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Updated: Jul 15, 2026
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Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
Early hearing screening: what is the best strategy?
Catherine Kolski1, Barbara Le Driant, Philippe Lorenzo
1University Hospital of Picardy, Department of Otorhinlaryngology, Place Victor Pauchet, 80000 Amiens, France. kolski.catherine@chu-amiens.fr
Summary
Universal newborn hearing screening is more effective than screening at two months. Newborn screening identifies more infants, reduces false positives, and minimizes negative impacts on maternal anxiety and parent-infant interactions.
Area of Science:
- Audiology
- Public Health
- Developmental Psychology
Background:
- Universal newborn hearing screening (UNHS) has been debated in France since the late 1990s.
- Two screening strategies exist: immediate (strategy 1) and at two months postpartum (strategy 2).
- Evaluating screening effectiveness and impact on parent-infant relationships is crucial for strategy selection.
Purpose of the Study:
- To compare the effectiveness of two hearing screening strategies in infants.
- To assess the impact of each strategy on the parent-infant relationship.
- To determine the optimal timing for newborn hearing screening implementation.
Main Methods:
- A study involving 5,790 infants: 3,202 in strategy 1 and 2,588 in strategy 2.
- 143 mother-infant pairs underwent psychological assessment for maternal anxiety and interaction quality.
- Comparison of screened infants, positive/false-positive rates, and follow-up adherence.
Main Results:
- Strategy 1 (newborn screening) showed significantly higher screening rates (95.72% vs. 64.18%) and lower false-positive rates (0.29% vs. 2.65%).
- Strategy 1 also had fewer infants lost to follow-up (8.8% vs. 38.5%).
- While screening itself had no impact, positive results significantly increased maternal anxiety and negatively affected interactions; UNHS minimizes this due to lower positive rates.
Conclusions:
- Universal newborn hearing screening (strategy 1) is the most efficient and effective approach.
- This strategy leads to better outcomes and fewer adverse psychological effects on families.
- UNHS is recommended for widespread implementation.
