Finalised at the European Consensus Development
Conference
on Neonatal Hearing Screening
15-16 May 1998, Milan
1. Permanent childhood hearing impairment* (PCHI) is a serious public health problem
affecting at least one baby in one thousand. Intervention is believed to be most
successful if commenced in the first few months of life. Therefore, identification by
screening at or shortly after birth has the potential to improve quality of life and
opportunities for those affected.
2. Effective programmes of intervention are well established.
3. Methods for identification of PCHI in the neonatal stage are now accepted clinical
practice. They are effective and can be expected to identify at least 80% of cases of PCHI
whilst incorrectly failing 2-3% of normally hearing babies in well-controlled programmes.
4. Neonatal testing in maternity hospitals is more effective and less expensive than
behavioural screening conventionally carried out at 7-9 months.
5. Targeting neonatal testing on only the 6-8% of babies at increased risk** of PCHI
reduces costs but cannot identify more than 40-50% of cases. Targeted neonatal hearing
screening in parallel with 7-9 month behavioural testing is more expensive and less
effective than universal neonatal screening.
6. Hearing screening in the neonatal period cannot identify acquired or progressive
hearing loss occurring subsequently. Surveillance methods are required to identify those
cases, which may be 10-20% of all permanent childhood hearing impairment.
7. Risks associated with neonatal hearing screening include anxiety from false positive
results and possible delayed diagnosis from false negative results, but these risks are
acceptable in view of the expected benefits.
8. Neonatal hearing screening should be considered to be the first part of a programme of
habilitation of hearing impaired children, including facilities for diagnosis and
assessment.
9. A system of quality control is an essential component of a neonatal hearing screening
programme. Quality control includes training of personnel and audit of performance. The
person responsible for quality control should be identified.
10. Although the healthcare systems in Europe differ from country to country in terms of
organisation and funding, implementation of neonatal screening programmes should not be
delayed. This will give new European citizens greater opportunities and quality of life
into the next millennium.
* Defined here as a bilateral permanent hearing impairment greater than or equal to 40 dB
averaged over the frequencies 0.5, 1, 2 and 4 kHz.
** Examples include neonatal intensive care and family history of hearing impairment.