Title: Hearing screening in preschool and school children in Portugal - A 18- year experience of Coimbra health school, Portugal

Abstract

Introduction: Hearing impairment in children can compromise the development of language and communication skills, academic achievements, and the negative impact of even minor alterations is recognised. Since implementation of Universal Newborn Hearing Screening, preschool and school hearing screening programmes would identify later onset or progressive hearing losses, conductive hearing loss, tinnitus and vertigo. Early identification of hearing loss is very important to provide optimal hearing conditions of school children, minimising the effects on the social, emotional and cognitive development of the individual, which are very important by the time the child starts primary school. Hearing loss can have a great impact on reading, writing, central auditory processing, and balance. Objective: Since 2002, the Coimbra Health School, Audiology BSC has developed hearing screening in the community. The objective of these screenings is to identify changes in hearing and / or in the middle ear in children between 5 and 17 years old, with a special emphasis on children aged 5-6 years. Methods: Children with parental consent were evaluated by otoscopy, tympanometry and audiometry (1, 2 and 4 KHz presented at 40 and 20 dB intensity). A small questionnaire is done to children aged 10 years and over. The results were classified as pass or refer. Every non-normal result of any category would imply referral to the child's primary health care doctor or directly to ENT specialist. Results: Over years it was found that the prevalence of audiological alterations decreases with the child's growth but at 5/6 years old it`s about 30%. This percentage is often confirmed by the observation of an ENT specialist and by audiology hospital laboratories. Conclusion: To implement and perform a preschool and school hearing screening is important and necessary but at 5-6 years (with a high predisposition to middle ear problems) hearing screening should be mandatory with the main objective of identifying and referring for treatment children who present alterations in order to reduce the consequences of the hearing impairment.