2019 JCIH Guidelines – Assessing Children Who Cannot be Evaluated Using Behavioral Testing
Approximately 40% of young children who are deaf or hard of hearing have coexisting conditions that, in some cases, may render audiologic evaluation challenging (e.g., physical, intellectual, psychological, or emotional needs or barriers).1
Some children may never become candidates for conventional/behavioral testing methods for the purpose of determining and validating frequency-specific hearing thresholds.
Periodic monitoring of hearing status to assess possible delayed-onset or progressive hearing loss (e.g., congenital Cytomegalovirus [CMV]) may also require continued use of electrophysiological measurements.
This creates a potential dilemma when anesthesia is required for initial and/or repeated ABR measurement for the purpose of diagnosis and monitoring.
“Recent research has shown the potential risk to cognitive function in the young child who undergoes general anesthesia.2 The benefits and risks must be carefully weighed and the JCIH recognizes that medically fragile children may not be candidates for anesthesia.” 3
Professional judgment as well as input and observations from the family are necessary to determine if use of amplification and/or other assistive technology has a probable chance of enhancing access to auditory information.
2019 JCIH Guidelines – Read full article: https://digitalcommons.usu.edu/jehdi/vol4/iss2/1/
1. Gallaudet Research Institute. (2013, August). Regional and national summary report of data from the 2011-12 annual survey of deaf and hard of hearing children and youth. Washington, DC: GRI, Gallaudet University.
2. Sun, L., Li, G., Miller, T., Salorio, C., Byrne, M. W., Bellinger, D. C., . . .McGowan, F. X. (2016). Association between a single general anesthesia exposure before age 36 months and neurocognitive outcomes in later childhood. JAMA, 315(21), 2312–2320.
3. The Joint Committee on Infant Hearing (2019). Year 2019 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. The Journal of Early Hearing Detection and Intervention, 4(2), 1-44.
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