|Title||Congenital and Prelingual Deafness in Children|
By the end of this module Clinical Scientist in HSST, with respect to congenital and prelingual deafness, will be able to analyse, synthesise, evaluate and apply knowledge and perform specialist assessment and treatment of patients demonstrating the attitudes and behaviours necessary for the role of a Consultant Clinical Scientist within a patient focused service and in particular will be able to suspect, identify, diagnose and manage congenital and prelingual deafness in children.
Knowledge and understanding
By the end of this module Clinical Scientists in HSST will analyse, synthesise, evaluate and apply their expert knowledge required with respect to:
- the signs, symptoms and presentation of deafness in babies and young children.
- the aetiology of hearing disorders and the likelihood of involvement of other systems.
- the need to refer to a paediatrician or audiovestibular physician for a full developmental and aetiological assessment.
- evidence based and appropriate investigations.
- the impact of deafness on speech and language development, education, social and emotional development of the child.
- normal speech and language development in a child
- the management of a deaf child including alternative modes of communication, educational needs and amplification.
- psychological and cultural issues surrounding deafness, its diagnosis and management.
- the principles and practice of newborn hearing screening and management of the child referred through and beyond national programmes.
- local and national protocols and guidelines for identification, investigation and management of congenital and prelingual deafness.
- the test strategies and detailed methods of assessment of hearing to identify congenital and pre-lingual deafness.
- the epidemiology of permanent childhood hearing impairment (PCHI).
- amplification options including conventional hearing aids, implantable devices such as Bone Anchored Hearing Systems and cochlear implants. .
- the range of predicted potential outcomes, methods of assessing benefit and problems with amplification.
- the range of emotional reactions experienced by parents/carers following identification of deafness in a child and how to recognise this and refer appropriately.
- the roles of the various team members in care of the deaf child.
- the roles of other agencies and the third sector in meeting the support and information needs of families.
Technical and clinical skills
By the end of this module Clinical Scientists in HSST will be able to demonstrate a critical understanding of current research and its application to the performance and mastery of a range of technical skills whilst critically reflecting and applying in practice a range of clinical and communication skills to advise and communicate effectively with children and their families, carers and other healthcare professionals and will:
- take an accurate history including pre-, peri- and post-natal history and family history.
- Identify delay or abnormality in speech and language development and refer to a speech and language therapist
- elicit sensitive information from the parents/patient or carers that is relevant to assessment and management.
- identify information that is relevant to the test strategy and interpretation of the assessment
- undertake an appropriate, accurate and reliable hearing assessment
- perform a relevant and focused clinical examination as appropriate in the role of Consultant Clinical Scientist
- recognise features indicative of syndromic deafness.
- select, guide (or perform) and interpret the appropriate audiovestibular tests that are required to assess and manage the patient.
- communicate the need for other appropriate investigations that are required to assess and manage the child.
- communicate the results of diagnostic testing following newborn hearing screening, or identification at other times in childhood, and counsel the child/parents/carers about management and prognosis.
- assess benefits and problems of intervention and effectively communicate this to parents or carers and to the child when appropriate..
- contribute within the multidisciplinary team towards referral to other professionals including clinical genetics, specialist paediatrics, ophthalmology, education, social services as appropriate.
- reflect on the challenges of applying research to practice in relation to these areas of practice and suggest improvements, building on a critique of available evidence.
Attitudes and behaviours
By the end of this module Clinical Scientists in HSST will be expected to evaluate their own response to both normal and complex situations demonstrating the professional attributes and insights required of a Clinical Scientist in HSST working within the limits of professional competence referring as appropriate to senior staff and will:
- recognise and respond to the anxiety and stress caused by suspected deafness and the possible natural reactions surrounding the diagnosis.
- recognise the effect of audiological and aetiological uncertainty following identification of significant deafness in the newborn period and respond accordingly.
- recognise the cultural issues and parental views with regards to deafness and its management and respond accordingly.
- recognise the importance of multi-disciplinary and multiagency management of deaf children and respond accordingly.
- recognise the importance of the local pathways, protocols and guidelines for identification and management of the deaf child.
- recognise the importance of giving written information to families
- recognise the role of the third sector in providing information and support.
- be positive towards change through continuous improvement of services, with particular reference to auditing practice, evidence based practice, new and improved technologies.