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Audiology

We support the practice of audiologists, physicians and others with information about our services and with clinical practice guidelines for various populations.
About

Vision

Achievement of optimal communication potential for all children.

Mission

Making a positive difference for children and their families as the province wide centre for specialized pediatric audiology.

Hearing testing

Hearing testing is provided on a referral basis or through interdisciplinary team assessments. We also provide hearing testing on an on-call basis for the otolaryngologists (ear, nose and throat doctors) here at BC Children’s. Our staff do not dispense hearing aids, rather we work with our community partners to ensure that children receive the assistance they need. Hearing testing, hearing counselling and cochlear implant services are all provided. 


We have a close relationship with the BC Early Hearing Program


The neonatal follow-up clinic, the cleft palate & craniofacial team and the oncology teams at BC Children's all have some Audiology Service.

Care Paths/Practice Guidelines

We have produced follow-up guidelines as suggested in Care Paths for specific populations such as neonatal follow-up, cleft palate and craniofacial and syndromic children.   

General populations

General populations who are at risk for hearing loss include those with Low Birthweight (<1200 grams), Low APGAR scores, TORCHES, Respiratory Distress, Head Trauma or Brain Disorder and Hyperbilirubinemia.  

Family history

Children who have a family history of congenital hearing loss are also at risk for hearing loss.  

Meningitis

This clinical guideline addresses the audiology follow-up for children with meningitis in BC. 

Neonatal follow-up

Infants who are in our neonatal intensive care unit who meet the criteria described here are offered enrollment in the Neonatal Follow Up Programme (NFUP). 

The recruitment criteria for the neonatal follow-up programme are:

  • Birthweight 800 grams or less.
  • Verified gestational age of 25 weeks or less.
  • Intra-parenchymal cerebral infarct ("Grade 4 Intraventricular Hemorrhage")
  • Periventricular Leukomalacia with cyst formation.
  • ECLS/ECMO (extra-corporeal life support/ extra-corporeal membranous oxygenation).
  • Retinopathy of prematurity, Grade 4, or lazered in the newborn period or any grade of ROP treated with Avastin.
  • Patient on approved and funded study.
  • Congenital Diaphragmatic Hernia (CDH).
  • Infants discharged home on oxygen.
  • Other unusual perinatal situations at the Director's discretion.

Once enrolled families are offered visits at 4 months, 8 months, 18 months, 3 years and 4 1/2 years.

Intake review is done two months prior to those corrected dates and each discipline reports on whether their assessment is needed for that particular child. 

More information about the NFUP program can be found here:

NFU enrollment information for PHA final.pdf

For Audiology, in general the following applies:

  • CDH or any baby who has had ECMO – 4 months unsedated ABR is offered as well visits recommended in the community to complement the schedule above. It is recommended that these infants are assessed every 6 months until age 4 1/2 for late onset sensorineural hearing loss. If ECMO does not occur until later in life, follow up needs to occur for 4 1/2 years AFTER the ECMO treament.  
  • Infants who passed newborn hearing screening - 8 months behavioural assessment offered. Infants who have not had ear specific hearing testing in community may be offerred either an 18 month, a 3 year or a 4 1/2 yr. assessment.  
There are many exceptions to this guideline, each child's case is reviewed with the information we have at the time and if hearing loss has not been ruled out by the time of their visit, we will book Audiology as part of their visit. 

Since the inauguration of the NFUP in 1983, the NFUP multidisciplinary team has provided clinical care to many children and their families and systematically evaluates the long term outcomes of these children. Team members include neonatologists, psychologists, occupational and physical therapists, speech and language pathologist, social workers and audiologists.

 

Cleft palate & craniofacial

Patients with cleft lip and/or cleft palate and some craniofacial anomalyies are referred to the team.  

Many infants with cleft lip and/or palate receive nursing support early in life for feeding and other consultation.  

Generally, babies with cleft palate receive a hearing screening through the BC Early Hearing Program as well as a diagnostic hearing test prior to 3 months of age and again at around 9 months of age, prior to their cleft repair surgery.  

Many children with cleft palates have more episodes of middle ear fluid than children without clefts.  For this reason many get ear tubes (myringotomy tubes) at the time of their palate repair and are followed closely by ENT. 

The audiologist on the team works closely with public health audiology in the community to ensure appropriate follow up hearing testing is provided in the early years.   

For more information the Cleft Palate Program Nurse can be contacted at 604-875-2345 local 7057.

Care paths

This clinical guideline is designed to address the audiology follow up for children with cleft palate, craniofacial anomalies and syndromes associated with hearing loss. 

Several specific care paths have been developed for various groups of children covered in this guideline. 

Care paths have been developed for three groups of children with syndromes with varying degrees of known risk of late onset permanent hearing loss.

 

The Cleft Palate/Craniofacial Team at our hospital is an interdisciplinary team of professionals that includes a nurse practitioner, speech and language pathologist, orthodontist, plastic surgeon, otolaryngologist (ENT), pediatrician and audiologist. 

To see more information about the Cleft Palate Craniofacial Team see their website below:

 Patient handout 

Here is a brochure for Audiologists to provide and review with families of children with a cleft palate.  It is suggested that this brochure be provided at the early diagnostic ABR visit and/or around the first behavioural assessment, not at the time of screening.

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SOURCE: Audiology ( )
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