Early hearing detection and intervention (EHDI) programs are critical for ensuring optimal linguistic and cognitive development in children with hearing loss. A recent systematic review published in BMJ Paediatrics Open sheds light on the efficacy and validity of various EHDI models implemented in low-income and middle-income countries (L&MICs) in Asia. This blog post will explore the key findings from the study and offer practical insights for practitioners aiming to improve their skills and outcomes in EHDI.
Key Findings from the Systematic Review
The review analyzed 82 studies, categorized into newborn and infant screening programs and those for older children. The predominant screening methods for newborns and infants involved a two-stage objective otoacoustic emission (OAE) or automated auditory brainstem response (AABR) screening, followed by a detailed auditory brainstem response (ABR) to confirm hearing loss. For older children, a single-stage pure tone audiometry (PTA) screening was commonly used.
- Screening Tools and Protocols: The tools and protocols used were similar to those in high-income countries (HICs), but there was no uniformity within each country.
- Personnel: Audiologists were the most frequent screening personnel for newborns and infants, while otolaryngologists, school instructors, and nurses often conducted screenings for older children.
- Challenges: Major challenges included loss to follow-up, limited coverage, and high referral rates. Financial burden and travel distance also contributed to low follow-up rates.
- Facilitators: Effective tracking systems, financial assistance, and combining hearing screening with other health screenings improved follow-up rates and coverage.
Practical Insights for Practitioners
Based on the findings, practitioners can take several steps to enhance the efficacy of EHDI programs:
- Adopt Uniform Protocols: Establishing standardized protocols within countries can help ensure consistency and improve outcomes.
- Leverage Technology: Utilize information and communication technology (ICT) for data management and follow-up reminders to minimize loss to follow-up.
- Train Non-Specialists: Providing adequate training to nurses, health workers, and school instructors can expand the workforce capable of conducting screenings.
- Focus on Impact Evaluation: Conducting long-term studies to assess the cost-benefit and impact outcomes can help in refining and sustaining EHDI programs.
Implementing these strategies can significantly improve the effectiveness of EHDI programs, ultimately leading to better outcomes for children with hearing loss.
To read the original research paper, please follow this link: Early hearing detection and intervention (EHDI) programmes for infants and young children in low-income and middle-income countries in Asia: a systematic review.