我国儿童听力障碍的“筛-诊-治-康”体系建设

doi:10.12372/jcp.2025.25e0844

Abstract

Abstract:

Delayed screening, diagnosis, and intervention for hearing impairment can significantly hinder the development of speech-language, cognitive, and communication abilities in children. Over the past two decades, China has made substantial progress in establishing a comprehensive system for pediatric hearing screening, diagnosis, treatment, and rehabilitation (referred to as the “screen-diagnose-treat-rehabilitate” system). This review focuses on national policies, key technologies, and service models across the entire continuum of care for childhood hearing impairment—from early screening and diagnosis to intervention and rehabilitation, as well as emerging roles of artificial intelligence, telemedicine, and genetic screening in improving screening efficiency and enhancing service accessibility. The paper further proposes a future-oriented pediatric hearing healthcare system characterized by interdepartmental coordination, intelligent and precise service delivery, scalability, and full-process management.

Key words: hearing impairment, hearing screening, diagnosis, treatment, child

CLC Number:

WANG Shuo, LI Yue, HUANG Lihui. Childhood hearing loss: construction of the screening, diagnosis, and intervention system in China[J].Journal of Clinical Pediatrics, 2025, 43(12): 883-889.

References 35

[1]	World Health Organization. World report on hearing[EB/OL]. Geneva: World Health Organization, 2021 [2025-07-16]. https://www.who.int/publications/i/item/9789240020481.
[2]	Lieu JEC, Kenna M, Anne S, et al. Hearing loss in children: a review[J]. JAMA, 2020, 324(21): 2195-2205. doi: 10.1001/jama.2020.17647 pmid: 33258894
[3]	李颖, 王雪瑶, 周怡, 等. 0-6岁听力正常儿童听性脑干反应演化规律及声传导功能异常儿童的特征[J]. 临床耳鼻咽喉头颈外科杂志, 2023, 37(3): 225-230.
	Li Y, Wang XY, Zhou Y, et al. Evolution of auditory brainstem response in 0-6 years old normal hearing children and characteristics of children with abnormal acoustic conduction[J]. Linchuang Erbiyanhou Toujingwaike Zazhi, 2023, 37(3): 225-230.
[4]	Athanasopoulos M, Samara P, Batsaouras G, et al. Making a difference from day one: the urgent need for universal neonatal hearing screening[J]. Children (Basel), 2024, 11(12): 1479-1489.
[5]	黄丽辉, 韩德民. 中国新生儿听力筛查40年[J]. 中华耳鼻咽喉头颈外科杂志, 2023, 58(7): 729-737.
	Huang LH, Han DM. Forty-year history of newborn hearing screening program in China[J]. Zhonghua Erbiyanhou Toujingwaike Zazhi, 2023, 58(7): 729-737.
[6]	中华人民共和国卫生部办公厅. 《新生儿疾病筛查技术规范》[EB/OL]. [2025-07-16]. https://www.nhc.gov.cn/wjw/gfxwj/200412/768b4abfa08b4d3d9116ed6dd3b0c9de.shtml.
[7]	中华人民共和国卫生部. 《新生儿疾病筛查技术规范(2010年版)》[EB/OL]. [2025-07-16]. https://www.nhc.gov.cn/zwgk/wtwj/201304/e6215cd2b1c541c6914aefeb542e3467.shtm.
[8]	中华人民共和国国家卫生健康委. 《出生缺陷防治能力提升计划(2023-2027年)》[EB/OL]. [2025-07-16]. https://www.gov.cn/lianbo/bumen/202308/content_6900318.htm.
[9]	中华人民共和国国家卫生和计划生育委员会办公厅. 儿童耳及听力保健技术规范[EB/OL]. [2025-07-16]. https://www.nhc.gov.cn/zwgk/wtwj/201304/23623f839ce64d0498e3d372115ecef8.shtml.
