Post‐natal hearing loss in universal neonatal hearing screening communities: Current limitations and future directions

Abstract

Universal hearing screening has dramatically improved outcomes for babies born with detectable hearing abnormalities; yet there are some infants who develop significant hearing problems after passing a neonatal screen. There is much conjecture as to the number and the characteristics of infants with post-natal hearing losses; yet evidence suggests that many children may be affected, and that a large proportion have no discoverable cause. Currently, screening programmes use lists of risk factors to enroll babies into surveillance programmes. This practice is problematic because audiological follow-ups are expensive and under-utilised, and parental disclosure is often inaccurate. The large databases from universal neonatal programmes could inform the development of effective, evidence-based practice and policy for the detection and intervention of children who develop post-natal hearing losses.

Is Hearing Loss in Infants Associated With Risk Factors? Evaluation of the Frequency of Risk Factors

“…Risk factors are only as useful as their predictive power. Many children have ototoxic medications while in neonatal intensive care, or have a family history of hearing loss, but very few of these develop a problem [12]. …”

Children With Sensorineural Hearing Loss After Passing the Newborn Hearing Screen

“…12 In our study, we describe children who have passed both OAE and/or ABR screening tests but then were found to have SNHL.…”

Timeliness of Service Delivery for Children With Later-Identified Mild-to-Severe Hearing Loss

“…There is evidence that a substantial number of children with permanent HL are identified after the neonatal period (Dedhia, Kitsko, Sabo, & Chi, 2013; Hutt & Rhodes, 2008). Watkin and Baldwin (2011) conducted a cohort study over a 10-year period in Great Britain, after initiation of UNHS.…”

“…These risk factor registries can be used to identify babies who should be targeted for ongoing hearing monitoring, but in practice these registries are not very effective (Beswick, Driscoll, & Kei, 2012; Beswick, Driscoll, Kei, & Glennon, 2012; Hutt & Rhodes, 2008). In the second case, some children are missed by NHS, in particular those with low frequency HL and/or minimal/mild degrees of HL (Davis, Reeve, Hind, & Bamford, 2001).…”