Three to five year-old children with hearing problems tend to have better language development if they had their hearing screened at birth, compared to those who were checked later on via behavioral testing, Dutch researchers report in an article published in JAMA (Journal of the American Medical Association). The authors explain that long-term hearing problems during childhood (permanent childhood hearing impairment) is a fairly common and serious condition. For a child's development and social skills, picking up on auditory stimuli is crucial. Therefore, detecting any hearing impairment early on is vital so that sound amplification may be provided if needed.

The researchers wrote:

Until some years ago, distraction hearing screening (behavioral testing) was used for hearing screening around the age of 9 months. Newborn hearing screening (within 2 weeks of birth) was introduced in many developed countries because it was thought that the earlier permanent childhood hearing impairment was diagnosed, the less developmentally disadvantaged children would become. However, to date no strong evidence exists for universal implementation of newborn hearing screening.

Anna M. H. Korver, M.D., Ph.D., from Leiden University Medical Center, Leiden, the Netherlands, and team set out to compare the outcomes of hearing screening at birth versus distraction hearing screening in children aged 3 to 5 years with permanent childhood hearing impairment.

Distraction hearing screening was gradually replaced in 65 Dutch regions from 2002 to 2006. Screening type depended on availability at birth date and where the child was born and was not linked to the developmental prognoses of each child.

The researchers included all children born between 2003 and 2005 in The Netherlands. All the children aged 3 to 5 years with permanent childhood hearing impairment were identified. Evaluations were completed in December 2009.

335,560 children received newborn hearing screening while 234,826 received distraction hearing screening during the study period. 263 kids who had received hearing screening at birth were followed-up and diagnosed with childhood hearing impairment, a rate of 0.78 per 1,000. In regions that offered only distraction hearing screening 171 were diagnosed with childhood hearing impairment, a rate of 0.73 per 1,000.

The researchers carried out a general performance measurement on 300 children, 183 from the screening at birth group and 118 from the other group. Both groups had similar hearing impairments and types of education.

80 children who were screened at birth and 70 who received distraction hearing screening had an analysis of extensive developmental outcomes.

The researchers found that those screened at birth had overall higher developmental outcome scores compared to the other kids. The investigators add that the analysis included among other things, quality of life, gross motor development and social development.

The authors wrote:

The results of [this] study 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.

According to Deafness Research UK, the first hearing check a baby used to receive was at the age of seven or eight months. The Infant Distraction Test (IDT) was performed by a health visitor. IDT was not very accurate and 50% of babies with hearing problems were not detected, typically until they were 18 months old - IDT relied on babies reacting appropriately to sounds. A significant number of hearing impaired children who were not identified with IDT were not diagnosed until the age of three years. Consequently, a deaf child at the age of three might have had a vocabulary of just 25 words, compared to 700 for 3-year old with normal hearing. Throughout the UK the Infant Distraction Test was replaced with Newborn Hearing Screening Programmes.

Sources: JAMA, Leiden University Medical Center, Deafness Research UK.

"Newborn Hearing Screening vs Later Hearing Screening and Developmental Outcomes in Children With Permanent Childhood Hearing Impairment"
Anna M. H. Korver, MD, PhD; Saskia Konings, MD; Friedo W. Dekker, PhD; Mieke Beers, PhD; Capi C. Wever, MD, PhD; Johan H. M. Frijns, MD, PhD; Anne M. Oudesluys-Murphy, MB, PhD; for the DECIBEL Collaborative Study Group
JAMA. 2010;304(15):1701-1708. doi:10.1001/jama.2010.1501