European Journal of Pediatrics

, Volume 169, Issue 11, pp 1353–1360 | Cite as

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)
  • Anna-Katharina RohlfsEmail author
  • Thomas Wiesner
  • Holger Drews
  • Frank Müller
  • Achim Breitfuß
  • Regina Schiller
  • Markus Hess
Original Paper


From the actual point of view, the “sensitive period” for the effects of hearing impairment on speech and language development is within the first year of life. Early exposure to acoustic or electric stimulation can compensate for the acoustic deficit. A regional-based, specifically designed concept of a universal newborn hearing screening (UNHS) was started in Hamburg in the year 2002. For the first time in Germany, a comprehensive protocol including screening measurement, follow-up procedures, tracking, and early intervention was implemented. An interdisciplinary approach from the very beginning could be realized. Sixty-three thousand, four hundred fifty-nine out of 65,466 births were registered during the period August 2002 to July 2006, 93% were primarily screened. 3.3% failed the test and 31.3% were lost to follow-up. A total of 118 children were diagnosed with hearing loss in the follow-up. The median age at time of diagnosis was 3.5 months. Seventy-four children received hearing aids. Out of these 74 children, 6 were subsequently supplied with cochlear implants. The high lost-to-follow-up rate is the biggest challenge for the tracking. Our results will be discussed in part II.


Interdisciplinary approach Multicenter newborn hearing screening Screening and failure rate Lost-to-follow-up Number of babies with hearing losses 



The project received partial funding from the Ministry for Social and Family Affairs (BSFM) and the Ministry of Environment and Health (BUG) in the first 2 years; the subsequent financing of the part-time jobs was supplied by funds donated to the H.A.H.N. e.V.. From August 2008 to January 2009, financing was supplied by the Social and Health Authority of Hamburg (BSG). None of the sponsors was involved in the study design, collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.

Training support was received from “Hamburg working group for hearing screening of newborns registered association” (Hamburger Arbeitskreis für Hörscreening bei Neugeborenen, eingetragener Verein (H.A.H.N. e.V.)). The authors are grateful to the staff and management of the participating hospitals, pediatricians, and pediatric audiologists without whom this project would have been unsuccessful. We thank each professional who identified the children for screening.

We thank Dr. Axel von der Wense, chairman of the H.A.H.N. e.V. for his valuable comments. We thank Professor Reinhard G. Matschke (Hannover, Germany) for his support and advice. We thank Mr. Hans-Joachim Wagner (service manager, Natus Europe) and Mr. Fritz Mack (general manager, Mack Medizintechnik GmbH) for their comments on the screening devices.

Conflict of interest

Neither the authors nor their departments have received any financial support from any industry or other external source related to the text in this manuscript.


  1. 1.
    Anonymous (1995) Joint Committee on Infant Hearing 1994 Position Statement. American Academy of Pediatrics Joint Committee on Infant Hearing. Pediatr 95:152-156Google Scholar
  2. 2.
    Bradford BC, Baudin J, Conway MJ et al (1985) Identification of sensory neural hearing loss in very preterm infants by brainstem auditory evoked potentials. Arch Dis Child 60:105-109Google Scholar
  3. 3.
    Durieux-Smith A, Picton TW, Edwards CG et al (1987) Brainstem electric-response audiometry in infants of a neonatal intensive care unit. Audiol 26:284–297CrossRefGoogle Scholar
  4. 4.
    Erenberg A, Lemons J, Sia C et al (1999) Newborn and infant hearing loss: detection and intervention. American Academy of Pediatrics. Task Force on Newborn and Infant Hearing, 1998–1999. Pediatrics 103:527–530CrossRefPubMedGoogle Scholar
  5. 5.
    Finckh-Krämer U, Spormann-Lagodzinski M, Gross M (2000) German registry for hearing loss in children: results after 4 years. Int J Pediatr Otorhinolaryngol 56:113–127CrossRefPubMedGoogle Scholar
  6. 6.
    Fortnum HM, Summerfield AQ, Marshall DH et al (2001) Prevalence of permanent childhood hearing impairment in the United Kingdom and implications for universal neonatal hearing screening: questionnaire based ascertainment study. Br Med J 323:536–540CrossRefGoogle Scholar
  7. 7.
    Fryauf-Bertschy H, Tyler RS, Kelsay DM et al (1997) Cochlear implant use by prelingually deafened children: the influences of age at implant and length of device use. J Speech Lang Hear Res 40:183–199PubMedGoogle Scholar
  8. 8.
    Gross M, Finckh-Krämer U, Spormann-Lagodzinski M (2000) Congenital hearing disorders in children. 1: Acquired hearing disorders. HNO 48:879–886CrossRefPubMedGoogle Scholar
  9. 9.
    Kral A, Hartmann R, Tillein J et al (2001) Delayed maturation and sensitive periods in the auditory cortex. Audiol Neurootol 6:346–362CrossRefPubMedGoogle Scholar
  10. 10.
    Kunze S, Schnell-Inderst P, Hessel F et al (2004) Hörscreening für Neugeborene. Ein Health Technology Assessment der medizinischen Effektivität und der ökonomischen Effizienz. berichte/hta063_bericht_de.pdf
  11. 11.
    Martines F, Porrello M, Ferrara M et al (2007) Newborn hearing screening project using transient evoked otoacoustic emissions: Western Sicily experience. Int J Pediatr Otorhinolaryngol 71:107–112CrossRefPubMedGoogle Scholar
  12. 12.
    Matschke RG (1993) Untersuchungen zur Reifung der menschlichen Hörbahn. Georg Thieme Verlag, StuttgartGoogle Scholar
  13. 13.
    McClelland RJ, Watson DR, Lawless V et al (1992) Reliability and effectiveness of screening for hearing loss in high risk neonates. Br Med J 304:806–809CrossRefGoogle Scholar
  14. 14.
    Ponton CW, Moore JK, Eggermont JJ (1999) Prolonged deafness limits auditory system developmental plasticity: evidence from an evoked potentials study in children with cochlear implants. Scand Audiol Suppl 51:13–22PubMedGoogle Scholar
  15. 15.
    Reuter G, Cords SM, Issing P et al (1997) Intracochlear, electrical, multichannel stimulation effects on the development of auditory system in neonatally deafened kittens. Am J Otol 18(6 Suppl):S13–14PubMedGoogle Scholar
  16. 16.
    Ruben RJ (1997) A time frame of critical/sensitive periods of language development. Acta Otolaryngol 117:202–205CrossRefPubMedGoogle Scholar
  17. 17.
    Swigonski N, Shallop J, Bull MJ et al (1987) Hearing screening of high risk newborns. Ear Hear 8:26–30CrossRefPubMedGoogle Scholar
  18. 18.
    Uus K, Bamford J (2006) Effectiveness of population-based newborn hearing screening in England: ages of interventions and profile of cases. Pediatrics 117:e887–893CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Anna-Katharina Rohlfs
    • 1
    Email author
  • Thomas Wiesner
    • 2
  • Holger Drews
    • 1
  • Frank Müller
    • 1
  • Achim Breitfuß
    • 1
  • Regina Schiller
    • 1
  • Markus Hess
    • 1
  1. 1.Department of Voice, Speech and Hearing DisordersUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Department of Phoniatrics and Pediatric AudiologyWerner Otto InstitutHamburgGermany

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