Newborn Hearing Screening Challenges in 2013
Universal newborn hearing screenings (UNHS) have been tremendously successful. Yoshinaga-Itano (2013) reported in an American Academy of Audiology interview "some 98 or 99 percent of all children born in the United States are screened for hearing loss by age 1 month…." However, despite aggressive, appropriate, and successful implementation of UNHS, children may develop hearing loss after their UNHS. Dedhia et al (2013) report a group of patients with "later onset hearing loss" who (in general) are as of yet, not well studied. As anticipated, these children are later identified and diagnosed, and experience later intervention that may facilitate increased speech and language delay, as well as cognitive and social skill impairment.
The authors note that because UNHS is widely known to be highly effective, it may actually present parents, pediatricians, and family doctors with a false sense of security. Of the children who passed UNHS and were later identified as having hearing loss, the suspicion of hearing loss most often came from the parents, the second most common referral source were school screenings, third was from speech and language delays (prompting further investigation) and fourth was from primary care medical screenings.
Of note, of the children identified as having later onset hearing loss, the authors divided them into four general categories, 1- progressive or acquired hearing loss, 2- false-negative screening results, 3- false interpretation of screening (operator error), and 4- miscommunication/misinterpretation of results given to the family.
Dedhia et al note that some children with later onset hearing loss may be diagnosed very late. Within their study group, the mean age at time of diagnosis for children with severe-to-profound hearing loss was 4 years 7 months (range was from 1 month to 9 years 4 months). Of note, for lesser degrees of hearing loss the age at time of diagnosis was older. For children with moderate hearing loss the mean age at diagnosis was 5 years 6 months, and for children with mild hearing loss, the mean age at diagnosis was 6 years.
The authors conclude their study highlights the importance of knowing that passing UNHS does not guarantee normal hearing. Some children may have slight/mild hearing loss and may (therefore) pass the UNHS, and other children may develop hearing loss after their UNHS. They recommend parents and professionals should recommend audiologic testing in all children with speech and language delays, despite having passed UNHS.
For More Information, References, and Recommendations
Dedhia K, Kitsko D, Sabo D, Chi DH. (2013) Children With Sensorineural Hearing Loss After Passing the Newborn Hearing Screen. JAMA Otolaryngol Head Neck Surg 139(2).