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Identifying deafness in early childhood: requirements after the newborn hearing screen
1Whipps Cross University Hospital, Leytonstone, London, UK. peter.watkin@whippsx.nhs.uk
Insights
Newborn hearing screening is effective, but postneonatal care pathways are essential for identifying all cases of childhood deafness, including late-onset and missed impairments.
Area of Science:
- Audiology
- Pediatric Health
- Public Health
Background:
- National newborn hearing screening programs are established.
- Longitudinal data is needed to optimize pediatric hearing care pathways.
Purpose of the Study:
- To determine the necessity of postneonatal care pathways for identifying childhood hearing loss.
- To quantify the yield of different hearing impairment types identified post-newborn screening.
Main Methods:
- A 10-year cohort study followed 35,668 births.
- Children were tracked until the first year of primary school.
Main Results:
- 3.65/1000 children had permanent hearing impairment at school entry.
- Postneonatal pathways identified 51% of all permanent hearing impairments, including missed congenital, late-onset, and mild/unilateral cases.
- Newborn screening identified only 0.9/1000 moderate or worse bilateral deafness, with pathways identifying an additional 0.61/1000.
Conclusions:
- Postneonatal care pathways are crucial for comprehensive childhood hearing loss detection.
- These pathways complement newborn screening by identifying impairments missed or developing later.
Background:
Newborn hearing screening has been nationally implemented, but longitudinal cohort follow-up is required to inform Children's Hearing Services of the requirements for postneonatal care pathways.
Methods:
A 10-year cohort of 35 668 births enrolled into a Universal Neonatal Hearing Screen was followed up until the children had completed the first year of primary school.
Results:
There were 3.65/1000 children with a permanent hearing impairment of any degree embarking on their education. 1.51/1000 had a moderate or worse bilateral deafness but only 0.9/1000 with this degree of deafness had been identified by newborn screening. Postneonatal care pathways were required to identify those with congenital impairments missed by the screen (0.11/1000), those moving into the district (0.25/1000) and those with late onset deafness (0.25/1000). An additional postneonatal yield of 1.2/1000 had mild or unilateral impairments. When all degrees of impairment were considered 51% of the children with a permanent hearing impairment had required identification by postneonatal care pathways.
Conclusions:
Despite the success of the newborn hearing screen, the provision of postneonatal pathways remains essential for identifying deafness in early childhood.
