Skip to main content
SpringerLink
Log in

Universal newborn hearing screening, a revolutionary diagnosis of deafness: real benefits and limitations

  • Review Article
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The finding that early detection of permanent congenital childhood hearing loss produces worthwhile benefit in terms of improved speech and language provides the rationale for the universal screening of newborns. The aim of the present study is to collect the current evidence with regard to the efficacy, the results and outcomes of universal hearing screening programs. An extensive search of the literature was performed in Medline and other available database sources. Study selection was based on the evaluation of the protocols used and the assessment of their efficacy in the early diagnosis of congenital hearing impairment. The initial referral rate and the rate of false positives were also evaluated. A total of 676,043 screened children have been identified in 20 studies. The average initial referral rate in these studies was 3.89%. The initial referral rate varied from 0.6 to 16.7%. The lost-to-follow-up rates varied from 3.7 to 65%. Although universal hearing screening is now widely adopted, there are still some serious drawbacks and limitations. False positives rates remain considerably high when newborns are screened with TEOAE’s. The combination of TEOAE’s and a-ABR provides a significantly reduced referral rate. Close cooperation between audiological centres and maternity units and a dedicated secretariat team are of paramount importance with regard to the reliability and efficacy of universal hearing screening.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Shah VA, Yeo CL (2007) Identifying risk of neonatal hyperbilirubinaemia and early discharge for glucose-6-phosphate dehydrogenase deficient newborns in Singapore. Ann Acad Med Singap 36(12):1003–1009

    PubMed  Google Scholar 

  2. Geelhoed EA, Lewis B, Hounsome D, O’leary P (2005) Economic evaluation of neonatal screening for phenylketonuria and congenital hypothyroidism. J Paediatr Child Health 41(11):575–579

    Article  PubMed  CAS  Google Scholar 

  3. Thompson DC, McPhillips H, Davis RL, Lieu TL, Homer CJ, Helfand M (2001) Universal newborn hearing screening: summary of evidence. JAMA 286(16):2000–2010

    Article  PubMed  CAS  Google Scholar 

  4. Seymour CA, Thomason MJ, Chalmers RA et al (1997) Newborn screening for inborn errors of metabolism: a systematic review. Health Technol Assess 1(11):i–iv, 1–95

    Google Scholar 

  5. Korres S, Nikolopoulos TP, Peraki EE et al (2008) Outcomes and efficacy of newborn hearing screening: strengths and weaknesses (success or failure?). Laryngoscope 118(7):1253–1256

    Article  PubMed  CAS  Google Scholar 

  6. Yoshinaga-Itano C, Apuzzo ML (1998) The development of deaf and hard of hearing children identified early through the high-risk registry. Am Ann Deaf 143(5):416–424

    PubMed  CAS  Google Scholar 

  7. Yoshinaga-Itano C, Apuzzo ML (1998) Identification of hearing loss after age 18 months is not early enough. Am Ann Deaf 143(5):380–387

    PubMed  CAS  Google Scholar 

  8. Yoshinaga-Itano C, Sedey AL, Coulter DK, Mehl AL (1998) Language of early- and later-identified children with hearing loss. Pediatrics 102(5):1161–1171

    Article  PubMed  CAS  Google Scholar 

  9. Yoshinaga-Itano C (2003) Early intervention after universal neonatal hearing screening: impact on outcomes. Ment Retard Dev Disabil Res Rev 9(4):252–266

    Article  PubMed  Google Scholar 

  10. Lin HC, Shu MT, Chang KC, Bruna SM (2002) A universal newborn hearing screening program in Taiwan. Int J Pediatr Otorhinolaryngol 63(3):209–218

    PubMed  Google Scholar 

  11. Aidan D, Avan P, Bonfils P (1999) Auditory screening in neonates by means of transient evoked otoacoustic emissions: a report of 2,842 recordings. Ann Otol Rhinol Laryngol 108(6):525–531

    PubMed  CAS  Google Scholar 

  12. Capua A, Constantini D, Martufi C et al (2007) Universal hearing screening: the Siena (Italy) experience on 19,700 newborns. Early Hum Dev 83:601–606

    Article  PubMed  Google Scholar 

  13. Uilenburg N, Kaufmann-de Boer M, Van der Ploeg K et al (2009) An implementation study of neonatal hearing screening in Netherlands. Int J Audiol 48:108–116

