Pediatricians Ignore Screenings That Flag Hearing Problems in Children, New Study Finds
Pediatricians are not referring more than half of the children who fail hearing screenings
for further tests, according to new research by a
Saint Louis University physician.
The study was published in the
October issue of the Archives of Pediatrics and
doing tests that they're ignoring," says Donna R. Halloran, M.D., assistant professor
of pediatrics at Saint Louis University School
of Medicine, and a study author.
"Stop doing the test if you are not going to pay attention to it. Or, if you
are going to do the test, pay attention to the results."
Halloran and her colleagues evaluated hearing screening results during 1,061 routine
doctors' visits at three academic and five private practices in Alabama. They
found that 10 percent of the children failed a hearing screening, which means
that they missed reacting to at least one frequency sounded in either ear at
the 20-decibel level. Of those children who failed the test, 59 percent received
no further evaluation.
"My biggest problem is it's such a waste of money," says Halloran, who
also is a SLUCare pediatrician at SSM Cardinal Glennon Children's Hospital. "It
surprises me that in a litigious society we're ignoring screening results."
About 3 percent of the population has hearing impairment, Halloran says, which
means the routine hearing screening picks up false positives. However, if
more than half of those who fail hearing screenings are not referred for in-depth
evaluation by an audiologist, some children who have hearing problems might not
get the help they need.
"At 4 years, they'll start to have some language delays that some people argue
are not reversible," Halloran says. "A mild speech delay will be overlooked
until they get into kindergarten. And even with severe hearing loss, huge improvements
can be made with hearing aids."
While the study was conducted between 1998 and 2000, in 2003 the American Academy
of Pediatrics revised its standards of hearing loss upwards -- to 25 decibels,
Halloran says. That's the equivalent, she says, to having 20:30 vision instead
of 20:20, and likely fewer children would fail that screening. However,
the research brings a new question to light: How do doctors decide what to do
when young patients have an abnormal screening result?
"The findings from this study are worrisome because physicians took no further
action in more than 50 percent of the children who failed the hearing screening," Halloran
says. "Further evaluation or intervention must take place to allow
children with possible hearing impairment to benefit from screening practices.
Screening that does not result in action for those failing the screening wastes
resources and fails to initiate necessary intervention for hearing loss."
Established in 1836, Saint Louis University School of Medicine has the distinction
of awarding the first M.D. degree west of the Mississippi River. Saint Louis University
School of Medicine is a pioneer in geriatric medicine, organ transplantation,
chronic disease prevention, cardiovascular disease, neurosciences and vaccine
research, among others. The School of Medicine trains physicians and biomedical
scientists, conducts medical research, and provides health services on a local,
national and international level.
November 2, 2005