Early detection of hearing impairment in the affected infants is important for medical treatment and subsequent educational intervention to assure development of communication skills.
In 1973, the Joint Committee on Infant Hearing Screening recommended identifying infants at risk for hearing impairment by means of five criteria, and suggested follow-up audiologic evaluation of these infants until accurate assessments of hearing could be made (AAP Newsletter Supplement, October 1973). Since the incidence of moderate to profound hearing loss in the at-risk infant group is 2.5% to 5.0%, audiologic testing of this group is warranted. Acoustic testing of all newborn infants has a high incidence of false-positive and false-negative results and is not universally recommended.
Recent research suggests the need for expansion and clarification of the 1973 criteria. This 1982 statement expands the risk criteria and makes recommendations for the evaluation and treatment of the hearing-impaired infant.
A. Risk criteria
Factors that identify those infants who are at risk for having hearing impairment include the following:
1. Family history of childhood hearing impairment
2. Congenital perinatal infection (eg, cytomegalovirus, rubella, herpes, toxoplasmosis, syphilis)
3. Anatomic malformations involving the head or neck (eg, dysmorphic appearance including syndromal and nonsyndromal abnormalities, overt or submucous cleft palate, morphologic abnormalities of the pinna)
4. Birth weight < 1,500 gm
5. Hyperbilirubinemia at level exceeding indications for exchange transfusion
6. Bacterial meningitis, especially Haemophilus influenzae
7. Severe asphyxia which may include infants with Apgar scores of 0 to 3 or who fail to institute spontaneous repiration by ten minutes and those with hypotonia persisting to 2 hours of age
- Copyright © 1982 by the American Academy of Pediatrics