Universal newborn hearing screening: a question of evidence.

The objective of this paper is to present data on the ages of diagnosis and hearing-aid fitting of children with permanent congenital or early-onset hearing loss who were identified through neonatal hearing screening (NHS) programs or medical referral. Data were collected for 709 children born between 1980 and 2003. Children who were screened were diagnosed significantly earlier (mean 6.3 months) than referred children (mean 39.5 months). For the referred children, the ages of diagnosis and amplification improved over time but remained unacceptably high. In addition, there was an inverse relationship between degree of loss and age of diagnosis, with children with lesser degrees of hearing loss identified later than those with severe to profound hearing loss. These results contribute to the evidence that NHS programs lower the ages of diagnosis and amplification and lead to earlier improved hearing. It is argued that early access to hearing should be the desired primary outcome of NHS. The numerous studies demonstrating improved ages of diagnosis resulting from NHS programs constitute adequate evidence to support these initiatives.