural and remote centres where there are between 20-500 births a year. Because of this, careful evaluation of the newborn hearing screening programme is needed before the programme is expanded. Over the first 17 months of the programme, we have detected a prevalence of congenital bilateral permanent hearing loss of less than 1 per 1,000. This prevalence rate is in the low range of those reported elsewhere(3, 4). Thus we have recognised the possibility that either the prevalence of permanent childhood hearing loss in Western Australia is truly low, or that babies with a hearing loss are passing the hearing screen (‘false negatives’). Given that babies with a hearing loss who pass the screen are likely not to be diagnosed for several years, there is a need for ongoing surveillance of the whole cohort. In order to obtain prevalence data and ensure ongoing monitoring, we are currently setting up a population-based database. This database will contain details of all Western Australian children, born 1999 and later, who are diagnosed with a permanent hearing loss by the age of five years. Given the results reported by Fortnum et al(1), we now may need to consider extending the database to children diagnosed beyond the age of five years. We support the need for databases that can ensure ongoing monitoring of newborn hearing screening programmes as well as providing population-based prevalence of permanent childhood hearing impairment. Authors Helen D Bailey, B Health Sci (Nurs) Hons, MPH, Coordinator, Western Australian Newborn Hearing Screening Programme, TVW Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, PO Box 855 West Perth WA 6872, Carol Bower, MBBS, PhD, Head, Epidemiology, TVW Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, PO Box 855 West Perth WA 6872, Kim Gifkins, BSc(Hons), Research assistant, Hearing Loss Prevalence Programme, TVW Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, PO Box 855 West Perth WA 6872, Harvey L Coates, MS, FRACS, Senior ENT surgeon, Princess Margaret Hospital for Children, PO D184, Perth WA 6001, We declare that there are no conflicts of interest. Corresponding author: Helen Bailey, email helenb@ichr.uwa.edu.au 1. Fortnum HM, Summerfield AQ, Marshall DH, Davis AC, Bamford JM. Prevalence of permanent childhood hearing impairment in the United Kingdom and implications for universal neonatal hearing screening: questionnaire based ascertainment study. Bmj 2001;323(7312):536. 2. Russ S. Measuring the prevalence of permanent childhood hearing impairment. The introduction of screening makes this important and timely. Bmj 2001;323(7312):525-6. 3. Fortnum H, Davis A. Epidemiology of permanent childhood hearing impairment in Trent Region, 1985-1993. Br J Audiol 1997;31(6):409-46. 4. Parving A. Congenital hearing disability--epidemiology and identification: a comparison between two health authority districts. Int J Pediatr Otorhinolaryngol 1993;27(1):29-46.