The Effectiveness of Screening Programs Based on High-Risk Characteristics in Early Identification of Hearing Impairment

TLDR

Prompt identification of educationally significant hearing loss remains a challenge, but evidence suggests that birth certificate‑based high‑risk registries can improve early detection. The study evaluates the efficiency of birth certificate‑based screening programs and considers broader implementation with enhanced parent and provider education. The authors surveyed 70 parents/guardians of 6‑9‑year‑old children with significant sensorineural losses born during the program’s operation to assess identification history. Children with at least one risk factor were identified on average 7.7 months earlier, yet only 50 % of affected children had risk factors and many at‑risk children were missed; including NICU admission as a risk factor would have captured 63 %.

Abstract

Prompt identification of educationally significant hearing loss is yet an unattained goal. However, there is some evidence that the ability to identify and diagnose hearing loss at an early age has been significantly improved through the use of carefully designed screening protocols such as birth certificate-based high-risk registries. To evaluate the efficiency of birth certificate-based screening programs, 70 parents and guardians of 6- to 9-yr-old children with significant sensorineural losses were surveyed regarding their child's identification history. Each of these children was born in the state during the time a birth certificate-based screening program was in full operation. Results indicate that children with at least one risk factor for hearing impairment were identified an average of 7.7 mo earlier than children with no risk history. However, only 50% of the children with sensorineural hearing losses exhibited any of the risk factors and a significant number of children with risk factors were missed by the system. Had admission to a neonatal intensive care unit been considered a risk factor, 63% of the children would have exhibited at least one risk factor. More extensive implementation of high-risk registries in conjunction with more widespread education of parents and primary care providers regarding early behavioral indicators of hearing loss, procedures for referral, and appropriate intervention and management services needs to be considered (Ear Hear 12 5312-319).