Is a universal school entry hearing screen worthwhile?

Abstract

ObjectivesTo assess the effectiveness of a universal school entry hearing screen (sweep audiogram). MethodsInformation was obtained from the audiology service and Community Child Health records, if available, for children who had an abnormality detected by the screen. Questionnaires were sent to general practitioners to enquire about the subsequent management. ResultsOf the 4501 children screened, an abnormality was detected in 227 children.The yield for new, clinically significant bilateral sensorineural hearing losses requiring aiding was nil, whereas that for new [i.e. previously unknown to the Ear, Nose and Throat (ENT) department], significant cases of conductive hearing loss requiring surgical management was 0.5%. The response rate from the questionnaire was 81.3%. Eighty children were referred to ENT with a range of hearing loss of 11-50 decibels (dBHL) better ear average. This resulted in surgical management in 52. ConclusionWe found a small yield from the school entry screen, and, with a robust preschool service in place and effective reactive system for testing school age children, there may be justification for dismantling the school entry screen.

Current practice, accuracy, effectiveness and cost-effectiveness of the school entry hearing screen

“…19 At the time of that survey of 96 services, four services had discontinued their SES programme as a result of local audit. 20 In programmes where the SES was not carried out by dedicated screeners, competing programmes, such as immunisation, took priority over the SES, affecting its performance. There was also an awareness that information may have been incomplete as there were no available data from services that may have been provided by non-medical service leads.…”

“…The most common was that the screen effectively identifies children with hearing impairment; in general (38), impairment of late onset or acquired since the newborn screen (30), OME (20), unilateral (15) or unsuspected losses (seven). Other suggested benefits of the screen were that it could exclude hearing loss as a cause 13 2.77 0.72-7.56 of a child's difficulties (24) and that it raised awareness among teachers and parents and allowed surveillance (13).…”