SCREENING FOR HEARING LOSS IN CHILDREN
All Vision-Hearing Technicians have to undergo special training to be able to practice.
Vision Hearing Technicians (VHTs) are provided as a screening service by either Community Health Services attached to District Health Boards, or Iwi (Maori Health) providers. This is in line with Government policy to provide for Maori, Maori health workers, who work in partnership with Primary Health services.
ASSESSMENT AND SCREENING
Objectives:
Early identification of prevalent, undetected ear and eye problems in children. Many defects are a symptomatic, treatable, and only revealed by screening.
Tympanometry:
Children are checked at 4 years of age Identifies children who will be found to have
- Chronic Otitis Media with effusion
- Grommets, perforation and / or discharging ear
- Persistent middle ear effusion (fluid)
TYMPANOMETRY IS NOT A TEST OF HEARING
Vision screening:
Identifies children who fail the distance vision test.
Myopia:
Can also identify
- Astigmatism
- Ambylopia - lazy eye, common cause -squint
- Significant hyperopic problems.
Pure tone Audiometry:
Children are checked from 4 years of age
Detects hearing loss above the screening levels.
Two types of hearing loss are conductive hearing loss, which is usually treatable, or the more permanent sensori-neural hearing loss.
Colour vision screening:
This is to detect children with the most common inherited colour vision defects.
Nationally, only boys are screened, as incidence is higher
R1 in 12 boys
R 1 in 200 girls
GROUPS TESTED IN SCREENING PROGRAM
Pre-school Children:
Tympanometry 4 - 5 year olds:
- Letter matching vision test (4 year olds only)
- Binocular tests (penlight & cover test) where vision test result is uneven
(Pure tone audiometry recommended only in clinic situation for 4 year olds only)
New Entrant Level: 5yrs:
- Tympanometry
- Pure tone audiometry
- Letter matching vision test
- Binocular tests (penlight & cover test)
Year 7: 11-12yrs
- 4-metre vision test using eye chart
- Colour vision - boys only
Children in other age groups:
- Tested on request when of serious concern
- If a child misses routine screening at any level
Follow up Tests:
- A serial test paradigm is used in the screening programme
- Children who marginally fail the initial test are retested 10 - 16 weeks later
- Second test failures are referred for treatment
- Previously referred defects requiring a recheck following intervention.
Areas of Responsibility:
- Schools are visited on a regular basis
- Usual interval between visits is between 10 - 16 weeks
- Children who pass the initial test are not tested again until they reach the next cohort screening group.
Immediate referral for the following
- Discharging ear
- Earache or sore ear
- Perforated eardrum
- Obstruction of the ear canal - wax or foreign body
- Serious level of failure on Audiometry
- Significant visual acuity test fail
- Binocular test fail
- Child complaining of headaches/blurred vision
Referral to:
- Mobile Ear Clinic - Ear Nurse Specialist
- Family doctor
- Audiology - if failed hearing only
- Optometrist/Ophthalmologist - eyes
Note: At risk (targeted) pre-schools are defined as those feeding in to schools that have had a failure rate at new entrant testing of more than 15% in the preceding year. Children are usually referred to Ear Nurse Specialist services within 5 - 10 days.
LINKAGES:
Parents, caregivers,
Kaiawhena (teacher), Kaiako (assistant) - Te Kohanga Reo (Maori
Language pre-schools) and Pacific Island nests (Pacific
Language pre-schools)
Ear Nurse Specialist - refers back for re testing.
Community educators
Audiologists,
Public Health Nurses
Other Vision Hearing Technicians
Family Doctors - refers children for follow-up ear test after treatment
Schoolteachers, Principals
ENT Specialists or Otorhinolaryngologist - refer children for follow
up ear testing in three months.
Special Education Services - Speech language therapists
Maori Health Providers
Plunket Nurses
Other Allied Health Professionals
For further information, please contact:
contact your local DHB
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