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Canadian Paediatric Society

Newborn hearing screening

Permanent hearing loss is one of the most common congenital disorders of childhood, occurring in about two per 1,000 live births. Universal newborn hearing screening (UNHS) leads to earlier diagnosis and intervention, which means better outcomes for children with a hearing impairment.21

Without screening, children with hearing loss are typically not diagnosed until they reach 2 years of age, with mild and moderate hearing losses often going undetected until children are in school. Universal screening would detect most infants with hearing loss by the time they are 3 months old, with an intervention started by 6 months of age.

Children with hearing loss who are not supported by early intervention can experience irreversible shortfalls in communication and psychosocial skills, cognition and literacy. Deafness can lead to lower academic achievement, underemployment, difficulty with social adaptation and psychological distress later on. Such effects are directly proportional to the severity of hearing loss and the time lag between diagnosis and intervention. Evidence shows that infants with hearing impairments who are diagnosed and receive intervention before 6 months of age score 20 to 40 percentile points higher on school-related measures (language, social adjustment and behaviour) compared with children who receive intervention later.

The two-step screening procedure implemented by most UNHS programs is highly efficient and cost-effective, particularly considering the lifetime costs of deafness. The Canadian Paediatric Society recommends that provinces and territories provide UNHS for all infants via a fully funded, integrated program that ensures: all babies are screened by 1 month, diagnoses are confirmed by 3 months and interventions are in place by 6 months of age.

Province/Territory2012 status2016 statusRecommended actionsComments
British Columbia

Excellent

Excellent

Meets all CPS recommendations.

Alberta

Fair

Fair

Implement a universal newborn hearing screening and intervention program. 

Hearing screening through the EHDI Program is currently available in select sites across the province, and by October 2018 will be available to all babies born in Alberta. 

Saskatchewan

Fair

Poor

Implement a universal newborn hearing screening and intervention program. 

Only the Saskatoon Health Region has a universal hearing screening program.

Manitoba

Poor

Excellent

Meets all CPS recommendations.

The Universal Newborn Hearing Screening Act received Royal Assent and the Universal Hearing Screening Program goes into effect on September 1, 2016.

Ontario

Excellent

Excellent

Meets all CPS recommendations.

Quebec

Good

Fair*

Implement a universal newborn hearing screening and intervention program. 

The CPS recognizes that a pilot project announced in 2009 is ongoing, with intensive program development to this point. There is concern, however, that full implementation has been delayed due to underfunding.

New Brunswick

Excellent

Excellent

Meets all CPS recommendations.

Nova Scotia

Excellent

Excellent

Meets all CPS recommendations.

Prince Edward Island

Excellent

Excellent

Meets all CPS recommendations.

Newfoundland and Labrador

Fair

Fair

Implement a universal newborn hearing screening and intervention program. 

Yukon

Good

Fair*

Implement a universal newborn hearing screening and intervention program. 

While a standardized, fully accessible system is not in place, the CPS recognizes that because most births occur in Whitehorse, nearly 90% of infants are screened. Also, each community health centre has access to newborn hearing screening equipment.
 

The CPS appreciates that retaining clinicians is an ongoing challenge.

Northwest Territories

Good

Fair*

Implement a universal newborn hearing screening and intervention program. 

The CPS appreciates that having a scattered population and limited access to centralized testing and corrective services pose significant challenges.
 

There are birthing centres in Inuvik, Hay River and Fort Smith, but audiology services are only available in Yellowknife.

Nunavut

Poor

Poor

Implement a universal newborn hearing screening and intervention program. 

The CPS appreciates that having a scattered population and limited access to centralized testing and corrective services pose significant challenges.

Excellent

Province/territory has a fully funded, integrated hearing screening program, with all babies screened by 1 month of age, diagnoses confirmed by 3 months, and interventions in place by 6 months.

 

Fair

Province/territory has a partial program. Testing is provided selectively (e.g., in neonatal intensive care units to infants at risk for hearing loss) or supportive services are limited by geography.

Poor

Province/territory does not offer newborn hearing screening.

*For provinces or territories that have gone from “Good” to “Fair”, this does not mean legislation has regressed. Rather, the “Good” indicator from the previous status report no longer exists. The indicators have been compressed into three.

Endnotes

  1. Patel H, Feldman M; Canadian Paediatric Society, Community Paediatrics Committee. Universal newborn hearing screening. Paediatr Child Health 2011;16(5):301-5.