Page 22 - Primary Care Audiology

Hearing loss in children

Permanent childhood hearing impairment (PCHI) is relatively rare,
affecting between 0.08% and 0.3% of children. 41

Although only a relatively small proportion of children will have a
permanent hearing loss, each child will require early diagnosis and
ongoing support to maximise their quality of life and life chances.
So, the UK National Screening Committee recommends high-
quality screening for PCHI in all newborns and appropriate follow-
up care if a hearing loss is suspected. 42

The newborn hearing screening programme has led to overall
improvements in the detection of PCHI. However, a history of
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unacceptable variation in the quality of children’s hearing care
across the UK has resulted in repeated system challenges, letting
down many children. 44
A strong consensus exists across the sector and the wider NHS that
the quality of childhood services must improve. To achieve this
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goal, we must learn from the past and use the evidence to find the
best solutions for the future.

The relatively low incidence of PCHI means services need some
concentration of expertise to maintain quality and safety, with
previous national guidelines recommending that audiologists caring
for children assess at least 20-30 new childhood cases a year.
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We also know that, as many children with hearing loss will need
additional support, they will often benefit from accessing a
centre with a multi-disciplinary team and specialist ongoing
support and management. 47

Given the need for specialist equipment and concentration of
specialist skills, paediatric audiology (unlike most paediatric eye care
services, for example) is not well-suited to a universal primary care
service across many sites. Paediatric hearing services, therefore,
need to remain concentrated in specialist hubs led by appropriately
trained and experienced audiologists working with paediatricians,
ENT specialists, speech and language therapists and other experts.

22 NCHA Primary care audiology – accessible ear and hearing care for all 23