[10]	黄丽辉, 王雪瑶. 儿童迟发性听力损失: 值得重视[J]. 中华耳鼻咽喉头颈外科杂志, 2018, 53(3): 172-176.
	Huang LH, Wang XY. Childhood delayed-onset hearing loss deserves close attention[J]. Zhonghua Erbiyanhou Toujingwaike Zazhi, 2018, 53(3): 172-176.
[11]	中国残联, 教育部, 民政部, 等. 《“十四五”残疾人康复服务实施方案》[EB/OL]. [2025-07-16]. https://www.gov.cn/zhuanti/2021-08/20/content_5650192.htm.
[12]	Norton SJ, Gorga MP, Widen JE, et al. Identification of neonatal hearing impairment: evaluation of transient evoked otoacoustic emission, distortion product otoacoustic emission, and auditory brain stem response test performance[J]. Ear Hear, 2000, 21(5): 508-528. doi: 10.1097/00003446-200010000-00013
[13]	Patel K, Thibodeau L, McCullough D, et al. Development and pilot testing of smartphone-based hearing test application[J]. Int J Environ Res Public Health, 2021, 18(11): 5529-5539. doi: 10.3390/ijerph18115529
[14]	中华预防医学会儿童保健分会. 儿童听力保健专科建设专家共识[J]. 中国妇幼健康研究, 2023, 34(12): 1-6.
	Child Health Society of Chinese Preventive Medicine Association. Expert consensus on the children hearing care specialty construction[J]. Zhongguo Fuyou Jiankang Yanjiu, 2023, 34(12): 1-6.
[15]	国家卫生和计划生育委员会新生儿疾病筛查听力诊断治疗组. 婴幼儿听力损失诊断与干预指南[J]. 中华耳鼻咽喉头颈外科杂志, 2018, 53(3): 181-188.
	Expert Group on Universal Newborns Hearing Screening of the National Health and Family Planning Commission. Guideline for the early diagnostic evaluation and intervention of hearing loss in infants[J]. Zhonghua Erbiyanhou Toujingwaike Zazhi, 2018, 53(3): 181-188.
[16]	Chen J, Shi Y, Kong Y, et al. Cochlear implant facilitates the use of talker sex and spatial cues to segregate competing speech in unilaterally deaf listeners[J]. Ear Hear, 2023, 44(1): 77-91.
[17]	Zhang Y, Chai Y, Zhang Y, et al. Neural plasticity and hearing-speech development in children with auditory brainstem implants for congenital hearing loss due to severe inner ear malformation[J]. Adv Sci (Weinh), 2025: e2406092.
[18]	Lv J, Wang H, Cheng X, et al. AAV1-hOTOF gene therapy for autosomal recessive deafness 9: a single-arm trial[J]. Lancet, 2024, 403(10441): 2317-2325. doi: 10.1016/S0140-6736(23)02874-X
[19]	中华医学会耳鼻咽喉头颈外科学分会听力学组, 中华耳鼻咽喉头颈外科杂志编辑委员会. 新生儿及婴幼儿早期听力检测及干预指南(草案)[J]. 中华耳鼻咽喉头颈外科杂志, 2009, 44( 11 ): 883-887.
[20]	Wen C, Li X, Huang L, et al. Current status of universal newborn hearing screening program at 26 institutions in China[J]. Int J Pediatr Otorhinolaryngol, 2020, 138: 110131. doi: 10.1016/j.ijporl.2020.110131
[21]	郑可, 吴诗欣, 曾祥丽. 2017-2019年广东省新生儿听力初筛、复筛、随访现况及影响因素 [J]. 听力学及言语疾病杂志, 2022, 30(2): 184-187.
	Zheng K, Wu SX, Zeng XL. Newborn hearing screening in Guangdong Province: status and influencing factors of initial screening, rescreening and follow-up[J]. Tinglixue Ji Yanyu Jibing Zazhi, 2022, 30(2): 184-187.
[22]	Wen C, Zhao X, Li Y, et al. A systematic review of newbornand childhood hearing screening around the world: comparison and quality assessment of guidelines[J]. BMC Pediatrics, 2022, 22(160): 1-21. doi: 10.1186/s12887-021-03049-5
[23]	亓贝尔, 黄丽辉, 程晓华, 等. 北京城乡结合部新生儿普遍听力筛查分析[J]. 听力学及言语疾病杂志, 2010, 18(1): 14-16.
