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What is the role of the distraction test of hearing?
Insights
The infant hearing distraction test in Bristol over-identifies minor hearing loss, delaying diagnosis for children with severe sensorineural hearing loss (SNHL). This screening method is no longer effective for identifying SNHL.
Area of Science:
- Audiology
- Pediatric Health
- Public Health Screening
Background:
- Infant hearing screening is crucial for early detection and intervention.
- The distraction test has been a common method for assessing hearing in infants.
- Accurate data recording is essential for effective public health screening programs.
Purpose of the Study:
- To evaluate the effectiveness of the distraction test for infant hearing loss screening in Bristol.
- To assess the accuracy of screening and referral rates generated by the National Child Health Computer.
- To determine the test's ability to identify significant hearing impairments, particularly sensorineural hearing loss (SNHL).
Main Methods:
- Review of the distraction test's use within the Bristol and District Health Authority.
- Analysis of data recording accuracy and its impact on screening outcomes.
- Follow-up investigations of children who failed the distraction test and those identified with hearing aids.
Main Results:
- Inaccuracies in data recording were identified, questioning the reliability of reported screening and referral rates.
- Of 130 children failing the distraction test, only 35% had moderate conductive hearing loss; none had severe loss.
- The test identified only 21% of children with sensorineural hearing loss (SNHL) requiring hearing aids, with 15% presenting late.
Conclusions:
- The current distraction test in Bristol identifies a high number of infants with minor hearing issues.
- Referrals for these minor cases create delays in secondary services for infants with more significant hearing loss.
- The distraction test is no longer the primary or most effective method for detecting SNHL in infants.
Abstract:
The use of the distraction test as a screen for hearing loss in infancy was reviewed in the Bristol and District Health Authority. Inaccuracies in data recording were found which challenged the screening and referral rates produced by the National Child Health Computer. Representative samples of children failing the distraction test and children needing hearing aids were followed up through the screening process. Of 130 children failing the test, only 46 (35%) had moderate conductive hearing loss and none had a severe loss. Of 34 children with sensorineural hearing loss (SNHL) requiring hearing aids, seven (21%) were identified by the test and five (15%) presented late after having been screened. The distraction test as now used in Bristol identifies large numbers of children with minor hearing loss. The referral of these children to the secondary services leads to delays for those children with more significant loss. The test is no longer the main method for identifying children with SNHL.