{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T23:26:43Z","timestamp":1765495603614,"version":"3.48.0"},"reference-count":20,"publisher":"BMJ","issue":"6757","license":[{"start":{"date-parts":[[1990,10,20]],"date-time":"1990-10-20T00:00:00Z","timestamp":656380800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1990,10,20]]},"abstract":"<jats:p>OBJECTIVE--To examine the methods used to investigate children at high risk of congenital hearing impairment, and to see whether the introduction of evoked response audiometry has reduced the mean age at which hearing loss is identified. DESIGN--Clinicians who notified children to the national congenital rubella surveillance programme were asked retrospectively to complete a questionnaire examining the methods used to identify hearing impairment and the age at testing in two consecutive five year cohorts. The presence or absence of hearing loss was confirmed by obtaining the results of audiometric evaluations and, whenever possible, a recent pure tone audiogram. SETTING--The United Kingdom. PATIENTS--Children notified to the national congenital rubella surveillance programme and born in 1978-87 in whom IgM specific for rubella was detected shortly after birth. MAIN OUTCOME MEASURES--The age at which hearing loss was identified and the degree of loss in decibels at 250, 500, 1000, 2000, and 4000 Hz measured by pure tone audiometry. RESULTS--61 (52%) Of 117 children born in 1978-82 had a hearing impairment of 40 dB or greater in both ears. The mean loss was 93 dB. In the following five years 75 (47%) of 159 children had impaired hearing, their mean loss being 96 dB. The age at which the hearing loss was confirmed decreased from 11.6 to 9.8 months as a result of earlier auditory evoked response testing. Nevertheless, only eight (13%) of the children with hearing impairment born in 1978-82 and 16 (21%) of those born in 1983-7 had these tests performed in the first six months of life. CONCLUSIONS--Unacceptable delays in identifying hearing loss occurred in this high risk group because of failure to arrange auditory evoked response testing in early infancy. Evoked response audiometry is sensitive and specific and should be undertaken within the first few months of life for all infants known to be at risk of sensorineural hearing loss.<\/jats:p>","DOI":"10.1136\/bmj.301.6757.903","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T15:19:55Z","timestamp":1238685595000},"page":"903-905","source":"Crossref","is-referenced-by-count":8,"title":["Delayed detection of congenital hearing loss in high risk infants."],"prefix":"10.1136","volume":"301","author":[{"given":"N J","family":"Wild","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Sheppard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R W","family":"Smithells","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Holzel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Jones","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1990,10,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1542\/peds.83.3.385","article-title":"Auditory brainstem responses and clinical follow-up of high-risk infants","volume":"83","author":"Kramer, S.J.; Vertes, D.R.; Condon, M.","year":"1989","unstructured":"Kramer SJ, Vertes DR, Condon M. Auditory brainstem responses and clinical follow-up of high-risk infants. Pediatrics 1989;83:385-92.","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1542\/peds.79.2.206","article-title":"Deafness: ever heard of it? Delayed recognition of permanent hearing loss","volume":"79","author":"Coplan, J.","year":"1987","unstructured":"Coplan J. Deafness: ever heard of it? Delayed recognition of permanent hearing loss. Pediatrics 1987;79:206-13.","journal-title":"Pediatrics"},{"key":"ref_3","article-title":"Childhood deafness in the European Community","author":"Martin, J.A.M.; Moore, W.J.","year":"1979","unstructured":"Martin JAM, Moore WJ. Childhood deafness in the European Community. Luxemburg: Commission of the European Communities, 1979.","journal-title":"Luxemburg: Commission of the European Communities"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1136\/adc.64.9.1280","article-title":"Onset and severity of hearing loss due to congenital rubella infection","volume":"64","author":"Wild, N.J.; Sheppard, S.; Smithells, R.W.; Holzel, H.; Jones, G.","year":"1989","unstructured":"Wild NJ, Sheppard S, Smithells RW, Holzel H, Jones G. Onset and severity of hearing loss due to congenital rubella infection. Arch Dis Child 1989;64: 1280-3.","journal-title":"Arch Dis Child"},{"key":"ref_5","first-page":"165","article-title":"Age at fitting ofhearing aids and speech intelligibility","volume":"20","author":"Markides, A.","year":"1986","unstructured":"Markides A. Age at fitting ofhearing aids and speech intelligibility. BrJAudiol 1986;20: 165-7.","journal-title":"BrJAudiol"},{"key":"ref_6","article-title":"The development of language","volume-title":"Carmichael's manual ofchild psychiatry","author":"McNeill, D.","year":"1970","unstructured":"McNeill D. The development of language. In: Mussen PH, ed. Carmichael's manual ofchild psychiatry. New York: John Wiley, 1970."