Hearing Screening in Newborns -- the Sooner, the Better

Children with permanent hearing impairment who received screening as newborns demonstrated better developmental outcomes and quality of life at ages three to five years than those who received hearing screening through behavioral testing, according to a study published in the Journal of the American Medical Association.

Auditory input is essential for developmental functioning, and awareness of a child’s hearing ability is critical in creating opportunities for early amplification when necessary, said Anna M. H. Korver, MD, PhD, of Leiden University Medical Center, lead author of the study. Although several countries have implemented newborn hearing screening programs, because of the potential benefits of early detection, no strong evidence had existed to support universal introduction of newborn hearing screening.

With that in mind, Korver and colleagues for the DECIBEL Collaborative Study Group studied the association between developmental outcomes and newborn hearing screening compared with distraction hearing screening in 3- to 5-year-old children with permanent childhood hearing impairment. Between 2002 and 2006, 65 regions in the Netherlands replaced distraction hearing screening with newborn hearing screening. The type of screening offered, according to researchers, was based on availability at the place and date of birth, and was independent of developmental prognoses of individual children. All children born in the Netherlands between 2003 and 2005 were included in the study, and all children with permanent childhood hearing impairment were identified between the ages of three and five.

During the study period, 335,560 children were born in a region where newborn hearing screening was offered and 234,826 in a region where distraction hearing screening was offered. At follow-up, 263 children in a newborn hearing screening region had been diagnosed with permanent childhood hearing impairment and 171 children in a distraction hearing screening region.

A total of 301 children (69.4%) participated in analysis of general performance measures; the two groups (newborn hearing screening and distraction hearing screening) were comparable in degree of hearing impairment and type of education. Analysis of extensive developmental outcomes, which included 80 children born in newborn hearing screening regions and 70 in distraction hearing screening regions, showed that overall, children in newborn hearing screening regions had higher developmental outcome scores in terms of social development, gross motor development, and quality of life.

The researchers concluded that “compared with distraction hearing screening, a newborn hearing screening program was associated with better developmental outcomes at age 3 to 5 years among children with permanent childhood hearing impairment.”

These results “add evidence to the presumed importance and effectiveness of the implementation of universal newborn hearing screening programs. Because this study was performed nationwide, among all children born in the Netherlands in 3 subsequent years, we believe our results can be generalized to other countries with universal hearing screening programs, but the feasibility and effectiveness of newborn hearing screening programs in other countries remain to be studied,” said the authors in an online article.

To access the JAMA study, click here.

Would you be in favor of the implementation of universal hearing screening programs for newborns in the US? What are the potential risks of these types of tests?