Targeted surveillance for postnatal hearing loss: a program evaluation.

Area of Science:

• Pediatric audiology
• Public health surveillance
• Early childhood development

Background:

• Effective monitoring of early childhood hearing is crucial but lacks evidence-based methods post-newborn screening.
• A risk factor registry approach was explored to identify children with postnatal hearing loss.

Purpose of the Study:

• To describe a targeted surveillance program utilizing a risk factor registry.
• To identify children with postnatal hearing loss after initial newborn screening.

Main Methods:

• A cohort of children born in Queensland (2004-2009) with a 'pass' on newborn hearing screening and at least one risk factor were included.
• Children underwent targeted surveillance assessments throughout early childhood per diagnostic protocols.

Main Results:

• 7320 children were referred; 56 (0.77%) had postnatal hearing loss (mild and sensorineural most common).
• Syndromes, craniofacial anomalies, and severe asphyxia showed higher yields; low birth weight and meningitis had low yields.
• Program limitations included a 32.4% lost contact rate, assessment delays, and extensive testing on normal-hearing children. Indigenous children had higher lost contact rates.

Conclusions:

• The targeted surveillance program detected postnatal hearing loss but demonstrated significant limitations.
• Revisions to assessment time frames, procedures, and discharge criteria are needed for program viability.
• Further examination of individual and combined risk factors is recommended to improve postnatal hearing loss detection.