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0030-6665(20)31467-5","article-title":"New technology in infant hearing screening","volume":"22","author":"Northern, J.L.; Gerkin, K.P.","year":"1989","unstructured":"Northern JL, Gerkin KP. New technology in infant hearing screening. Otolaryngol Clin North Am 1989;22:75-87.","journal-title":"Otolaryngol Clin North Am"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1001\/archotol.1988.01860200071021","article-title":"Screening for auditory dysfunction in infants by evoked oto-acoustic emissions","volume":"114","author":"Bonfils, P.; Uziel, A.; Pujol, R.","year":"1988","unstructured":"Bonfils P, Uziel A, Pujol R. Screening for auditory dysfunction in infants by evoked oto-acoustic emissions. Arch Otolaryngol Head Neck Surg 1988;114: 887-90.","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1097\/00003446-198407000-00010","article-title":"A comparison of auditory brain stem response and behavioural screening in high risk and normal newborn infants","volume":"5","author":"Jacobson, J.T.; Morehouse, C.R.","year":"1984","unstructured":"Jacobson JT, Morehouse CR. A comparison of auditory brain stem response and behavioural screening in high risk and normal newborn infants. Ear Hear 1984;5:247-53.","journal-title":"Ear Hear"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1055\/s-0028-1091366","article-title":"The ups and \"downs\" of high risk screening: the Utah statewide program","volume":"8","author":"Mahoney, T.M.; Eichwald, J.G.","year":"1987","unstructured":"Mahoney TM, Eichwald JG. The ups and \"downs\" of high risk screening: the Utah statewide program. Seminars in Hearing 1987;8:155-63.","journal-title":"Seminars in Hearing"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1097\/00003446-198309000-00002","article-title":"The hearing impaired infant: patterns of identification and habilitation","volume":"4","author":"Stein, L.; Clark, S.; Kraus, N.","year":"1983","unstructured":"Stein L, Clark S, Kraus N. The hearing impaired infant: patterns of identification and habilitation. Ear Hear 1983;4:232-6.","journal-title":"Ear Hear"},{"key":"ref_12","first-page":"13","article-title":"Early identification of sensorineural hearing impairment","volume":"40","author":"Elssmann, S.F.; Matkin, N.D.; Sabo, M.P.","year":"1987","unstructured":"Elssmann SF, Matkin ND, Sabo MP. Early identification of sensorineural hearing impairment. The HearingJournal 1987;40:13-7.","journal-title":"The HearingJournal"},{"key":"ref_13","first-page":"61","article-title":"Guidelines for the identification of hearing impairment in at risk infants age birth to 6 months","volume":"30","author":"American Speech-Hearing-Language Association","year":"1988","unstructured":"American Speech-Hearing-Language Association. Guidelines for the identification of hearing impairment in at risk infants age birth to 6 months. ASHA 1988;30:61-4.","journal-title":"ASHA"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1542\/peds.81.5.650","article-title":"Hearing loss in infants with persistent fetal circulation","volume":"81","author":"Hendricks-Munoz, K.D.; Walton, J.P.","year":"1988","unstructured":"Hendricks-Munoz KD, Walton JP. Hearing loss in infants with persistent fetal circulation. Pediatrics 1988;81:650-6.","journal-title":"Pediatrics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1097\/00003446-198604000-00004","article-title":"Progressive sensorineural hearing loss in survivors of persistent fetal circulation","volume":"7","author":"Naulty, C.M.; Weiss, I.P.; Herer, G.R.","year":"1986","unstructured":"Naulty CM, Weiss IP, Herer GR. Progressive sensorineural hearing loss in survivors of persistent fetal circulation. 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Prevention and treatment of catheter-associated urinary tract infections.J Infect 1985;10:96-106.","journal-title":"J Infect"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.301.6757.903","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.301.6757.903","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T23:22:07Z","timestamp":1765495327000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.301.6757.903"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1990,10,20]]},"references-count":20,"journal-issue":{"issue":"6757","published-online":{"date-parts":[[1990,10,20]]},"published-print":{"date-parts":[[1990,10,20]]}},"alternative-id":["10.1136\/bmj.301.6757.903"],"URL":"https:\/\/doi.org\/10.1136\/bmj.301.6757.903","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"type":"print","value":"0959-8138"},{"type":"electronic","value":"1468-5833"}],"subject":[],"published":{"date-parts":[[1990,10,20]]}}}