Targeted surveillance for postnatal hearing loss: A program evaluation

Beswick, Rachael, Driscoll, Carlie, Kei, Joseph and Glennon, Shirley (2012) Targeted surveillance for postnatal hearing loss: A program evaluation. International Journal of Pediatric Otorhinolaryngology, 76 7: 1046-1056. doi:10.1016/j.ijporl.2012.04.004

Author Beswick, Rachael
Driscoll, Carlie
Kei, Joseph
Glennon, Shirley
Title Targeted surveillance for postnatal hearing loss: A program evaluation
Journal name International Journal of Pediatric Otorhinolaryngology   Check publisher's open access policy
ISSN 0165-5876
Publication date 2012-07
Sub-type Article (original research)
DOI 10.1016/j.ijporl.2012.04.004
Volume 76
Issue 7
Start page 1046
End page 1056
Total pages 11
Place of publication London, United Kingdom
Publisher Elsevier
Collection year 2013
Language eng
Formatted abstract

The importance of monitoring hearing throughout early childhood cannot be understated. However, there is a lack of evidence available regarding the most effective method of monitoring hearing following the newborn screen. The goal of this study was to describe a targeted surveillance program using a risk factor registry to identify children with a postnatal hearing loss.

All children who were born in Queensland, Australia between September 2004 and December 2009, received a bilateral ‘pass’ on newborn hearing screening, and had at least one risk factor, were referred for targeted surveillance and were included in this study. The cohort was assessed throughout early childhood in accordance with Queensland's diagnostic assessment protocols.

During the study period, 7320 (2.8% of 261,328) children were referred for targeted surveillance, of which 56 were identified with a postnatal hearing loss (0.77%). Of these, half (50.0%) were identified with a mild hearing loss, and 64.3% were identified with a sensorineural hearing loss. In regards to risk factors, syndrome, craniofacial anomalies, and severe asphyxia had the highest yield of positive cases of postnatal hearing loss for children referred for targeted surveillance, whereas, low birth weight, bacterial meningitis, and professional concern had a particularly low yield. Limitations of the targeted surveillance program were noted and include: (1) a lost contact rate of 32.4%; (2) delays in first surveillance assessment; (3) a large number of children who required on-going monitoring; and (4) extensive diagnostic assessments were completed on children with normal hearing. Examination of the lost contact rate revealed indigenous children were more likely to be documented as lost contact. In addition, children with one risk factor only were significantly more likely to not attend a surveillance appointment.

Positive cases of postnatal hearing loss were detected through the targeted surveillance program. However, the limitations of the program question the usefulness of this service delivery model. For targeted surveillance to continue, time frames for assessment, assessments performed, and discharge criteria need to be revisited. The contribution of individual and combined risk factors in detecting postnatal hearing loss should also be examined in more detail.
Keyword Postnatal hearing loss
Risk indicators
Intervention Programs
Position Statement
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Health and Rehabilitation Sciences Publications
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