    Article  PubMed  Google Scholar 

  14. Mason JA, Herrmann KR (1999) Universal infant hearing screening by automated auditory brainstem response measurement. Pediatrics 103(3):670–672

    Article  Google Scholar 

  15. Clemens CJ, Davis SA, Bailey AR (2000) The false-positive in universal newborn hearing screening. Pediatrics 106(1):E7

    Article  PubMed  CAS  Google Scholar 

  16. Lin HC, Shu MT, Lee KS, Lin HY, Lin G (2007) Reducing false positives in newborn hearing screening program: how and why. Otol Neurotol 28(6):788–792

    Article  PubMed  CAS  Google Scholar 

  17. Lam BC (2006) Newborn hearing screening in Hong Kong. Hong Kong Med J 12(3):212–218

    PubMed  CAS  Google Scholar 

  18. (1998) Controlled trial of universal neonatal screening for early identification of permanent childhood hearing impairment. Wessex Universal Neonatal Hearing Screening Trial Group. Lancet 352(9145):1957–1964

  19. Mehl AL, Thomson V (2002) The Colorado newborn hearing screening project, 1992–1999: on the threshold of effective population-based universal newborn hearing screening. Pediatrics 109(1):E7

    Article  PubMed  Google Scholar 

  20. Kanne TJ, Schaefer L, Perkins JA (1999) Potential pitfalls of initiating a newborn hearing screening program. Arch Otolaryngol Head Neck Surg 125(1):28–32

    PubMed  CAS  Google Scholar 

  21. Vohr BR, Carty LM, Moore PE, Letourneau K (1998) The Rhode Island Hearing Assessment Program: experience with statewide hearing screening (1993–1996). J Pediatr 133(3):353–357

    Article  PubMed  CAS  Google Scholar 

  22. Finitzo T, Albright K, O’Neal J (1998) The newborn with hearing loss: detection in the nursery. Pediatrics 102(6):1452–1460

    Article  PubMed  CAS  Google Scholar 

  23. Dalzell L, Orlando M, Prieve B et al (2000) The New York State universal newborn hearing screening demonstration project: ages of hearing loss identification, hearing aid fitting, and enrollment in early intervention. Ear Hear 21(2):118–130

    Article  PubMed  CAS  Google Scholar 

  24. Low WK, Pang KY, Ho LY, Lim SB, Joseph R (2005) Universal newborn hearing screening in Singapore: the need, implementation and challenges. Ann Acad Med Singapore 34(4):301–306

    PubMed  CAS  Google Scholar 

  25. Lagnagne T, Leveque M, Schmidt P, Chays A (2010) Universal newborn hearing screening in the Champagne–Ardenne region: a 4-year follow up after early diagnosis of hearing impairment. Int J Pediatric Otorhinolaryngol 74:1164–1170

    Article  Google Scholar 

  26. Rohlfs AK, Wiesner T, Drews H et al (2010) Interdisciplinary approach to design, performance and quality management in a multicenter newborn hearing screening project. Introduction, methods and results of the newborn hearing screening in Hamburg (Part I). Eur J Pediatr 169:1353–1360

    Article  PubMed  Google Scholar 

  27. Neumann K, Gross M, Bottcher P et al (2006) Effectiveness and efficiency of a universal newborn hearing screening in Germany. Folia Phoniatr Logop 58:440–455

    Article  PubMed  Google Scholar 

  28. Ghirri P, Liumbruno A, Lunardi S et al (2011) Universal neonatal audiological screening: experience of the University Hospital of Pisa. Italian J Pediatrics 37:16

    Article  Google Scholar 

  29. Yoshinaga-Itano C (2004) Levels of evidence: universal newborn hearing screening (UNHS) and early hearing detection and intervention systems (EHDI). J Commun Disord 37(5):451–465

    Article  PubMed  Google Scholar 

  30. Cao-Nguyen MH, Kos MI, Guyot JP (2007) Benefits and costs of universal hearing screening programme. Int J Pediatr Otorhinolaryngol 71(10):1591–1595

    Article  PubMed  Google Scholar 

  31. Web site of National Centre for Hearing Assessment & Management (NCHAM) Utah State University, Utah. Last modified 11 Apr 2008

