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Published on: January 23, 2017
Ten-year outcome of newborn hearing screening in Austria
Viktor Weichbold1, Doris Nekahm-Heis, Kunigunde Welzl-Mueller
1Clinical Department of Hearing, Voice and Speech Disorders, Innsbruck Medical University, Austria. viktor.welchbold@uklibk.ac.at
Insights
The Austrian universal neonatal hearing screening (UNHS) program significantly improves early detection of congenital hearing loss. However, delays in diagnosis and intervention persist for some screened infants, necessitating program improvements.
Area of Science:
- Pediatrics
- Audiology
- Public Health
Background:
- Current healthcare standards advocate for congenital hearing loss confirmation by three months and intervention by six months.
- The Austrian universal neonatal hearing screening (UNHS) program, established in 1995, utilizes a two-stage transient oto-acoustic emissions screening approach.
- This study assesses the UNHS program's effectiveness in meeting established early detection and intervention timelines.
Purpose of the Study:
- To evaluate the Austrian universal neonatal hearing screening (UNHS) program's success in confirming congenital hearing loss by three months and initiating intervention by six months.
- To compare the timeliness of diagnosis and intervention between screened and unscreened children with hearing loss.
- To identify potential areas for improvement within the UNHS program.
Main Methods:
- A retrospective chart review and data analysis of children diagnosed with permanent congenital sensorineural hearing impairment since 1990.
- Inclusion of data from all Austrian institutions involved in childhood hearing loss diagnosis and treatment.
- Comparison of outcomes between children who underwent UNHS and those who did not, focusing on age at diagnosis and intervention.
Main Results:
- Data from 321 hearing-impaired children were analyzed; 167 were screened and 154 were not.
- By three months, hearing loss was diagnosed in 35% of screened children versus 2% of unscreened children.
- By six months, 61% of screened children received intervention compared to only 4% of unscreened children.
Conclusions:
- The Austrian UNHS program substantially increases early detection rates for congenital hearing loss.
- Despite screening, a notable percentage of infants experience delays in hearing loss confirmation and intervention.
- Further attention to the reasons for these delays is crucial to maximize the UNHS program's effectiveness.
Objective:
Current health care standards recommend that congenital hearing loss be confirmed before age three months and intervened for before age six months. This study evaluated to what extent the Austrian universal neonatal hearing screening (UNHS) program achieves this goal. The Austrian UNHS program is a hospital-based, two-stage screen based on transient oto-acoustic emissions, as promoted in 1995 in a position paper of the Austrian ENT Society.
Methods:
Retrospective chart review and data analysis. All Austrian institutions engaged in the diagnosis and treatment of childhood hearing loss were requested to provide their data on children with permanent congenital sensorineural hearing impairment registered since 1990. Children who had undergone hearing screening, were compared to those who had not. Main outcome measures were age at confirmation of and age at intervention for the hearing loss. In each group, the percentage of children, whose hearing loss was confirmed by age three months, and intervened for by age six months, was determined.
Results:
Data from 321 hearing-impaired children were useable. Of these children, 167 were screened and 154 were not. At age three months, a hearing loss was diagnosed in 35% of screened children, but in only 2% of unscreened. These percentages rose to 69% and 6%, respectively, at age six months and to 81% and 12%, respectively, at age one year. Intervention mostly started within less than one month after diagnosis. At age six months, 61% of screened children, but only 4% of unscreened children, had undergone intervention.
Conclusions:
Hearing screening enormously increases the number of early-detected children. However, in quite a few screened children hearing loss is neither confirmed within three months after birth, nor intervened for within six months after birth. Reasons for the delay must be paid attention in order to warrant that UNHS can be as effective as possible.