	Qi BE, Huang LH, Cheng XH, et al. The universal newborn bearing screening (UNHS) in the urban-rural hospitals in Beijing[J]. Tinglixue Ji Yanyu Jibing Zazhi, 2010, 18(1): 14-16.
[24]	American Academy of Audiology. American academy of audiology childhood hearing screening guidelines[EB/OL]. 2013. https://www.cdc.gov/ncbddd/hearingloss/documents/aaa_Childhood-Hearing-Guidelines-_2011.pdf.
[25]	Ruan Y, Wen C, Cheng X, et al. Genetic screening of newborns for deafness over 11 years in Beijing, China: More infants could benefit from an expanded program[J]. Biosci Trends, 2024, 18(4): 303-314. doi: 10.5582/bst.2024.01178
[26]	《孕期耳聋基因筛查专家共识》专家组, 河北省卫生健康委员会, 中国医疗保健国际交流促进会耳内科学分会, 等. 孕期耳聋基因筛查专家共识[J]. 中华耳科学杂志, 2022, 20(2): 217-221.
	Expert Group of the Expert Consensus on Genetic Screening for Hearing Loss during Pregnancy, Health Commission of Hebei Province, Branch of Audiology and Vestibular Medicine in China International Exchange and Promotive Association for Medical and Health Care, et al. Expert Consensus on Genetic Screening for Hearing Loss during Pregnancy[J]. Zhonghua Erkexue Zazhi, 2022, 20(2): 217-221.
[27]	Wu W, Lü J, Li Y, et al. A new hearing screening system for preschool children[J]. Int J Pediatr Otorhinolaryngol, 2014, 78(2): 290-295. doi: 10.1016/j.ijporl.2013.11.026
[28]	崔庆佳, 葛芳, 韩任杰, 等. MAGIC纯音筛查法在3-6岁儿童听力筛查应用的可行性探讨[J]. 临床耳鼻咽喉头颈外科杂志, 2025, 39(1): 14-18.
	Cui QJ, Ge F, Han RJ, et al. Feasibility of MAGIC pure tone screening in children aged 3 to 6 years[J]. Linchuang Erbiyanhou Toujingwaike Zazhi, 2025, 39(1): 14-18.
[29]	Deng L, Yang X, Cheng X, et al. Hearing loss trajectory and prediction model for children with enlarged vestibular aqueduct[J]. Am J Otolaryngol, 2025, 46(1): 104573. doi: 10.1016/j.amjoto.2024.104573
[30]	Liang S, Xu J, Liu H, et al. Automatic recognition of auditory brainstem response waveforms using a deep learning-based framework[J]. Otolaryngol Head Neck Surg, 2024, 171(4): 1165-1171. doi: 10.1002/ohn.840 pmid: 38822760
[31]	Turchetti G, Bellelli S, Palla I, et al. Systematic review of the scientific literature on the economic evaluation of cochlear implants in paediatric patients[J]. Acta Otorhinolaryngol Ital, 2011, 31(5): 311-318. pmid: 22287822
[32]	American Academy of Audiology. Clinical practice guidelines: Pediatric amplification[EB/OL]. 2013. https://www.audiology.org/wp-content/uploads/2021/05/PediatricAmplificationGuidelines.pdf.
[33]	冯清源, 曹永茂, 陶泽璋. 家庭支持力度与听障儿童康复效果相关性的研究进展[J]. 听力学及言语疾病杂志, 2024, 32(2): 172-175.
	Feng QY, Cao YM, Tao ZZ. Research progress on the correlation between family support intensity and rehabilitation outcomes in children with hearing impairment[J]. Tinglixue Ji Yanyu Jibing Zazhi, 2024, 32(2): 172-175.
[34]	国家卫生健康委办公厅. 婴幼儿早期发展服务指南(试行)[EB/OL]. [2025-07-16]. https://www.nhc.gov.cn/fys/c100078/202502/19c9c6dee0274d23822f313a99ae1779.shtml
[35]	Appx Ninja. Deaf talk - speech to text[EB/OL]. [2025-07-16]. https://download.cnet.com/deaf-talk-speech-to-text/3000-2150_4-78174910.html.