  32. Ciorba A, Hatzopoulos S, Busi M, Guerrini P, Petruccelli J, Martini A (2008) The universal newborn hearing screening program at the University Hospital of Ferrara: focus on costs and software solutions. Int J Pediatr Otorhinolaryngol 72(6):807–816

    Article  PubMed  Google Scholar 

  33. Bottcher P, Gramb M, Euler HA et al (2009) Cost analysis of a universal newborn hearing screening for clinics using the State of Hesse as an example. HNO 57:21–28

    Article  PubMed  CAS  Google Scholar 

  34. Rohlfs AK, Wiesner T, Drews H et al (2010) Interdisciplinary approach to design, performance and quality management in a multicenter newborn hearing screening project. Discussion of the results of newborn hearing in Hamburg (Part II). Eur J Pediatr 169:1453–1463

    Article  PubMed  Google Scholar 

  35. Erenberg A, Lemons J, Sia C et al (1998) Newborn and infant hearing loss: detection and intervention. American Academy of Pediatrics. Task Force on Newborn and Infant Hearing 1998–1999. Pediatrics 103:527–530

    Google Scholar 

  36. Deutsches Konsensuspapier zu Neugeborenenhorscreening—Programmen 3.0 (2001). (http://www.neugeborenenhorscreening.de)

  37. Finckh-Kramer U, Spormann Lagodzinski M, Nubel K et al (1998) Is diagnosis of persistent pediatric hearing loss still made too late? HNO 46:598–602

    Article  PubMed  CAS  Google Scholar 

  38. Korver A, Konings S, Decker F et al (2010) Newborn hearing screening vs later hearing screening and developmental outcomes in children with permanent childhood hearing impairment. JAMA 304:1701–1708

    Article  PubMed  CAS  Google Scholar 

  39. Stelmachowicz PG, Mace AL, Kopun JG, Carney E (1993) Long -term and short-term characteristics of speech: implications for hearing aid selection for young children. J Speech Hear Res 36(3):609–620

    PubMed  CAS  Google Scholar 

  40. Hatzopoulos S, Petruccelli J, Ciorba A et al (2009) Optimizing otoacoustic emission protocols for a UNHS program. Audiol Neurootol 14:7–16

    Article  PubMed  CAS  Google Scholar 

  41. Sininger Y (2002) Auditory neuropathy in infants: implications on early hearing detection and intervention programs. Audiol Today 16–21

  42. Berg AL, Spitzer JB, Towers HM et al (2005) Newborn hearing screening in the NICU: profile of failed auditory brainstem response/passed otoacoustic emission. Pediatrics 116:933–938

    Article  PubMed  Google Scholar 

  43. Korres S, Nikolopoulos T, Ferekidis E et al (2003) Otoacoustic emissions in universal hearing screening: which day after birth should we examine the newborns? ORL J Otorhinolaryngol Relat Spec 65:199–201

    Article  PubMed  Google Scholar 

  44. Nennstiel-Ratzel U, Arenz S, von Kries R et al (2007) The model project “newborn auditory screening” in the Upper Palatinate: high process and result quality of an interdisciplinary concept. HNO 55:128–134

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

None to declare.

Author information

Authors and Affiliations

  1. ENT Department, ELPIS General Hospital, 7 Dimitsanas St., 11528, Athens, Greece

    George X. Papacharalampous & Dimitrios I. Davilis

  2. 2nd ENT Department, University of Athens Medical School, Attikon General Hospital, Haidari, Athens, Greece

    Thomas P. Nikolopoulos

  3. 1st ENT Department, University of Athens Medical School, Hippocrateion General Hospital, Athens, Greece

    Ioannis E. Xenellis & Stavros G. Korres

Authors
  1. George X. Papacharalampous
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas P. Nikolopoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dimitrios I. Davilis
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ioannis E. Xenellis
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stavros G. Korres
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to George X. Papacharalampous.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Papacharalampous, G.X., Nikolopoulos, T.P., Davilis, D.I. et al. Universal newborn hearing screening, a revolutionary diagnosis of deafness: real benefits and limitations. Eur Arch Otorhinolaryngol 268, 1399–1406 (2011). https://doi.org/10.1007/s00405-011-1672-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-011-1672-1

Keywords

Search

Navigation