Outcomes of an Early Childhood Hearing Screening Program in a Low-Income Setting

Area of Science:

• Pediatrics
• Audiology
• Public Health

Background:

• Early identification of childhood hearing loss is crucial to prevent speech, language, and developmental delays.
• Newborn hearing screening is standard, but many children develop postnatal hearing loss or are lost to follow-up.
• Preschool-based hearing screening programs offer a potential solution for identifying children with hearing impairments, but evidence on their effectiveness is limited.

Purpose of the Study:

• To evaluate the outcomes of a hearing screening program implemented in low-income, urban public preschools.
• To identify risk factors associated with hearing loss in preschool-aged children within this population.

Main Methods:

• A retrospective cohort study analyzed data from 6820 children aged 2-6 years screened between 2015 and 2019.
• A two-tiered screening approach using conditioned play pure-tone audiometry (CPA) and distortion product otoacoustic emissions (OAEs) was employed.
• Multivariate logistic regression was used to determine risk factors for hearing loss.

Main Results:

• The screening program achieved a 99.6% completion rate.
• 5.9% of children were referred for further evaluation, with a final diagnosis of hearing loss in 13.6% of those evaluated.
• The prevalence of conductive hearing loss was 2.9%, and sensorineural hearing loss was 0.2%.
• No significant association was found between primary language, race, ethnicity, sex, and referral or hearing loss rates.

Conclusions:

• Preschool-based hearing screening programs are effective in identifying early childhood hearing loss.
• Teacher concerns were found to be associated with the final diagnostic hearing status of children.
• These programs are valuable for early detection and intervention, mitigating potential developmental delays.