Enhance hearing, communication and access to relevant information
|Strategy||Recommendation and Grading||Evidence Studies||Evidence -Based Guidelines|
|When to Perform Audiology Assessment||GPP: Tell families/caregivers that hearing assessment is recommended for the following reasons:|
Audiological assessment contributes different information at each stage in the disease process and the treatment progress.
|Choice of Audiology Assessment||GPP: Tell families/caregivers that hearing can be evaluated at any time after birth. The type of assessment depends upon the:|
Valid hearing assessment requires a quiet test environment.
|Screening and Surveillance||GPP: Hearing screening at school entry in populations with near-universal OM and CHL is not recommended. Hearing screening in older asymptomatic children (single pass/fail assessment) is not recommended.|
Regular surveillance (with appropriate testing when indicated) is preferred to school entry screening.
|GPP: Put the children with recurrent, persistent and chronic OM conditions on a review register. These children should be assessed as recommended in these guidelines specific to the OM diagnosis.|
|Signs of Hearing Loss||GPP: Tell families/caregivers that the most obvious clue to the presence of the hearing loss is a history of OM. Hearing loss may have been present for some time before noticeable signs are observed and reported.||IV135||I~A14|
|GPP: Observe and ask questions about hearing behaviors:|
Hearing loss in cross cultural settings can lead to inappropriate assumptions. People might judge a person with hearing loss to be ‘inattentive’, ‘uninterested’, ‘rude’ or ‘stupid’.
|Effects of Hearing Loss||GPP: Tell families/caregivers that hearing loss affects verbal and written communication. It is associated with:||IV68;137;138|
|Enhancing Language Acquisition||GPP: Encourage families/caregivers to:|
Children with hearing loss often benefit from a quiet environment and additional language stimulation.
|Recommended Educational and Rehabilitation Support||GPP: Tell people working with children (e.g. in child care centres, kindergartens, schools) about the high rates of hearing loss and factors affecting hearing in educational settings.||IV113||I~A20|
|Recommended Educational and Rehabilitation Support continued||GPP: Tell caregivers and teachers that for children with ongoing mild hearing loss averaging <35dB, the most common forms of intervention include:|
|GPP: Tell caregivers and teachers that for children with ongoing mild to moderate hearing loss averaging >35dB, the most common forms of intervention include:|
|GPP: Tell caregivers and teachers that children with severe and profound hearing loss averaging >65dB must urgently receive:|
|GPP: Tell families that they can enhance their children’s learning at school by providing support at home.|
Written ENT specialist advice is required to advise whether there are any medical contraindications to the fitting of personal amplification.
|Recommended Educational and Rehabilitation Support continued||In the choice of hearing device audiologists will consider the following factors:|
|Communicating with a Hearing Impaired Person||Grade C: If talking to a hearing impaired person, make sure that you speak slowly and clearly after gaining their attention in well-lit conditions. Health educators should use visual prompts and cues and public address systems if available.||III115;116||I~A15|
|GPP: Use listening devices to assist communication with hearing-impaired patients.|
|GPP: Speak in the patient’s language (or use interpreters) to communicate important messages. Try to establish why communication is breaking down e.g. hearing, language or cultural differences?|
|Speech Therapy||GPP: Refer to a speech pathologist all children suspected of speech and language delay (see list of behaviours to observe under ‘Diagnosis of OM’).|