Six year effectiveness of a population based two tier infant hearing screening programme

Area of Science:

• Audiology
• Public Health
• Pediatrics

Background:

• Congenital hearing impairment (CHI) affects infant development.
• Early diagnosis and intervention are crucial for managing CHI.
• Universal infant hearing screening programs aim to improve early detection rates.

Purpose of the Study:

• To evaluate the effectiveness of the Victorian Infant Hearing Screening Program (VIHSP) in reducing the median age of diagnosis for bilateral congenital hearing impairment (CHI) greater than 40 dB HL.
• To compare diagnosis ages and rates between pre- and post-implementation cohorts of the VIHSP in Victoria, Australia.

Main Methods:

• A comparative study of infant birth cohorts from 1989 (pre-VIHSP) and 1993 (post-VIHSP) in Victoria.
• The VIHSP employed a two-tier approach: risk factor ascertainment and universal distraction testing.
• Auditory brainstem evoked response (ABR) was used for high-risk infants, while others received distraction testing.

Main Results:

• The median age of diagnosis for CHI >40 dB HL decreased from 20.3 months (1989 cohort) to 14.2 months (1993 cohort).
• A significant increase in the diagnosis of severe CHI by 6 months of age was observed (21.7% in 1993 vs. 6.3% in 1989).
• Despite improvements in severe cases, overall results for moderate and profound CHI were disappointing, with no significant reduction in median diagnosis age.

Conclusions:

• The VIHSP successfully lowered the median age of diagnosis for severe congenital hearing impairment.
• The program facilitated earlier diagnosis for a greater number of infants with severe CHI.
• Overall program outcomes were considered disappointing, indicating a need for further improvements in early CHI detection.