Improvements in hearing loss screening programs in children are needed

Allison Mackey, PhD student at KI.
Photo credit: Ulf Sirborn

Screening programs for hearing loss in children need to be better at collecting data and measuring outcomes to improve quality, for example to improve the proportion of follow-ups. This shows a new dissertation from Karolinska Institutet.  One in 500 infants has permanent hearing loss, which can affect their development of the spoken language. The spoken language creates the conditions for reading, social communication and education.

A delay in language development can have consequences for life, and it is therefore important that infants and children with hearing impairments get the right effort as early as possible, says Allison Mackey, who recently completed his doctoral dissertation under the supervision of Inger Uhlén at Department of Clinical Science, Intervention and Technology, Karolinska Institutet.

Lack of data collection

The dissertation evaluated, among other things, how well the hearing screening programs performed as well as the strategies used to improve their results.

Among other things, we conducted an international survey on the status of screening programs in both high- and middle-income countries in Europe, as part of a large multicenter project. It showed that most high-income countries perform hearing screening on all newborn babies, while only a few middle-income countries have similar programs. We also found that most countries lacked available data showing the results of the screening programs, says Allison Mackey.

Important to improve the proportion of follow-ups

The dissertation also shows that lost follow-up is an area of particular interest.

In many of the programs around the world, a high proportion of infants whose first screening gave an unapproved result will not return for a follow-up assessment. This may be due to a number of factors, but we could see, for example, that the experience and knowledge of the staff participating in the screening program had an impact on how well this worked, says Allison Mackey.

The criteria for approved results used for screening are important determinants of how sensitive the program is. Tightened criteria will cause more children with hearing loss to be detected in the screening program.

However, the lack of data in many screening programs makes it difficult to evaluate its quality. If decision makers want to address issues, such as lost follow-up, they must first know the current situation. Therefore, the very first step in improving a screening program is to set up a system of processes for collecting data and regularly monitoring and evaluating results, says Allison Mackey.

Allison Mackey defends her doctoral dissertation on October 14.

Source/Credit: Karolinska Institutet | Anna Molin

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