Coming To Your Senses

The University of Iowa, in partnership with the Iowa Lions Foundation and communities throughout Iowa are initiating a program to objectively screen infants and children between 6 months and 4 years of age for loss of sight and hearing.

Vision and hearing loss affect a significant portion of our population. Early detection and treatment can prevent permanent and debilitating loss of sight and language and reading impairments caused by undetected hearing loss. Unfortunately, these conditions are not easily detected without an examination. Currently children are not screened until they enter school. For many, this is too late. Coming to Your Senses will provide early screening of vision and hearing for preschool children.

The goals of the project are:

• Objectively screen sight and hearing in children between 6 months and 4 years of age.
• Educate the public about the risk of undetected vision and hearing loss in infants and young children throughout Iowa.
• Identify ways to sustain vision and hearing screening programs of this type.

The project was make possible with financial support from the Iowa Lions, the Lions Club International Foundation, and the Wellmark Foundation of Iowa. Volunteer Lions from each of the nine Iowa Lions districts will work with the project coordinator and audiologist to organize and conduct the screening clinics throughout all of Iowa’s 99 counties. The Lions hope to establish a permanent endowment to help support Coming to Your Senses and research dealing with vision and hearing loss in infants and children.

The University of Iowa will provide technical and educational expertise, coordinate the program, and train personnel to use new technology, tested first at the University, to accurately detect vision and hearing loss in infants and children utilizing trained volunteers.

VISION

Amblyopia is the most common vision problem in preschool children. It is a decrease in vision in one or both eyes and arises without structural damage to the eye or optic nerve. When amblyopia is undetected or left untreated, it results in permanent vision loss that may adversely affect a person throughout life. The incidence of amblyopia in the United States is estimated to be 3 to 5 % of the population. This means that as many as 7,800 Iowa children under the age of 4 years suffer from poor vision in one or both eyes. If amblyopia is detected and treated early in life, permanent visual loss can be prevented.

In recent years, portable screening devices that can test preverbal children have been developed. One of the most advanced screening systems is the MTI Photoscreener™. The University of Iowa has been working with the MTI since its development. The MTI Photoscreener™, a modified Polaroid camera, captures two images of the eyes. Due to the optics of the camera, the photographs demonstrate whether a child has a misalignment of the eyes (strabismus), a cataract, or a need for glasses. Any of these conditions, left untreated, can result in amblyopia. The MTI Photoscreener™ is useful as a mass screening tool and can be effectively used by trained volunteers.

HEARING

The incidence of children with moderate types of hearing loss may be as high as 5%. Children with mild to moderate hearing loss may have an impaired ability to understand speech, to listen, to talk, to comprehend language, to learn to read, to socialize with others, and to develop and use intellectual and vocational skills. Rehabilitation of mild to severe hearing loss can be accomplished with hearing aids. The earlier hearing aids are fitted, the greater the chance of achieving normal language and reading skills. Cochlear implants, pioneered at the University of Iowa, are now available for profoundly deaf children and allow the development of language and reading skills that approach those of children with normal hearing.

Identification of hearing loss before the age of 2 years is usually difficult. It is clear that there is significantly better language development in hearing impaired children identified and treated before the age of 6 months. Unfortunately, the average age when hearing loss is identified is about 2½ to 3 years of age.

Early identification of hearing loss using autoacoustic emissions is the first step in the identification process and the road to rehabilitation.

The Coming to Your Senses Program will be able to screen children 6 months to 4 years of age using a transient otoacoustic emission-testing device, a hand-held automated instrument. The tester places a small plus in the child’s ear, a series of soft clicks is transmitted to the ear and a hand-held computer measures an "echo" that comes back from the inner ear into the ear canal, the computer indicates "pass" or "refer". The child need not respond in any way and the test is completely painless. Trained volunteers can easily perform the test without risk to the infant or child being screened.

Referral

Children identified with a potential vision or hearing threatening problem will be referred to local professionals for evaluation and possible treatment. Families will be encouraged to seek further evaluation and treatment by local practitioners. If families or local practitioners prefer, the child may be seen at the University of Iowa.