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Universal newborn hearing screening in Zefat, Israel: the first two years
Peter Gilbey1, Carmi Kraus, Reem Ghanayim
1The Otolaryngology, Head & Neck Surgery Unit, Ziv Medical Center, Zefat, Israel. peter.g@ziv.health.gov.il
Insights
Early newborn hearing screening is crucial for development. This study evaluated Israel's new universal newborn hearing screening program, finding it nearly meets but has not yet achieved optimal performance benchmarks.
Area of Science:
- Pediatric audiology
- Public health initiatives
- Neonatal care
Background:
- Untreated congenital hearing loss negatively impacts child development.
- Early detection and intervention by 6 months significantly improve outcomes.
- A universal newborn hearing screening program was mandated in Israel starting January 1, 2010.
Purpose of the Study:
- To evaluate a new universal newborn hearing screening program.
- To assess the program's performance against established benchmarks.
- To identify areas for improvement in early hearing detection.
Main Methods:
- A two-stage screening protocol using otoacoustic emissions and automated auditory brainstem response.
- Review of screening data for neonates born between March 15, 2010, and December 31, 2011.
- Comparison of program metrics to expert-defined performance benchmarks.
Main Results:
- Screening coverage reached 94.8% (5212 of 5496 live births).
- 5.18% (270 neonates) were referred for diagnostic testing.
- The program demonstrated high initial screening rates.
Conclusions:
- The newborn hearing screening program is approaching, but not yet meeting, quality benchmarks.
- Completing screenings before hospital discharge is recommended.
- Active parental engagement in early detection is vital.
Objective:
Unidentified hearing loss at birth can adversely affect speech and language development as well as academic achievement and social-emotional development. Historically, moderate-to-severe hearing loss in young children was not detected until well beyond the newborn period. Around 0.5 to 5 in every 1000 neonates and infants have congenital or early childhood onset sensorineural hearing impairment. When identification and intervention occur at no later than 6 months of age, the infants perform much higher on school-related measures. Therefore, early detection is vitally important. Toward the end of 2009, the Israeli ministry of health issued a directive establishing a universal newborn hearing screening program in all hospitals in the country from 01.01.10. The objectives of this study are to evaluate a newly established universal newborn hearing screening program, to assess performance and to compare measurements of performance to performance benchmarks representing a consensus of expert opinion. The benchmarks are the minimal requirements that should be attained by high-quality early hearing detection programs.
Methods:
As specified by the ministry of health, a two-stage screening protocol was implemented using otoacoustic emissions and automated auditory brainstem response. Screening results of all neonates born from the initiation of the program on 15th March 2010 until the end of 2011 were reviewed.
Results:
The total number of live births during the study period was 5496. Of these, 5334 (97%) started screening for hearing loss but only 5212 completed the screening process, giving a screening coverage of 94.8%. Of the 5212 neonates completing the screening process, 270 (5.18%) were referred for full diagnostic testing.
Conclusions:
The newly established universal newborn hearing screening program at the Ziv Medical Center in Zefat closely approaches, but does not yet meet the minimal requirements that should be attained by high-quality early hearing detection programs. Every effort should be made to complete the screening tests before discharge from hospital. Screening staff should actively encourage parents to participate in all stages of early detection.
