Joint Committee on Infant HearingJoint Committee on Infant Hearing 2007 Summary
Following are the principles of the Joint Committee on Infant Hearing (JCIH) 2007 Position Statement:
- All infants will have access to a newborn hearing screening test using physiologic measures before 1 month of age.
- All infants who do not pass the initial hearing screening and the subsequent rescreening should have appropriate diagnostic audiologic evaluation by an audiologist trained in infant testing and a medical evaluation to confirm the presence of hearing loss before 3 months of age.
- All infants with confirmed permanent hearing loss should receive intervention service including amplification if warranted before 6 months of age.
- A simplified, single point of entry into an intervention system appropriate to children with hearing loss is optimal.
- The EHDI system should be family-centered with infant and family rights and privacy guaranteed through informed choice, shared decision making, and parental consent.
- Families should have access to information about all intervention and treatment options and counseling regarding hearing loss.
- The child and family should have immediate access to high-quality technology, including hearing aids, cochlear implants, and other assistive devices when appropriate.
- All infants and children should be monitored for hearing loss in the medical home. Continued assessment of hearing and communication development should be provided by appropriate providers to all children with or without risk indicators for hearing loss at specified intervals.
- Appropriate interdisciplinary intervention programs for deaf and hard of hearing infants and their families should be provided by professionals knowledgeable about childhood hearing loss. Intervention programs should recognize and build on strengths, informed choices, traditions, and cultural beliefs of the families.
RISK INDICATORS ASSOCIATED WITH PERMANENT CONGENITAL, DELAYED-ONSET OR PROGRESSIVE HEARING LOSS IN CHILDHOOD
(Joint Committee on Infant Hearing Position Statement, 2007)
The timing and number of hearing reevaluations for children with risk factors should be customized and individualized depending on the relative likelihood of a subsequent
delayed-onset hearing loss.
Risk indicators that are in bold print are of greater concern for delayed-onset hearing loss and will need close audiologic monitoring. The previous 2000 JCIH position statement recommended every 6 months for the first three years.
Infants who pass the neonatal screening but have any of the other risk factor should have at least 1 diagnostic audiology assessment by 24 to 30 months of age.
- Caregiver concern regarding hearing, speech, language, or developmental delay.
- Family history of permanent childhood hearing loss. If a blood relative of the infant had a permanent hearing loss from birth or which began in early childhood and needed a hearing aid or special schooling for the hearing-impaired. This DOES NOT include hearing loss due to illness, ear infections, or aging.
- Neonatal intensive care of more than 5 days or any of the following regardless of length of stay: ECMO, assisted ventilation, exposure to ototoxic medications (gentamicin and tobramicin) or loop diuretics (Furosemide/Lasix), and hyperbilirubinemia that requires exchange transfusion.
- In utero infections, such as CMV, herpes, rubella, syphilis, and toxoplasmosis. 5. Craniofacial anomalies, including those that involve the pinna, ear canal, ear tags, ear pits, and temporal bone anomalies.
- Physical findings, such as white forelock, that are associated with a syndrome known to include a sensorineural or permanent conductive hearing loss.
- Syndromes associated with hearing loss or progressive or late-onset hearing loss, such as neurofibromatosis, osteopetrosis, and Usher syndrome; other frequently identified syndromes include Waardenburg, Alport, Pendred, and Jervell and Lange- Nielson.
- Neurodegenerative disorders, such as Hunter syndrome, or sensory motor neuropathies, such as Friedreich ataxia and Charcot-Marie-Tooth syndrome.
- Culture-positive postnatal infections associated with sensorineural hearing loss, including confirmed bacterial and viral (especially herpes viruses and varicella) meningitis.
- Head trauma, especially basal skull/temporal bone fracture that requires hospitalization.
PEDIATRICS Volume 120, Number 4, October 2007