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Screening for hearing loss in childhood: issues, evidence and current approaches in the UK
John Bamford1, Kai Uus, Adrian Davis
1Audiology & Deafness Group, School of Psychological Sciences, The University of Manchester, UK. john.bamford@manchester.ac.uk
Insights
The UK replaced the infant distraction test with universal newborn hearing screening (NHSP) to improve early detection of congenital hearing loss. This program aims for earlier identification and intervention for permanent childhood hearing impairment.
Area of Science:
- Audiology
- Public Health
- Pediatrics
Background:
- Historically, childhood hearing loss screening in the UK relied on an infant distraction test and a school entry screen.
- The infant distraction test showed underperformance, prompting a review of screening methodologies.
- Emerging evidence highlighted the critical importance of early identification and intervention for permanent congenital hearing loss.
Purpose of the Study:
- To evaluate the effectiveness of the initial phase of England's national newborn hearing screening programme (NHSP).
- To summarize evidence on the transition from the infant distraction test to universal newborn hearing screening.
- To identify unresolved issues in childhood hearing loss management and screening.
Main Methods:
- Review of evidence on the efficacy of universal newborn hearing screening.
- Analysis of the implementation and initial outcomes of the NHSP in England.
- Identification of ongoing research addressing persistent challenges in childhood hearing loss.
Main Results:
- The national newborn hearing screening programme (NHSP) was implemented to replace the underperforming infant distraction test.
- The initial phase of the NHSP, completed in 2005, provided data on the effectiveness of this new screening approach.
- Evidence supports the efficacy of universal newborn hearing screening for early detection of permanent congenital hearing loss.
Conclusions:
- The shift to universal newborn hearing screening (NHSP) represents a significant advancement in detecting childhood hearing loss early.
- Key issues such as late-onset hearing loss, mild/unilateral impairments, and the role of school entry screening require further investigation.
- Ongoing research is crucial for optimizing intervention and management strategies for all types of childhood hearing loss.
Abstract:
Until recently, screening for childhood hearing loss in the UK was based on two universal (i.e. whole population) screens: the infant distraction test screen at age eight months and the school entry hearing screen at age four to five years. Evidence reviewed in the 1990s indicated that the infant distraction test screen was seriously underperforming, but that (based on technology that had become available in the 1980s and 1990s) universal newborn hearing screening could be efficacious. At the same time, evidence was emerging on the importance and value of very early identification and intervention for permanent congenital childhood hearing loss. This led to the decision to implement a national newborn hearing screening programme (NHSP) in England and to phase out the distraction test at eight months. The initial implementation of the programme will be completed in 2005, and we summarize the evidence on the effectiveness of the first phase of the programme here. A number of important issues concerning childhood hearing loss and its management remain unresolved: the burden of late-onset and temporary childhood hearing losses, the most effective approaches to intervention and management, the case for screening for mild and/or unilateral hearing loss, and the role of the School entry screen. Some of the current research efforts to address these are outlined.
