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Hearing
Early detection of hearing loss allows for early treatment, which prevents social and learning difficulties. For example, the development of speech is a finely timed process.
Speech is designed to be heard and learnt at an early age. If this process does not occur on time there is less likelihood of success at a later time.
The incidence of permanent hearing loss is approximately:
Northland 2.3/1000 live births in New Zealand
Auckland 2.0/1000 live births in New Zealand
Canterbury 1.0/ 1000 live births in New Zealand (National Audiology Centre 1998)
Current prevalence of hearing loss at school entry is 13.5% in Maori, 15.7% in Pacific children and 6.7% in others.
There are two different types of hearing problem:
- Sensorineural hearing loss. This is generally permanent and affects the inner ear or auditory nerve. It is usually present at birth due to congenital abnormality, heredity factors, viral infections during pregnancy eg. rubella, or birth events such as lack of oxygen at birth or high levels of jaundice.
The ideal is to identify these children by 6 months of age. Currently most of these children are discovered at around 2-3 years of age, by which time major learning loss will have occurred.
- Conducive hearing loss. This occurs as the result of problems in the middle ear or blocked ear canals.
A major problem in New Zealand is glue ear (otitis media with effusion). This affects 9% of five year olds
(Public Health Commission 1995) and persists in some children causing major learning difficulties.
Primary Prevention
For prevention of sensorineural hearing loss, efforts should concentrate on a safe pregnancy,
labour and delivery, and on immunisation, particularly of rubella, mumps, measles, and haemophilus influenzae type b.
For prevention of glue ear there are two factors:
- Promoting breastfeeding - breastfeeding provides some protection.
- Reduction of environmental factors such as tobacco smoke, overcrowding and housing dampness.
Socio-economic realities present major difficulties for parents and whanau.
Early Detection
The Well Child screens are:
- A checklist for hearing loss at birth (refer to page 7 of the WellChild Tamariki Ora Health Book)
- The hearing questionnaire at each Well Child visit. These questions are included in the WellChild Tamariki Ora Health Book.
- Otoscopic examination of the child's ears looking for signs of glue ear.
- Pre-school testing (tympanometry which has proven effective in identifying glue ear.
- Speech and behavioural problems may be indicators of hearing problems.
(Reference: WellChild Health Prefessionals Booklet 2004)
The following person has agreed to act as the national contact for issues related to hearing with respect to Wellchild/Tamariki Ora
Dr Andrea Kelly
Audiologist, Starship Hospital
Ph 09 307 4949 ext 7377
AndreaK@adhb.govt.nz |
