Early detection of childhood hearing impairment was associated with higher scores for language but not for speech in midchildhood.

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Behaviour problems are found more commonly in children with hearing loss and the level of behaviour problems is highest amongst those children with hearing loss with the least developed language capabilities.

The mean societal cost in the preceding year of life at 7 to 9 years of age was 14092.5 pound sterling for children with PCHI, compared with 4206.8 pound sterling for the normally hearing children, a cost difference of 9885.7 pound sterling. After adjusting for severity and other potential confounders in a linear regression model, mean societal costs among children with PCHI were reduced by 2553 pound sterling for each unit increase in the z score for receptive language. Using similar regression models, exposure to a program of UNS was associated with a smaller cost reduction of 2213.2 pound sterling, whereas costs were similar between children whose PCHI was confirmed at <9 or >9 months. CONCLUSIONS. The study provides rigorous evidence of the annual health, social, and broader societal cost of bilateral PCHI in the preceding year of life at 7 to 9 years of age and shows that it is related to its severity and has an inverse relationship with language abilities after adjustment for severity.

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Early management of permanent childhood hearing impairment results in improved language. Family participation is also an important factor in cases that are confirmed late, especially for children with severe or profound permanent childhood hearing impairment.

From a cohort of 10 686 live births, 322 (3%) were identified as being at risk of a hearing impairment defined as moderate, or worse. These neonates were screened by measurement of auditory brainstem responses. The neonatal at risk screening programme was effective in terms of both yield and cost. The mean age at which hearing aids were fitted was 6 months in the children identified by the neonatal screen. Such a programme is both practicable and useful in a district general hospital. The yield from the neonatal programme was, however, only 43% of the total number of deaf children eventualiy identified from the cohort. The need to identify more deaf children by a sensitive infant distraction test screening programme remains.

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