All infants born at JGH now being tested for possible hearing loss

Program helps prevent developmental problems as babies get older

The Jewish General Hospital is now among the first several healthcare centres in Quebec to routinely screen for possible hearing loss in all infants born in the hospital and in the Côte-des-Neiges Birthing Centre.

Screening—for about 4,000 babies per year at the JGH and 350 at the Birthing Centre—is quick and painless, and is often performed within 24 hours of birth, seven days a week. Parents receive the results as soon as the test has been completed.

Until recently, screening was performed at the JGH only for babies who were at some degree of risk or who had been admitted to the hospital’s Neonatal Intensive Care Unit for at least 48 hours.

“Infants whose hearing loss isn’t discovered at a very early age could also experience serious psycho-social repercussions in the future, as a result of their delay in developing communication skills,” explains Gina Mills, who is Interim Assistant to the Director of Rehabilitation and Multidisciplinary Services.

 “However, by screening newborn babies, we can alert parents whether further testing is required,” says Ms. Mills, former Chief of Speech Pathology and Audiology at the JGH.

“As a result, the way will be open for earlier identification of a hearing loss and, if necessary, early intervention for auditory and communication development. This increases the chances that the child will be able to attend a mainstream school later on.

“Early intervention aims to promote optimal development. It can significantly reduce the negative impact of hearing loss not only on the child, but on the family and on society.”

The objective, she says, is to screen the baby for potential hearing loss within one month of birth. If the possibility exists, a diagnosis should be made within three months. Ideally, the baby should be fitted with a hearing aid or enrolled in a rehabilitation program within six months.

Even if no hearing loss is found, the program is worthwhile, Ms. Tsagaroulis adds, since it creates an opportunity for parents to meet with a Licensed Practical Nurse or audiologist and receive advice about what to watch for as the child gets older.

Although the mildest hearing losses are not always discovered, she says, screening does detect moderate to more significant losses through two types of tests.

In the Oto-Acoustic Emission test, small earbuds are placed in the infant’s ears, soft sounds are sent to the cochlea (the hearing organ), and the echoes are measured.

The Automated Auditory Brainstem Response test is a more in-depth investigation which is used for babies with certain risk factors, such as a family history of hearing loss. Electrodes introduce soft sounds to the ears to measure how well the auditory nerve is functioning.

While testing is generally conducted by Licensed Practical Nurses, two audiologists—Ms. Tsagaroulis and Chantal Tran—are available to provide assistance, if needed.

Ms. Mills says the project was implemented though close collaboration not only with the Nursing Directorate, but with Neonatology, Family Medicine and Pediatrics. IT also played a major role in developing the digital infrastructure that allows for coordination with the Ministry of Health.

In addition, the program also benefits from the considerable collaboration and support of the Directorate of Frontline Integrated Services of CIUSSS West-Central Montreal.

“We want these babies to start off with every advantage,” Ms. Tsagaroulis says. “That’s why I’m so glad that we can use our expertise to deal with possible problems before they get worse.”