Living in a silent world is not an option….

Imagine living in a world where you cannot hear anything: your mother’s loving voice, your siblings’ laughter, normal environmental sounds and music, someone standing behind you and calling your name. Living in silence places newborns, infants, and children at an enormous disadvantage. Newborns and young children who cannot hear have difficulty communicating, and may experience learning problems because the way infants and young children learn is often based on what they hear. Language acquisition and reading skills are intricately linked to hearing.

These are ideas and facts that nurse practitioners (NPs) and all pediatric healthcare providers must consider when establishing office practice policies for the assessment of newborns and infants who may have a congenital hearing loss, and children and adolescents who may have an acquired hearing loss. As a pediatric NP, I have only cared for newborns who are discharged from hospitals that have implemented the national recommendations to perform initial hearing screenings on all newborns before discharge. The results of the hearing screening are included on the newborn discharge summary sheet. Often, the hospitals have made the initial referral for a follow-up hearing screening if the newborn failed the hearing screening.

Until I read the article by Mary Beth Nierengarten, Early hearing detection and intervention, I thought the practice of screening for hearing loss in all newborns was an established national policy. Her article reports that only 41 states, the District of Columbia, and Guam mandate early screening for hearing loss.  It seems to me that NPs and all healthcare providers in the 9 states that do not mandate early hearing screenings should strongly advocate for this regulation. Why would anyone want to place newborns and infants at risk for known short- and long-term consequences of an undiagnosed hearing loss?

Ms Nierengarten provides a review of the assessment of newborns and children for hearing loss, referral practices, and guidelines for rescreening of children with suspected hearing loss using the medical home model and the Early Hearing Detection and Intervention (EHDI) 1-3-6 Timeline. Nurse practitioners should review this information for inclusion in their primary care practices. I highly recommend reading this and the other articles on hearing in this edition of Contemporary Pediatrics. The recommendations are an easy, cost-effective way to provide quality healthcare to children to ensure that they are not living in unnecessary silence.