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Universal neonatal hearing screening: past, present, and future
G T Mencher1, A C Davis, S J DeVoe
1MRC Institute of Hearing Research, Nottingham University, United Kingdom. mencher@is.dal.ca
Insights
Implementing universal newborn hearing screening requires addressing critical issues like target populations and false-positive management. A UK study highlights a gap between audiology standards and practice, urging caution for US universal screening initiatives.
Area of Science:
- Audiology
- Neonatal Care
- Public Health
Background:
- Historical context of newborn hearing screening methods.
- Introduction of otoacoustic emissions and behavioral testing.
- Emerging trends toward universal screening programs.
Purpose of the Study:
- To review historical newborn hearing screening methods.
- To identify key issues before universal screening implementation.
- To analyze audiology service preparedness for universal screening.
Main Methods:
- Historical review of screening techniques.
- Discussion of critical issues: target population, false positives, resources.
- Analysis of a UK study on audiology service delivery.
Main Results:
- A UK study revealed discrepancies between audiology standards and actual practice.
- Significant issues remain unresolved before widespread adoption of universal screening.
- Current US trends may outpace clinical center preparedness.
Conclusions:
- Universal newborn hearing screening necessitates careful planning and resource allocation.
- Addressing false-positive impacts and parent-child relationships is crucial.
- Caution is advised for the US to ensure readiness for universal screening programs.
Abstract:
After a brief review of the history of newborn hearing screening including the Downs behavioral testing procedure, the Crib-o-gram and similar devices, and the use of auropalpebral reflex and otoacoustic emissions, there is a discussion of key issues that need to be resolved before universal hearing screening is introduced. Included are questions regarding the target population(s) of screening programs, well baby versus NICU screening, dealing with false-positives and the effects on parent-child relationships, and finally, the availability of resources for screening and follow-up. The results of a recent study in the United Kingdom that assessed the current state of audiology services and found there is a difference between existing standards and what is actually being done in practice, are presented and considered in terms of current trends in the United States to move ahead with universal screening without a solid database of information regarding the preparedness of clinical centers to deal with the need for services that will result from the initiation of universal programs. Caution is urged.
