The longitudinal follow up of a universal neonatal hearing screen: The implications for confirming deafness in childhood

TLDR

The study aims to assess how universal neonatal hearing screening influences early confirmation of childhood deafness. Researchers followed three 10‑year cohorts—35,668 infants screened universally, 31,538 without neonatal screening, and 32,890 with targeted screening—to compare deafness confirmation rates at school age. Universal screening identified 3.65 per 1,000 children as deaf by school age, achieved 89% sensitivity for moderate‑to‑severe cases, and reduced the median confirmation age from 218 to 16 weeks, yet post‑neonatal identification still relies on reactive referral and needs further improvement.

Abstract

Objective: To examine the implications of universal neonatal screening for confirming deafness in early childhood. Design: A cohort that had received a universal neonatal hearing screen was followed-up until school entry, and confirmation of deafness compared with that from parallel cohorts that had not received the screen. Study: Three 10-year cohorts were compared: a cohort of 35 668 enrolled for universal neonatal hearing screening, a historical cohort of 31 538 when neonatal screening was unavailable, and a cohort of 32 890 when targeted screening was in place. Results: Prevalence of deafness by school age was 3.65/1000 with a neonatal yield of 1.79/1000. The screen had been 89% sensitive to moderate and worse deafness, 79% to unilateral deafness, and 49% to mild impairments. The median age of confirmation had been reduced from 218 to 16 weeks, but for those not identified neonatally there had been no significant improvement in the age of confirmation over the previous 25 years. The yield from post-neonatal screens had been reduced from 1.8/1000 to 0.2/1000, and with a yield of 0.8/1000, reactive referral remained a more effective route to identification. Conclusions: Even with UNHS in place post-neonatal routes to identification need to be maintained and improvements investigated.