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Paeds Vivasgrowth-development-and-behaviour

Paeds Vivas · growth-development-and-behaviour

Hearing impairment and development — branching viva

Structured oral on PCHI classification, early intervention, CI evidence, mild loss and OME.

branching clinical structured oral1 min readVerification in progress

Target exams

RACP DCEMRCPCH Clinical
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Target exams

RACP DCEMRCPCH Clinical
Prompt
Community clinic: 2-year-old with unclear speech; newborn screen passed; recurrent colds; loud TV.

Write your answer

Saved on this device. No marking — you are the marker.

Stem

A 2-year-old has unclear speech and loud television. Newborn hearing screen passed. There are recurrent colds. [8]

Examiner: Does a newborn pass exclude permanent hearing loss later? [1]

Strong answer: No. Late-onset and progressive losses occur. Clinical concern always warrants diagnostic audiology regardless of newborn pass. [1] [3]

Examiner: Why might mild bilateral loss still matter? [8]

Strong answer: Population data link slight-to-mild loss with academic, behavioural and quality-of-life effects. Classroom noise amplifies functional impact. [8]

Examiner: Outline principles after confirmed bilateral severe SNHL in infancy. [3]

Strong answer: Fit amplification promptly, enrol family-centred early intervention, arrange ENT/implant assessment as appropriate, pursue aetiology in parallel, support parent communication. Do not delay devices for testing alone. [3] [4]

Examiner: What did the CDaCI study add about cochlear implants? [4]

Strong answer: Prospective multicentre data showed spoken language development after implantation, with better trajectories associated with earlier implantation and related baseline factors among candidates. [4]

Examiner: When do tympanostomy tubes enter the OME conversation? [9]

Strong answer: For persistent/recurrent OME with hearing impact and developmental or educational concern per guideline criteria — not for every episode of cold-related fluid. Measure hearing and reassess. [9]

References5ShowHide
  1. [1]Yoshinaga-Itano C Outcomes of Universal Newborn Screening Programs: Systematic Review. Journal of clinical medicine, 2021.PMID 34202909
  2. [3]Muse C, Harrison J, Yoshinaga-Itano C, et al. Supplement to the JCIH 2007 position statement: principles and guidelines for early intervention after confirmation that a child is deaf or hard of hearing. Pediatrics, 2013.PMID 23530178
  3. [4]Niparko JK Spoken language development in children following cochlear implantation. JAMA, 2010.PMID 20407059
  4. [8]Wang J Academic, behavioural and quality of life outcomes of slight to mild hearing loss in late childhood: a population-based study. Archives of disease in childhood, 2019.PMID 31079073
  5. [9]Rosenfeld RM Executive Summary of Clinical Practice Guideline on Tympanostomy Tubes in Children (Update). Otolaryngology--head and neck surgery, 2022.PMID 35138976
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