Research at a Glance:
• Australia’s first national guidelines to streamline the management of children with hearing loss
• Guidelines based on bilateral versus unilateral hearing loss, clinical presentation and availability and quality of evidence
• Early-stage medical management needs to be improved to offer families correct and timely testing and reduce potentially unnecessary tests and referrals
• More than 12,000 Australian children have a significant hearing impairment
A network of medical experts has produced Australia’s first national guidelines to streamline the management of children with hearing loss.
More than 12,000 Australian children have a significant hearing impairment and on average one child is identified with hearing loss every day.
A working group of 15 Childhood Hearing Australasian Medical Professionals (CHAMP) network members developed the guidelines based on bilateral versus unilateral hearing loss, clinical presentation and availability and quality of evidence.
Published in the latest edition of the Journal of Paediatrics and Child Health, the guidelines also consider limited resource settings and family preferences.
They recommend that all children with any type of hearing loss should have cytomegalovirus (CMV) salivary testing within 21 days of birth. CMV acquired during pregnancy is the most common infective cause of hearing loss.
Children with non-syndromic bilateral hearing loss (hearing loss that is not associated with other signs and symptoms) should also have an MRI scan, genetic testing, audiology testing of family members and an eye/vision exam.
“In Australia, medical investigations of newly diagnosed infants and children has varied,” Dr Sung says. “National guidelines are important to streamline management, ensure investigations are completed within relevant timeframes, and reduce unnecessary stress for families.
“However, Australia does have high quality universal infant hearing screening which helps with early diagnosis, and enables early intervention, hearing device fitting and timely planning for cochlear implantation where appropriate.”
Dr Sung says early-stage medical management needs to be improved to offer families correct and timely testing and reduce potentially unnecessary tests and referrals.
She says all hearing-impaired children should have a comprehensive medical history and examination, with their families offered the opportunity to understand why their child has hearing loss.
“When a child is diagnosed with hearing loss, it is a very stressful time for the family,” Dr Sung says. “The last thing they need to deal with is multiple potentially unnecessary medical tests, appointments and referrals to specialists.
“Appropriate tests, when offered at the right time, could help direct management and reduce the stress families face when searching for an answer to the cause of their child’s hearing loss.”
The guidelines will be used by paediatricians, otolaryngologists and geneticists, and will also be helpful for general practitioners in Australia.
Researchers from Queensland Children’s Hospital, Gold Coast University Hospital, Sydney Children’s Hospitals Network, John Hunter Children’s Hospital, Monash Health, The Royal Children’s Hospital, the Monash Children’s Hospital and the Victorian Clinical Genetics Services also contributed to the findings.
Publication: Valerie Sung, Lilian Downie, Georgia A. Paxton, Karen Liddle, Catherine S. Birman, Wei Wei Chan, Carolyn Cottier, Alison Harris, Matthew Hunter, Elizabeth Peadon, Kenneth Peacock, Laurence Roddick, Elizabeth Rose, Kerryn Saunders and David J Amor. ‘Childhood Hearing Australasian Medical Professionals (CHAMP) network: consensus recommendations on aetiological investigation and medical management of childhood hearing loss in Australia‘, Journal of Paediatrics and Child Health.