Universal neonatal hearing screening versus selective screening as part of the management of childhood deafness

  • Review
  • Intervention


  • Mª Teresa Puig,

    Corresponding author
    1. Hospital de la Santa Creu i Sant Pau, Epidemiology Service - Iberoamerican Cochrane Center, Barcelona, Spain
    • Mª Teresa Puig, Epidemiology Service - Iberoamerican Cochrane Center, Hospital de la Santa Creu i Sant Pau, Sant Antoni Maria Claret , 171, 4a planta, Barcelona, 08041, Spain. tpuig@hsp.santpau.es.

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  • Antonio Municio,

    1. Hospital de Txagorritxu, Department of Ear, Nose and Throat, Vitoria-Gasteiz, Spain
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  • Mª Carme Medà

    1. Hospital de la Santa Creu i Sant Pau, Department of Ear, Nose and Throat, Barcelona, Spain
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The principal factors that decide how deafness affects a child's development are the degree of hearing impairment and the age at which it is diagnosed. A number of factors are thought to increase the risk of hearing impairment: low birth weight, prematurity, perinatal hypoxia and jaundice, among others. The high incidence of deafness in children without risk factors and the introduction of simple new screening tests of high sensitivity and specificity have led many prestigious bodies to recommend universal early detection programmes for deafness rather than screening targeted only at high-risk groups.


To compare the long-term effectiveness of a universal neonatal screening and early treatment programme for hearing impairment with: a) screening and treatment only of high-risk neonates and b) opportunistic screening and treatment.

Search strategy

Databases searched included MEDLINE (1966 to 2006), EMBASE (1974 to 2006), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2006) and registers of health technology assessment agencies as well as registers of clinical guidelines. The date of the last search was June 2006.

Selection criteria

Randomised controlled trials comparing universal neonatal screening with either high-risk screening or opportunistic screening for hearing impairment.

Data collection and analysis

Two review authors independently screened the search results to identify suitable trials.

Main results

No studies were identified which fulfilled the inclusion criteria.

Authors' conclusions

The long-term effectiveness of universal newborn hearing screening programmes has not been established to date. There is a need for controlled trials and before and after studies to address this issue further.

Plain language summary

Insufficient evidence to establish the long-term effectiveness of universal screening versus selective screening programmes for childhood deafness.

Neonatal hearing screening programmes aim to identify children born deaf. These programmes may test all children (universal screening) or only those with an increased probability of deafness (selective screening). This review has not identified any randomised trials comparing the long term results of either type of screening programme.