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All newborns should get hearing tests before leaving hospital, panel says


BETHESDA, Md. -- One in every 1,000 babies born in the United States is deaf at birth or suffers a severe hearing disorder. Yet, fewer than half of them are recognized as being hearing impaired until their condition has already compromised speech and language development, a panel of experts assembled by the National Institutes of Health has concluded.

The 15-member panel, which met in Bethesda for two days last week, recommended that all infants be screened for signs of hearing impairment, noting that the current practice of testing only those considered at high risk of hearing problems, such as children exposed to severe infections early in life, allows many cases to go undiagnosed until it is too late to forestall lifelong problems.

The panel recommended testing for all infants during the first three months of life, preferably at hospitals before they are discharged from newborn nurseries.

Hearing impairment can interfere with language development even before children move past the babbling stage. And for those with profound hearing loss, early detection can be essential for adjusting to life in both the hearing and deaf communities.

Early testing in hospitals is superior to waiting for later visits to the pediatrician, the panel said, because the vast majority of the nation's annual 4 million live births occur there and the children are accessible. In addition, the equipment and personnel needed for the tests can be centrally located at hospitals.

"Our recommendation is to test all children shortly after birth," Dr. Gregory J. Matz, a professor of otolaryngology at Loyola University of Chicago Medical Center and chairman of the panel, said after the meeting. "It's the only way to get all children and not miss any." He noted that in addition to those with severe hearing loss, an additional four or five of every 1,000 newborns also have some mild hearing loss.

The average age for identifying deaf or severely hearing-impaired children in this country is when they are almost 3 years old, child hearing experts said, and lesser degrees of hearing loss go undetected even longer.

Since the first three years of life are the crucial period for developing speech and language skills, they said, reduced hearing acuity in this period can interfere with communication skills for the rest of his or her life.

In addition, the panel said, early hearing problems hinder the development of the auditory nervous system, and can be harmful to social, emotional and academic development, as well as a person's vocational and economic potential.

American Speech-Language-Hearing Association president Thomas J. O'Toole praised the recommendations of the panel, saying they would encourage efficient and cost-effective screening of newborns. Mary Pat Moeller, coordinator for the Center for Childhood Deafness at Boys Town National Research Hospital in Omaha, Neb., said the recommendations of such an influential panel were "vitally important."

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