Family Pediatrician Role in Auditory Surveillance Program in the Friuli Venezia Giulia Region, Italy

The prevalence of confirmed childhood PHI increases with age and concerns have been expressed about hearing impaired children not picked up by the newborn screening programs.

In Friuli Venezia Giulia region childhood hearing surveillance (CHS) is performed by monitoring of Audiologic High Risks Registry (JCIH 2007) during the defined periodic health visits (at 1,3,6,9,12,18,24,36 months of age) done by the family paediatrician (FP).

In order to explore the validity of the audiological surveillance program we evaluated 600 children referred by FPs and subsequently studied for their audiological characteristics. 3-5,5% of children referred by CHS program were identified as having a permanent hearing loss.

Postneonatal routes of identification are today considered essential. While being aware of their current ineffectiveness, they need to be maintained and improvements investigated in order to obtain an operative policy for detection and an early management for children not identified by the UNHS program. The Italian National Health System recognises the FP as a key figure for childhood health and CHS. The FP ascertains the UNHS results and the following delivery steps. The regular visits to the FP place the FP in an optimal position to monitor auditory capacity of the growing child.

New audiologic tools for FP CHS activities should be developed and designed. The FP should be included in interdisciplinary education and training. It is indeed necessary to implement a public health system in parallel to the UNHS that can more effectively empower early referral and identification of hearing impaired children not identified by newborn screening.