Identifying deafness in early childhood: requirements after the newborn hearing screen

TLDR

Newborn hearing screening is nationally implemented, yet longitudinal follow‑up is needed to guide postneonatal care pathways. The study followed a 10‑year cohort of 35,668 births from universal neonatal hearing screening through the first year of primary school. Among these children, 3.65 per 1,000 had permanent hearing impairment, but only 0.9 per 1,000 of moderate‑to‑severe bilateral deafness were detected by newborn screening; postneonatal pathways identified an additional 0.11, 0.25, and 0.25 per 1,000 for missed congenital, district‑moving, and late‑onset cases, respectively, and yielded 1.2 per 1,000 mild/unilateral cases, meaning 51 % of all permanent impairments required postneonatal identification.

Abstract

<h3>Background</h3> Newborn hearing screening has been nationally implemented, but longitudinal cohort follow-up is required to inform Children9s Hearing Services of the requirements for postneonatal care pathways. <h3>Methods</h3> A 10-year cohort of 35 668 births enrolled into a Universal Neonatal Hearing Screen was followed up until the children had completed the first year of primary school. <h3>Results</h3> There were 3.65/1000 children with a permanent hearing impairment of any degree embarking on their education. 1.51/1000 had a moderate or worse bilateral deafness but only 0.9/1000 with this degree of deafness had been identified by newborn screening. Postneonatal care pathways were required to identify those with congenital impairments missed by the screen (0.11/1000), those moving into the district (0.25/1000) and those with late onset deafness (0.25/1000). An additional postneonatal yield of 1.2/1000 had mild or unilateral impairments. When all degrees of impairment were considered 51% of the children with a permanent hearing impairment had required identification by postneonatal care pathways. <h3>Conclusions</h3> Despite the success of the newborn hearing screen, the provision of postneonatal pathways remains essential for identifying deafness in early childhood.