School hearing screening: international experience and recommendations

Permanent childhood hearing loss is crucial for speech development and restricts learning abilities. Universal newborn hearing screening programs are well established to detect congenital hearing loss and address the need of hearing-impaired babies. Progressive or acquired permanent hearing loss can manifest later due to genetic causes, intrauterine or postnatal infections, middle ear diseases and excessive exposure to noise when listening the personal audio devices. The hearing loss prevalence in the population of 9 year-olds three times higher compared with newborns. School hearing screening is a part of hearing across the lifespan conception. The article presents international experience and recommendations for the organization of school hearing screening programs. A school-entry hearing test is mandatory, other grades might be screened also. The basic method is pure tone audiometry at frequencies of 500, 1 000, 2 000, 4 000 Hz at 20 dB. Otoscopy and tympanometry can be performed also, while whisper voice speech test is of low sensitivity. The main hearing screening issue is low follow-up of referrals to ascertain audiological assessment. Modern approaches to the prevention of hearing loss in schoolchildren and management of hearing impairements are described. Planning of hearing screening programs requires sufficient human and logistical resources, monitoring of  results and quality improvement, all stakeholders engagement.

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