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      Performance and characteristics of the Newborn Hearing Screening Programme in England: The first seven years

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          Abstract

          Objective: To assess the performance of the universal newborn hearing screen in England. Design: Retrospective analysis of population screening records. Study sample: A total of 4 645 823 children born 1 April 2004 to 31 March 2013. Results: 97.5% of the eligible population complete screening by 4/5 weeks of age and 98.9% complete screening by three months of age. The refer rate for the 12/13 birth cohort is 2.6%. The percentage of screen positive (i.e. referred) babies commencing follow up by four weeks of age and six months of age is 82.5% and 95.8% respectively. The yield of bilateral PCHL from the screen is around 1/1000. For bilateral PCHL in the 12/13 birth cohort the median age is nine days at screen completion, 30 days at entry into follow up, 49 days at confirmation, 50 days at referral to early intervention, and 82 days at hearing-aid fitting. Conclusion: The performance of the newborn hearing screening programme has improved continuously. The yield of bilateral PCHL from the screen is about 1/1000 as expected. The age of identification and management is well within the first six months of life, although there remains scope for further improvement with respect to timely entry into follow up.

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          Newborn hearing screening programs: overview.

          Implementation of systematic programs for early identification of hearing impairment in the newborn and infant is increasing in Canada and worldwide. This article outlines the rationale for these programs, methods of screening, audiologic assessment and intervention, program outcomes and the crucial role of physicians. Sources of high-quality, current evidence on key aspects of these programs are identified. There is an emerging, evidence-based consensus that a systematic approach based on universal newborn hearing screening (UNHS) and timely, appropriate follow-up services is practicable and will yield substantial net benefit for many affected children and families. Early identification programs lead to physicians being faced with infants under six months of age who already have detailed and accurate audiometry. Important challenges include a systematic approach to etiologic evaluation of the young infant with permanent hearing impairment and the facilitation of prompt, non-medical interventions.
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            Newborn hearing screening and follow-up: are children receiving recommended services?

            Newborn hearing screening programs have been implemented by all 50 states and most U.S. territories to detect hearing loss in infants and prevent delays in speech, language, and social and emotional development. To monitor progress toward national goals, the Centers for Disease Control and Prevention (CDC) collects data from state and territorial programs. This article summarizes findings from the CDC Early Hearing Detection and Intervention (EHDI) Hearing Screening and Follow-up Survey (HSFS) and provides a summary of recent efforts to identify infants with hearing loss in the U.S. The HSFS was sent to representatives of U.S. EHDI programs to gather aggregate screening, diagnostic, intervention, and demographic data for 2005 and 2006. We analyzed these data to evaluate progress toward national goals. In 2005 and 2006, more than 90% of infants were screened for hearing loss. Of these infants, 2% in both years did not pass their final screening. Out of those not passing the final screening, approximately two-thirds were not documented as having a diagnostic finding. In both years, the reason reported for the majority of infants was loss to follow-up/loss to documentation (LFU/LTD). Although the majority of infants with permanent hearing loss were receiving intervention, more than 30% were classified as LFU/LTD and could not be documented as receiving intervention services. The HSFS enables the collection of more complete data that highlight the progress in screening infants for hearing loss. However, data indicate improvements are needed to reduce LFU/LTD and meet the national benchmarks.
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              Age of suspicion, identification, and intervention for infants and young children with hearing loss: a national study.

              This study was designed to seek a nationwide perspective on the status of identification and intervention for infants and young children with hearing loss. Three hundred thirty-one parents, whose children ranged from infancy to 5 yr of age, returned a mail survey that included respondents from 35 states. Parents were asked to report the approximate age of suspicion, diagnosis, hearing aid fitting, and initiation of early intervention services. Demographic information, risk factors, if known, and reasons for delay were also investigated. Results revealed substantial delays between parental suspicion, audiologic-medical diagnosis, fitting of acoustic amplification, and initiation of early intervention services; however, the pattern of delay was different for children with known risk factors than it was for those without known risk factors. The median age of identification and intervention was lower than that reported by some previous investigators, although a considerable range was reported for each category. The median age of identification and intervention, although still higher than optimal, may be improving. Further research is needed to identify the many factors that continue to delay the timely management of hearing loss in young children.
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                Author and article information

                Journal
                Int J Audiol
                Int J Audiol
                IIJA
                iija20
                International Journal of Audiology
                Taylor & Francis
                1499-2027
                1708-8186
                3 June 2015
                13 March 2015
                : 54
                : 6
                : 353-358
                Affiliations
                [ a ] *NHS Newborn Hearing Screening Programme, Public Health England , London, UK
                [ b ]Formerly of NHS Newborn Hearing Screening Programme, Public Health England , London, UK
                Author notes
                Correspondence: Sally Wood, NHS Newborn Hearing Screening Pogramme, National Screening Programme Office , Skipton House, 80 London Rd, London, SE1 6LH, UK. E-mail: Sally.wood@ 123456phe.gov.uk
                Article
                989548
                10.3109/14992027.2014.989548
                4487563
                25766652
                8d488f5b-2f8d-46c7-a7c2-1649e6cf59fa
                © 2015 British Society of Audiology, International Society of Audiology, and Nordic Audiological Society

                This is an open-access article distributed under the terms of the CC-BY-NC-ND 3.0 License which permits users to download and share the article for non-commercial purposes, so long as the article is reproduced in the whole without changes, and provided the original source is credited.

                History
                : 30 June 2014
                : 9 November 2014
                Page count
                Figures: 5, Tables: 1, Equations: 0, References: 35, Pages: 6
                Categories
                Original Article

                Audiology
                newborn hearing screening,coverage,refer rate,follow up,yield,permanent childhood hearing loss,positive predictive value

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