Neonatal screening recommended for hearing impairmentBMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7119.1327j (Published 22 November 1997) Cite this as: BMJ 1997;315:1327
A national neonatal screening programme could identify children with a hearing impairment at a younger age and have a higher rate of detection than the distraction test currently used.
According to a report from the National Coordinating Centre for Health Technology Assessment, about 840 children are born in Britain every year with clinically significant permanent hearing impairment, and by 18 months of age 400 of these children will have been missed by current detection methods.
Professor Adrian Davis, senior scientist at the Medical Research Council's Institute of Hearing Research in Nottingham, and his team reviewed published and unpublished literature, surveyed current preschool hearing provision in Britain, and organised focus groups before concluding that universal neonatal screening has a lower cost and a higher sensitivity than the health visitors' distraction test.
The researchers found that the average age of detection was 26 months in those children screened by health visitors, with intervention at around 32 months. By contrast, neonatal screening programmes—available in two districts in Britain—resulted in intervention within six months, reducing the delay in development of communication skills.
The report recommends that the National Screening Committee should urgently address the need for a national screening programme for congenital hearing impairment, develop an adequate follow up system, and organise a model screening programme. Electronic tests are now available in the first week of life and have 95% specificity and around 90% sensitivity.
Undetected hearing impairment is a source of anguish for both children and parents, who often have difficulty in convincing health workers of their concerns. Susan Daniels, chief executive of the National Deaf Children's Society, said: “Parents unanimously agree that the earlier they know about their child's hearing loss the better for the child and for the whole family. But their experiences of aftercare to date leave them highly sceptical about the provision of adequate support services thereafter. The National Deaf Children's Society welcomes this report.”
A Critical Review of the Role of Neonatal Hearing Screening in the Detection of Congenital Hearing Impairment is available from the National Coordinating Centre for Health Technology Assessment, University of Southampton, Southampton SO16 7PX, price £50.