Universal newborn hearing screening improves quality of life for children with permanent hearing impairment
Article Outline
- Question
- Design
- Setting
- Participants
- Intervention
- Outcomes
- Main Results
- Conclusions
- Commentary
- References
- Copyright
Korver AM, Konings S, Dekker FW, Beers M, Wever CC, Frijns JH, et al. Newborn hearing screening vs later hearing screening and developmental outcomes in children with permanent childhood hearing impairment. JAMA 2010;304:1701-8.
Question
Among infants, does newborn hearing screening compared with distraction hearing screening conducted at 9 months of age, result in improvements in development, spoken communication, and quality of life?
Design
Population-based cohort study.
Setting
The Netherlands.
Participants
All children (N = 335 560 in newborn screening region and N = 234 826 in distraction hearing screening region) born in The Netherlands between 2003 and 2005.
Intervention
Between 2002 and 2006, all 65 regions in The Netherlands replaced distraction hearing screening with newborn hearing screening. At 3 to 5 years of age, all children with permanent childhood hearing impairment were identified.
Outcomes
Performance (education and spoken and signed communication), development (general and language), and quality of life.
Main Results
At follow-up, 263 children in newborn hearing screening regions (0.78 per 1000 children) and 171 children in distraction hearing screening regions (0.73 per 1000 children) had been diagnosed with permanent childhood hearing impairment. Three-hundred-one children (69.4%) participated in analysis of general performance measures. There was no difference between groups in the primary mode of communication or type of education. Around one-third of each group underwent extensive developmental testing and the authors found that overall, children in newborn hearing screening regions had higher developmental outcome scores compared with children in distraction hearing screening regions (Wilks λ = 0.79; F12 = 2.705; P = .003). For social development, the mean between-group difference in quotient points was 8.8 (95% CI, 0.8 to 16.7) and for gross motor development, 9.1 (95% CI, 1.1 to 17.1). For quality of life, the mean between-group difference was 5.3 (95% CI, 1.7 to 8.9), also in favor of children in newborn hearing screening regions.
Conclusions
Compared with distraction hearing screening, a newborn hearing screening program was associated with better developmental outcomes at 3 to 5 years of age among children with permanent childhood hearing impairment.
Commentary
Korver et al took advantage of a natural experiment, the implementation of newborn hearing screening in The Netherlands, to evaluate the impact of the detection of permanent hearing impairment by 2 weeks versus 9 months of age on development and quality of life. This study adds to the evidence supporting newborn screening, which was recently summarized by the US Preventive Services Task Force.1 In particular, the finding of improved quality of life among those detected by newborn screening is both important and novel, and strengthens the rationale for assuring that children who have an abnormal newborn screen receive timely diagnostic testing and, when necessary, treatment. Newborn hearing screening is the standard of care in the US. Unfortunately, there are substantial numbers of children with an abnormal newborn screen who are either lost to diagnostic follow-up or treatment by early-Intervention services.2 The report by Korver et al provides further evidence for busy clinicians about the critical importance of having systems in place to assure timely follow-up after newborn hearing screening.
References
PII: S0022-3476(11)00266-6
doi:10.1016/j.jpeds.2011.03.011
© 2011 Mosby, Inc. All rights reserved.
