Hearing Loss Diagnosis and Early Hearing-Related Interventions in Infants With or at High Risk for Cerebral Palsy: A Systematic Review

Abstract

Aim: To synthesize published evidence regarding hearing impairment diagnosis and interventions in infants with or at high risk for cerebral palsy in the first year after birth. Method: Nine databases were searched for MeSH terms up to February 2020. Included studies were published in English, enrolled infants with or at high risk for cerebral palsy, and addressed hearing evaluation/rehabilitation within the first year after birth. Quality of evidence was evaluated using RTI Item Bank and QUADAS-2. Results: Eighteen articles met inclusion criteria. Quality of the evidence ranged from low to high, revealing variability in diagnostic assessment methodologies and adherence to diagnostic schedules. Concerns for bias included lack of recognition of cerebral palsy effects and etiologies on functional hearing assessment methods and results. Two interventions (hearing aid and cochlear implantation) were identified; however, reported use was inconsistent. Interpretation: Hearing screening in infants with or at high risk for cerebral palsy requires evaluation of the entire auditory pathway preferentially using comprehensive electrophysiological panels of assessments. For infants with perinatal neural insults, pediatric neurologists are uniquely positioned to recommend adherence to systematic surveillance and comprehensive audiology assessments, regardless of comorbidities and motor impairments.

Frequency of hearing loss in children with cerebral palsy and parents’ perception regarding their child’s hearing.

“…Therefore, there is a need that routine screening for children who have CP need to be conducted so that children who have hearing loss or who are at high risk for developing hearing loss could be identified. 18 Timely identification and intervention for hearing loss among children with CP should be performed to decrease the overall burden of impairment among these children. 19 As this was a single center study conducted on a relatively small sample size during the Covid-19 pandemic, our findings cannot be generalized and should further be verified in large scale multicentric studies.…”

“High-risk for cerebral palsy” designation: A clinical consensus statement

“…Over the past twenty years, several systematic reviews in multiple domains of impairment associated with CP [73] beyond the motor component of activity limitations have been published. They range from daily living activities (feeding, sleeping) [74,75] to the senses (hearing, vision) [76,77] to child and family wellbeing and environment (pain, spasticity and tone management, orthotics, parent mental health and parenting) [78][79][80] and developmental functions (communication, cognition) [81].…”