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PEDIATRICS Vol. 104 No. 2 August 1999, pp. 351-354

Universal Newborn Hearing Screening: Should We Leap Before We Look?

The first 20% of the full text of this article appears below.

To the Editor.

Five years ago, Drs Paradise and Bess1,2 correctly cautioned to the wisdom of instituting universal newborn hearing screening programs without knowledge of ultimate costs and benefits. Through the efforts of hospital- and state-supported demonstration projects, more information regarding effective and preferred screening and follow-up protocols and procedures, personnel, costs, and linkage with early intervention services has accumulated. The current state of knowledge has advanced considerably from that existing 5 years ago.

Advocates of universal newborn hearing screening programs are not in disagreement with Dr Paradise that additional studies are needed to address prevalence and/or delayed onset of hearing loss, hearing loss in the absence of risk factors, unilateral hearing loss, and the effects of screening on parental bonding. There is, however, an increasing body of evidence, given our current state of knowledge, that supports the implementation of universal newborn hearing screening.

    PREVALENCE OF HEARING LOSS

Significant hearing loss is not as uncommon as Dr Paradise portends. Hearing loss occurs in approximately 1.8 to 3 per 1000 newborn nursery infants and in 2 to 4 per 100 neonatal intensive care infants.3-5 If one includes the mild to moderate hearing loss and the unilateral hearing loss, those numbers increase to and range from 3.7 to 56.3 per 1000, depending on age group of subjects.3,5 Use of the high-risk registry will detect only 50% to 60% of infants with congenital hearing loss.5,7,8

    UNDETECTED HEARING LOSS

Undetected hearing loss of any degree will have a significant impact on speech, language, cognitive, and psychosocial development.9,10 Educational delays of 1 year can occur for every 10 decibels (dB) of hearing loss above 25 dB.11 Bess and Tharpe,12,13 along with other researchers,14,15 demonstrated the poorer . . . [Full Text of this Article]