Newborn hearing screening
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Newborn screening coverage is high
In 2022–23, newborn hearing screening coverage of First Nations babies, using combined data for 6 states and the Northern Territory, was around 94%.
Newborn hearing screening aims to identify babies born with moderate to profound permanent childhood hearing loss, which is estimated to affect at least 1 to 2 babies per 1,000 births (Vos et al 2019). Newborn hearing screening involves a non-invasive hearing test that is quick and painless. Newborn hearing tests are usually performed at the bedside while a baby is still in hospital (Patel and Feldman 2011).
Identifying babies born with hearing loss as soon as possible after birth enables earlier intervention, leading to better language development and other outcomes (Ching et al. 2006; Leigh 2010; Neumann et al. 2019; Pimperton et al. 2016; Sininger et al. 2009).
About the data
This section presents information on the number and proportion of babies who have a newborn hearing test, the proportion who are then referred to audiology for further testing, and the proportions found to have permanent childhood hearing loss or other ear or hearing conditions.
The information comes from newborn hearing screening programs in states and territories. All states and territories have newborn hearing screening programs and collect data on their own programs, but consistent data is not available in all cases (see Table SCREENING 1: Availability of newborn hearing screening information by state and territory and Indigenous status, 2022–23).
The aim of newborn hearing screening is for all eligible babies to be screened for permanent childhood hearing impairment that is present at birth, by 4 weeks of age (based on corrected age, which accounts for the time between premature birth and the due date of a full-term pregnancy). A very small proportion of babies are not eligible for newborn hearing screening, for example due to medical reasons (NHSWG 2013). Parental consent is required for babies to be screened. Children at high risk of hearing loss may be referred directly to audiology services without being screened.
Towards a national data collection
A report assessing the feasibility of developing a national newborn hearing screening data collection was published by the AIHW in November 2023 (AIHW 2023).
An Australian national data collection for newborn hearing screening would improve the availability and quality of data. Such data would support nationally and internationally consistent measurement, reporting, and standards for evaluating programs and outcomes.
The availability of newborn hearing screening information for this report, from each state and territory, is summarised in Table SCREENING 1.
| Measure | NSWab | Vic. | Qldb | WAc | SA | Tas. | ACT | NTd |
|---|---|---|---|---|---|---|---|---|
| Eligibility for screening | First Nations only | Yes | Yes | Yes | Yes | First Nations only | No | Yes |
| Whether completed screening | Yes | Yes | Yes | Yes | Yes | First Nations only | No | Yes |
| Whether completed screening within or after one month of birth | No | Yes | Yes | Yes | Yes | First Nations only | No | No |
| Referral to an audiologist following screeninge | Yes | Yes | Yes | Yes | Yes | Yes | No | Yes |
| Diagnosis outcomes | Yes | Yes | Yes | No | Yes | No | No | Yes |
Notes:
- For New South Wales, the number of newborns eligible is for the 2022 calendar year, not the 2022–23 financial year.
- For New South Wales and Queensland, non-Indigenous includes Indigenous status not stated.
- For Western Australia, data is for public hospitals only.
- For the Northern Territory, data is from the Top End Health Service and the Central Australia Health Service.
- When the screening result is not in the normal range and further testing is required.
Participation
State and territory
In 2022–23, very large proportions of eligible First Nations babies had a newborn hearing screening test, ranging from 89% in New South Wales (6,000 babies) to 100% in Tasmania (340 babies). Newborn hearing screening rates were similar for First Nations babies and non-Indigenous babies (Figure SCREENING 1).
In 2022–23, newborn hearing screening coverage of First Nations babies, using combined data for the six states and the Northern Territory, was around 94%.
Age at screening
Most newborn hearing screening occurs within one month of birth. In 2022–23, around 94% of eligible First Nations babies in Victoria, Queensland, and public hospitals in Western Australia had a newborn hearing test within one month of birth, compared with 89% in Tasmania and 84% in South Australia. These data were not available for New South Wales, the Australian Capital Territory or Northern Territory.
The proportions of First Nations babies who had a newborn hearing test within one month of birth were slightly lower than non-Indigenous babies, ranging from around 2 percentage points in Victoria to nearly 7 percentage points lower in South Australia (Figure SCREENING 1).
Figure SCREENING 1: Babies who had a newborn hearing screening test and whether it was within one month of birth, by state/territory and Indigenous status, 2022–23
Sources: AIHW analysis of the NSW Statewide Infant Screening–Hearing (SWISH) program (unpublished); The Royal Children’s Hospital Melbourne data (unpublished); Queensland Health data (unpublished); Western Australia Department of Health data (unpublished); South Australia Women’s and Children’s Health Network data (unpublished); Tasmanian Health Service data (unpublished), Northern Territory Health data (unpublished).
