title: Limitations of universal newborn hearing screening in early identification of pediatric cochlear implant candidates.
abstract: OBJECTIVE
  To determine whether implementation of universal newborn hearing screening (UNHS) in the state of Illinois has affected the ages at diagnosis of hearing loss and implantation in children receiving cochlear implants and to determine how often children undergoing implantation had UNHS results with no indication of hearing loss (pass).
  
  
  METHODS
  Retrospective case review of 417 randomly selected pediatric implant recipients born before and after UNHS was mandated by law in Illinois. Data analyzed included hearing screening status, ages at initial diagnosis of sensorineural hearing loss (SNHL) and severe to profound SNHL, and age at implantation.
  
  
  METHODS
  Tertiary care medical center.
  
  
  METHODS
  Children receiving implants from 1991 through 2008.
  
  
  METHODS
  Ages at diagnosis of SNHL and implantation.
  
  
  RESULTS
  Children born after legally mandated UNHS had significantly younger ages at diagnosis and implantation. However, a younger age at diagnosis of SNHL was not achieved in children who had passed UNHS or who were not screened. Approximately 30% of pediatric implant recipients passed UNHS, regardless of the cause of hearing loss or the presence or absence of known risk factors.
  
  
  CONCLUSIONS
  Almost one-third of our pediatric implant recipients pass UNHS and are older at the time of initial diagnosis and implantation than their peers who fail UNHS. Delayed onset of SNHL limits our ability to achieve early diagnosis and implantation of a significant number of deaf children. This problem will not be solved by the current design of universal hearing screening programs.
authors.affiliation: Division of Pediatric Otolaryngology, Section of Otology and Neurotology, Children’s Memorial Hospital, 2300 Children's Plaza, Box 265, Chicago, IL 60614-3394, USA.
authors.forename: Nancy Melinda
authors.initials: NM
authors.lastname: Young
authors.forename: Brian Kip
authors.initials: BK
authors.lastname: Reilly
authors.forename: Larisa
authors.initials: L
authors.lastname: Burke
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D019929:Cochlear Implantation; D003638:Deafness / Q000175:diagnosis* / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007087:Illinois; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000331:legislation & jurisprudence; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors