Universal newborn hearing screening: fine-tuning the process.

PURPOSE OF REVIEW: Universal newborn hearing screening (UNHS) is rapidly becoming the standard of care in hospitals across the country. The goals of Healthy People 2010 are to provide newborn hearing screening to all infants, ensure follow-up audiologic evaluations by 3 months of age, and provide smooth transition to early intervention by 6 months of age. Programs implemented in the 1990s are beginning to report data that will be useful to states new to screening. This article reviews recent trends, suggests appropriate screening protocols, and identifies areas for improvement in UNHS. RECENT
FINDINGS: Recent studies indicate the following: (1) screening programs can be cost-effective with low referral rates; (2) maternal stress is not necessarily a byproduct of screenings that end in referral; and (3) developmental outcomes for hearing-impaired infants born in screening hospitals are particularly encouraging. Areas for improvement include the following: (1) compliance in follow-up testing and (2) the establishment of a cohesive multidisciplinary team to manage the infant and provide support to the family.
SUMMARY: Hearing screening is only the first step in the care of a hearing-impaired infant. Programs need to ensure that families understand the necessity of follow-up testing without creating undue stress. The transition to early intervention should be seamless, with a cohesive team of health care professionals capable of providing medical, audiologic, communication, and educational management for the infant as well as emotional support for the family.