Health visitor screening versus vigilance: Outcomes of programmes for detecting permanent childhood hearing loss in West Berkshire

The Health Visitor Distraction Test (HVDT) screen for hearing was replaced in West Berkshire in 1989 with a vigilance programme incorporating a questionnaire. The detection of permanent congenital deafness (bilateral >50 dB HL) for all children born since 1984 has been audited to compare the two...

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Bibliographic Details
Published in:British Journal of Audiology 1999-06, Vol.33 (3), p.145-156
Main Authors: Sutton, G. J., Scanlon, R. E.
Format: Article
Language:English
Subjects:
Age Distribution
Berkshire
Child
Child, Preschool
clinical audit
Cohort Studies
distraction test
England
Health Promotion
Hearing Disorders - diagnosis
Hearing Disorders - epidemiology
Hearing impaired young children
Hearing Tests - methods
Humans
Identification
Infant
Infant, Newborn
Neonatal Screening
Programmes
Referral and Consultation
Retrospective Studies
Screening
Sensitivity and Specificity
sensorineural hearing loss
Severity of Illness Index
Surveys and Questionnaires
United Kingdom - epidemiology
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Summary:The Health Visitor Distraction Test (HVDT) screen for hearing was replaced in West Berkshire in 1989 with a vigilance programme incorporating a questionnaire. The detection of permanent congenital deafness (bilateral >50 dB HL) for all children born since 1984 has been audited to compare the two regimes. Sixty-two cases met the criteria, giving an ascertainment of 1.0 per 1000. Performance was similar under the two systems for severe/profound losses (>70 dBHL), but there was a longer tail of late-detected moderate losses (50-70 dB HL) under the vigilance regime. The sensitivity of the Health Visitor questionnaire in referring those with permanent hearing loss was very similar to that of the HVDT (39% compared with 42%). Coverage for the questionnaire was approximately 87%, but only 78% for the known cases. Referral rate was lower under the vigilance programme, at approximately 3%. The results suggest that a vigilance programme is likely to perform as well as the HVDT but no better. Despite subsequent modifications to the vigilance programme, the poor pickup of moderate losses probably indicates the limitations of parental and professional observation in detecting partial hearing problems. The evidence adds support to the recent recommendations for universal neonatal screening.
ISSN:0300-5364
1708-8186
DOI:10.3109/03005369909090094