Childhood hearing loss: construction of the screening, diagnosis, and intervention system in China

RichHTML

PDF (PC)

Like

Knowledge

Abstract

Cite this article

share this article

References 35

Related Articles 15

Metrics

Comments

Recommended 0

[1]	LIN Jinfeng, CHEN Yi, DENG Yan, FENG Ai, HUANG Juan, CHEN Lizhu, XIE Jingqi, NIE Xiaojing. A comparative study on the detection of anti-Nephrin antibodies in children's nephrotic syndrome by chemiluminescence method and cell-based assay [J]. Journal of Clinical Pediatrics, 2026, 44(8): 682-689.
[2]	ZHENG Fangyuan, WANG Miao, DING Mingming, LU Aidong, JIA Yueping, ZENG Huimin, ZHANG Leping. Next-generation sequencing identified gene variants and their prognostic impact in pediatric Philadelphia chromosome positive acute lymphoblastic leukemia [J]. Journal of Clinical Pediatrics, 2026, 44(8): 690-697.
[3]	ZHANG Xiao, FANG Hongjun, KUANG Xiaojun, WANG Lijuan, WU Zhao, JIANG Sha, LI Pei, WU Liwen. Analysis of the clinical and electrophysiological characteristics of atonic seizures in children [J]. Journal of Clinical Pediatrics, 2026, 44(8): 698-704.
[4]	WANG Mengqian, YANG Hui. Case series analysis of 13 intestinal Behcet’s syndrome in children [J]. Journal of Clinical Pediatrics, 2026, 44(8): 705-711.
[5]	WU Xirong, GAO Qi, GUO Siyuan, YIN Qingqin, QIN Qiang, YIN Ju, JIAO Anxia, CHEN Chenghao, WU Di, WANG Bei, DUAN Xiaomin, PENG Yun, XU Baoping, GAO Liwei. Clinical characteristics and prognosis of pulmonary mucormycosis in children with diabetes mellitus [J]. Journal of Clinical Pediatrics, 2026, 44(8): 712-720.
[6]	HAN Yanan, GE Lanlan, CUI Jieyuan. A case report of branchio-oto-renal syndrome caused by EYA1 gene variant with a 6-year follow-up [J]. Journal of Clinical Pediatrics, 2026, 44(8): 721-726.
[7]	SHI Jiayi, GAO Chunlin, JIA Lili, LU Yunyun, SUN Tao, ZHU Xiaodong, XIA Zhengkun, ZHANG Pei. Phenotypic characteristics and prognostic analysis of a pedigree with childhood isolated nephrotic syndrome caused by compound heterozygous mutations in the COQ2 gene [J]. Journal of Clinical Pediatrics, 2026, 44(8): 727-732.
[8]	CHENG Yuheng, XU Zizhao, CHEN Ying. Recent advances in the diagnosis and treatment of X-linked hypophosphatemic rickets [J]. Journal of Clinical Pediatrics, 2026, 44(8): 747-754.
[9]	Rachel Rosen, Osvaldo Borrelli, Christophe Faure, Katja Karrento, Usha Krishnan, Samuel Nurko, Nathalie Rommel, Alan Silverman, Michiel van Wijk, Marc Benninga (Author), Chinese Medical Association Parenteral and Enteral Nutrition Branch Pediatrics Group, The Subspecialty Group of Gastroenterology, The Society of Pediatric, Chinese Medical Association, Gastroenterology Group, Pediatrician Branch, Chinese Medical Doctor Association (Translator). Core interpretation and explanation of Rome Ⅴ diagnostic criteria: upper gastrointestinal disorders of gut-brain interaction in children and adolescents [J]. Journal of Clinical Pediatrics, 2026, 44(7): 595-608.
[10]	Carlo Di Lorenzo, Miguel Saps, Bruno P. Chumpitazi, Shaman Rajindrajith, Annamaria Staiano, Nikhil Thapar, Miranda van Tilburg, Carlos Velasco-Benítez, Arine Vlieger (Author), Chinese Medical Association Parenteral and Enteral Nutrition Branch Pediatrics Group, The Subspecialty Group of Gastroenterology, The Society of Pediatric, Chinese Medical Association, Gastroenterology Group, Pediatrician Branch, Chinese Medical Doctor Association (Translator). Core interpretation and explanation of Rome Ⅴ diagnostic criteria: lower and biliary disorders of gut-brain interaction in children and adolescents [J]. Journal of Clinical Pediatrics, 2026, 44(7): 609-621.
[11]	LI Xufeng, TANG Haoxun, LI Xingjun, ZHANG Lize, GAO Chenqing, ZHAO Shunying, LIU Jianhua. Clinical characteristics, chest CT imaging phenotypes, and their correlation with prognosis in 76 children with Chlamydia pneumoniae pneumonia [J]. Journal of Clinical Pediatrics, 2026, 44(7): 622-627.
[12]	WANG Zhen, SHAO Jingbo, ZHANG Na, XIA Min, ZHU Jiashi, DU Chengkan, LI Hong. Factors influencing long-term recurrence in pediatric acute lymphoblastic leukemia patients with low-risk disease at initial diagnosis: a five-year follow-up analysis of 254 cases from a single center [J]. Journal of Clinical Pediatrics, 2026, 44(7): 628-635.
[13]	GUO Xuemei, XUE Yao, WANG Yongren, RONG Liucheng, FANG Yongjun, LIN Rufeng. Clinical features and prognosis of childhood acute myeloid leukemia with CBFA2T3::GLIS2 fusion [J]. Journal of Clinical Pediatrics, 2026, 44(7): 636-643.
[14]	YANG Lijun, FU Dongxia, CUI Yan, YANG Junmei, ZHANG Liming. Clinical manifestation and genetic analysis of CHARGE syndrome caused by CHD7 gene variation [J]. Journal of Clinical Pediatrics, 2026, 44(7): 644-650.
[15]	HU Yan, YANG Fan, LIANG Aimin, MAO Meng. Identification and management of faltering growth in children: insights from the 13th International Conference on Nutrition and Growth [J]. Journal of Clinical Pediatrics, 2026, 44(6): 485-488.