Referral for further testing
After newborn hearing screening, some babies are referred on to an audiologist for further testing. The technology used for newborn hearing tests in Australia is called the automated auditory brainstem response. Using this technology, the rate of referrals to audiology following newborn hearing screening is expected to be less than 2% (NHSWG 2013).
In 2022–23, the proportions of First Nations babies referred to audiology for further testing following newborn hearing screening ranged from 0.7% in New South Wales and Western Australia, to 1.8% in Tasmania and the Northern Territory, 1.9% in Victoria, 2.5% in Queensland and 3.7% in South Australia.
Figure SCREENING 2: Babies referred to audiology following newborn hearing screening, by state/territory and Indigenous status, 2022–23
Bar chart shows First Nations babies referred to audiology from hearing screening, where data available, ranges from 0.7% in NSW and WA to 3.7% in SA,
| State/Territory | First Nations | Non-Indigenous |
|---|---|---|
| NSW | 0.7 | 0.4 |
| Vic. | 1.9 | 1.3 |
| Qld | 2.5 | 1.5 |
| WA | 0.7 | 0.9 |
| SA | 3.7 | 2 |
| Tas. | 1.8 | 0 |
| NT | 1.8 | 1.1 |
1. Refer rate is the percentage of babies who complete screening who received a refer or positive screening result.
2. Data for Western Australia are for babies born in public hospitals only.
3. The Northern Territory Top End Health Service includes Royal Darwin Hospital, Palmerston Regional Hospital, Katherine Hospital, Gove Hospital, Top End Mental Health Services and numerous remote health clinics.
4. There is no non-Indigenous data available for Tasmania.
Sources: AIHW analysis of the NSW Statewide Infant Screening–Hearing (SWISH) program (unpublished); The Royal Children’s Hospital Melbourne data (unpublished); Queensland Health data (unpublished); Western Australia Department of Health data (unpublished); South Australia Women’s and Children’s Health Network data (unpublished); Tasmanian Health Service data (unpublished), Northern Territory Health data (unpublished).
Diagnosis of hearing loss in babies
Audiological testing determines whether a baby has permanent childhood hearing loss, another hearing or ear condition, or normal hearing. Permanent childhood hearing loss in both ears that is moderate to profound affects around 1.3 babies per 1,000 population (NHSWG 2013).
Based on the combined data from the six states and the Northern Territory, 38 First Nations babies who had the newborn hearing test from July 2021–June 2023 were diagnosed with permanent childhood hearing loss, a rate of about 1.1 per 1,000 babies eligible for screening (Data table 2.1.2).
AIHW 2023. Environmental scan and assessment of the feasibility of developing a national neonatal hearing screening data collection, catalogue number PER 125. Canberra: AIHW.
Ching TY, Oong R and van Wanrooy E (2006) ‘The ages of intervention in regions with and without universal newborn hearing screening and prevalence of childhood hearing impairment in Australia’, Australian and New Zealand Journal of Audiology, 28:137–150.
Leigh G (2010) Early identification of hearing loss in Australia: Well begun is not well done! The 2010 Libby Harricks Memorial Oration, Sixth Australia National Deafness Sector Summit, Sydney.
NHSWG (Neonatal Hearing Screening Working Group) 2013, National framework for neonatal hearing screening, Department of Health, accessed 30 September 2024.
Neumann K, Chadna S, Tavartkiladze GA, White KR and Bu X (2019) ‘Newborn and infant hearing screening facing globally growing numbers of people suffering from disabling hearing loss’, International Journal of Neonatal Screening, 5(1):7.
Patel H & Feldman M (2011) ‘Universal newborn hearing screening’. Paediatrics & Child Health, 16(5):301-10. doi: 10.1093/pch/16.5.301.
Patel H and Feldman M (2011) ‘Universal newborn hearing screening’, Paediatric Child Health, 16:301–305.
Pimperton H, Blythe H, Kreppner J, Mahon M, Peacock JL, Stevenson J et al. (2016) ‘The impact of universal newborn hearing screening on long-term literacy outcomes: a prospective cohort study’, Archives of Disease in Childhood, 101:9–15.
Sininger YS, Martinez A, Eisenberg L, Christensen E, Grimes A and Hu J (2009) ‘Newborn hearing screening speeds diagnosis and access to intervention by 20–25 months’, Journal of American Geriatrics Society 20:49.
Vos, B., Noll, D., Pigeon, M, Bagatto M & Fitzpatrick EM (2019) ‘Risk factors for hearing loss in children: a systematic literature review and meta-analysis protocol’ Systematic Reviews 8, Article number 172, accessed 18 January 2023.