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The article introduces the process of obtaining a diagnosis and hearing screening of young children in the Czech Republic. The subsequent care has been described as multidisciplinary, with its main goals being early intervention, initiation of functional communication with the child and providing the child with professional Speech Therapy training. The submitted text includes the qualitative research outcomes that analyse the experience of parents of children with hearing loss. These outcomes will be published on the website https://hovoryozdravi.cz/. The research has been carried out by the Olomouc University Social Health Institute and also forms part of the "Promoting the effective use of assistive devices by children with hearing impairments" project (financially supported by TA ČR). Within our research, 20 interviews with parents were selected for the purpose of this article, in which focused on the factors influencing the care and parenting at an early age from the parents' perspective. In addition, topics are described that we found helpful in complementing the common clinical practice of Speech Therapy.

Bilateral congenital hearing impairment is a serious lifelong handicap for the disabled child, especially due to the limited reception of information, distorted speech development, different way of communication, and limitation in social relations including career advancements and income expectations. The consequences of hearing impairment can be reduced by diagnostic, therapeutic and rehabilitation procedures, which involve early diagnosis of hearing, active support of auditory perception by hearing aids and, if indicated, cochlear implantation. Because of the most recent changes in the methodology of screening for hearing impairment and the advance in hearing diagnostics and therapy to an earlier age, the authors aim to highlight these trends and publish the current re-quirements for optimizing comprehensive care for children with congenital hearing impairment.

Introduction: The prospective study reports on results of universal hearing screening of five years old children in Hradec Kralove and Pardubice regions. Methods: Children at the age of five underwent standard hearing screening by whispered voice test. Subsequently, children underwent ENT examination with pure tone audiogram. The whispered voice test sensitivity, specificity and kappa estimation agreement with pure tone audiometry were evaluated. Results: The study was carried out on 789 children. We proved hearing loss > 20 dB as a mean of four main frequencies in 9 %, bilaterally in 4 % of children. Conductive hearing loss was found out in 8 %, sensorineural in 1 % of five years old children. The whispered voice test had low sensitivity and specificity. In children with hearing loss > 20 dB the sensitivity was 60 %, specificity only 51 %. In case of hearing loss > 30dB the sensitivity increased to 65 %, specificity stayed on the level of 51%. The kappa estimation < 0.2 means pure agreement of pure tone audiogram with whispered voice test as well as patents hearing impairment survey. Conclusion: The incidence of hearing loss in preschool children and low efficacy of whispered voice test and patents hearing impairment survey advocate an audiometric hearing screening before beginning of school attendance. [ABSTRACT FROM AUTHOR]

Introduction: Individuals with hearing defects represent a very heterogeneous group. It is due to the fact that each hearing defect has its own importance and different impact on the person with the defect. The symptoms of hearing loss develop slowly and creepingly. If the hearing defect is not treated, it can deepen and influence the individuality of the person. The aim of this work was to verify, whether the hearing defect can be uncovered in the doctor's office by a short standardized questionnaire. Methods: The observation descriptive study provided information about the health state and hearing threshold of adult responders. The hearing was examined by audiometric examination. The authors examined the mean loss in the dB of the better hearing ear at the 500, 1000, 2000, and 4000 Hz frequencies. Each patient filled out the questionnaire concerning subjective perception of hearing handicap Hearing Handicap Inventory (HHI) kin a shortened version with 10 questions. The data were described by basic descriptive statistics. The statistical tests were evaluated at the 5% level of significance. Results: The group included 27,713 persons, 52.8% of the women (SD = 17.5). The mean age was 53.9 (SD = 18.88). The average hearing loss according to tone audiometry up to 25 dB affected 67.74% of individuals, light hearing loss (hardness of hearing) affected 20.38% of subjects. The average hearing losses of 41-68 dB were determined in 10.44%, the losses of 61-80 dB were in 1.23 of subjects and over 80dB affected 0.23% of the responders. There was a significant positive relationship between resulting score of hearing handicap and average losses according to tone audiometry on the better hearing ear, rs = 0.739 (p < 0.001). The sensitivity of HHI in responders with average hearing loss more than 41dB was 93% and sensitivity was 80%. The abbreviated version of HHI revealed that the risk of hearing handicap increases with age. In case of a rough the risk is higher for women and for persons working in a noisy environment. After adjustment the risk of hearing handicap is significantly higher for men and it was also higher for persons working in the noisy environment. Conclusion: Hearing Handicap Inventory (HHI) appears to be a possible screening tool to uncover hearing problems within the framework of preventive examinations by family physician. It is a simple, cheap and not time-consuming test, which determines emotional and social impact of hearing loss in common daily activities. A timely diagnosis and therapy of hearing loss could help to many persons with hearing defects to maintain a good quality of life for a longest possible period of time [ABSTRACT FROM AUTHOR]

Introduction: The hearing screening of children at the preschool and school age investigated, whether the children suffer from hearing loss, which might hamper development of speech and education. The main goal of the study was to diagnose hearing disorders in children beginning the compulsory education. The secondary aims of the study included determination of prevalence of hearing impairment in a population of children of the first classes of elementary schools, the prevalence of secretory otitis (OMS) and the establishment of the type and cause of the hearing impairment. Methods: The hearing screening examination included two parts. The first examination of audiometry was performed in the elementary schools and included the frequencies on 0.5, 1, 2 and 4 kHz at the intensity of 20 dB HL. The second examination included the basic ORL examination, standard tone audiometry and tympanometry. Results: Prevalence of hearing impairment in children of the first classes of the elementary schools was 2.3% (21 out of 913 children in all schools) or 3.1% (21 of 669 really examined children). A significant hearing impairment was determined in 8 children (0.9 % z 913 or 1.2 % of 669 children). OMS prevalence was established in 15 children 1.6 % of 913 children of the 1st classes of elementary schools or 2.2 % of 669 children examined. The most frequent case of hearing loss in our cohort proved to be OMS in 15 children (71.4% of the 21 children with hearing impairment). The other causes included dysfunction of the auditory tube in two children (9.2%), transitory hearing impairment with normal pressure conditions in the middle ear in three children (14.3%) and perceptual hearing loss in one child (4.8%). Discussion: The screening study diagnosed hearing impairment in two to three percent of children in the first classes of elementary schools, basically there was one percent of clinically important hearing impairment. Considering the high frequency of hearing impairment the authors suggest that a legislation measure of hearing screening should be introduced in children at the preschool age and at the beginning of the school attendance. The pediatrician should recommend audiometric examination of hearing and monitor the results. The otolaryngologist should be in charge of audiometric examination. [ABSTRACT FROM AUTHOR]

Early detection of hearing loss and consequent early rehabilitation with hearing aids or cochlear implants is crucial for the children's development and has been demonstrated in many studies. As the result, newborn hearing screening was implemented in many countries. Hearing screening of all newborns has not been implemented in the Czech Republic yet. In the North Moravian region, hearing screening of all newborn is conducted since 2010. The authors summarize their experience with implementation of the hearing screening within three years. They focus mainly on issues related to organization of screening. They offer solutions and practical advices on how to proceed in implementing of the screening and what to avoid, as well. They emphasize the need for long-term education of nurses and doctors of the newborn's and children's departments, who are "front line" and are the most important for the successful operation of the screening. To provide feedback on their work, it is another important point. The introduction of screening is not a short-term task but the task for several years. [ABSTRACT FROM AUTHOR]