Do all infants with congenital hearing loss meet the 1-3-6 criteria? A study of a 10-year cohort from a universal newborn hearing screening programme in Singapore

Abstract

Objective

To evaluate 1) the outcomes of a local universal newborn hearing screening (UNHS) programme and its audiological follow-ups at 3- and 6-month points, 2) the education outcomes of children with congenital hearing loss (CHL).

Design

Retrospective study that analysed data containing hearing screening, diagnosis, intervention and schooling information from electronic databases.

Study sample

Children aged 5 to 15 years old who were born between 2004–2014 and underwent UNHS in a local hospital.

Results

Over a 10-year cohort, 99.4% of 29,972 newborns underwent UNHS; approximately 90% of them were screened by 1 month of age. However, only 10% of the cohort strictly fulfilled the 1-3-6 criteria recommended by the Joint Committee on Infant Hearing. Lost to follow-up (LTF) rate was highest at post-diagnosis (35%). 80% of infants who were intervened between 6 and 48 months of age went to mainstream schools. The remaining 20% had additional disabilities or family factors.

Conclusions

A high UNHS coverage rate may not translate to meeting the 1-3-6 criteria. Despite ease of access to our healthcare system, LTF at post-diagnosis remained high. In the absence of additional disabilities or family factors, infants intervened during the sensitive window could still potentially make it into mainstream schools.

Keywords:

• Congenital hearing loss (CHL)
• education outcomes
• joint committee on infant hearing (JCIH)
• lost to follow-up (LTF)
• universal newborn hearing screening (UNHS)

Acknowledgements

The authors give their thanks and appreciation to A/Prof Roy Joseph for his permission to analyse the database from the Neonatal Department.

Ethical approval

Ethical approval was obtained from the National Healthcare Group Domain Specific Review Board (Domain D) on 18^th October 2018 (NHG DSRB Ref: 2018/00798).

Informed consent

Informed consent was waived due to the retrospective nature of this study.

Author contributions

A/Prof Loo, principal investigator, conceptualised and designed the study, reviewed the data collection and analyses, and obtained permission for data collection from the Neonatal Department for this research. Ms Tang conceptualised and designed the study, carried out the data collection and analysis, and drafted the initial manuscript. Mdm Ng provided guidance of use of the Hi-Track database for data collection, information on the process of UNHS, and provided data on newborns referred from UNHS to the ENT clinic for audiological evaluation. All authors have reviewed and edited the manuscript and approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data sharing is not available for this article as the ethics board only approved for the data to be used and shared within the research team for this study.

Additional information

Funding

This research was not funded by nor received any grants from any agency.