Universal screening for infant hearing impairment: not simple, not risk-free, not necessarily beneficial, and not presently justified

Universal screening for hearing impairment among infants may not be beneficial. The National Institutes of Health (NIH) recommends that all infants be screened for hearing impairment within the first three months of life, preferably before leaving the hospital at birth. Early hearing loss can affect speech and language development, academic achievement, economical potential and self-esteem. However, the validity of diagnostic tests, high numbers of false positive results and cost of treatment make universal screening programs inappropriate. Available diagnostic equipment is difficult to use and test results are hard to interpret. One test cannot detect low frequency hearing loss and the other often generates false positive results in the first 48 hours of life. Universal screening would cost about $200,000,000 per year, which may be an unnecessary expense given the lack of evidence on suitable treatments and early intervention.