In India, two children are born with hearing impairment per hour which amounts to 1/2000 to 1/10000 live births. 18000 children with hearing impairment are added to our population every year [1]. Universal newborn hearing screening is mandatory in most developed countries. WHO’s Newborn and Infant Screening Report (November 2009) postulates a 1-3-6 rule for newborn hearing screening programs, in which neonates should be ideally screened before 1 month of age, diagnosed by 3 months of age, and intervened by 6 months of age. Presently, Kochi seems to be the only city in India to have centralized new born hearing screening program [2]. The program has screened 1,01,688 babies and identified 162 babies with hearing loss [3].

We started centralized newborn hearing screening in October 2010 and have continued it till date. A two-tier screening approach with oto-acoustic emissions, and brainstem evoked response audiometry (BERA) was followed. A health care worker was identified and trained to carry out the screening test and documentation. The screener travelled to the identified locations, screened the babies, and provided the provisional reports, following which formal report was mailed to them.

From October 2010 to December 2015, we screened a total of 1716 babies. 809 babies were from well-baby nurseries and 907 babies were from neonatal intensive care unit. 299 babies failed the first screen, but only 66 out of 299 appeared for rescreen. Eighteen babies failed the rescreen and were recommended BERA testing. However, none of the babies turned up for BERA testing or could not be tracked further.

Poor follow-up for rescreening and diagnostic BERA was the greatest challenge to our endeavor. As compared to the experience from Kochi [3], the number of children we screened is much less and follow-up is poor. The dropout of children could possibly be due to lack of effective communication between the screener and the parent, which may be due to lack of background in speech and hearing. We plan to overcome this by introduction of an audiologist to coordinate the patient screening and place audiology interns to carry out the screening. We believe that a centralized two-tier approach is the best and most economically viable approach to neonatal hearing screening, provided adequate communication is established by the screening personnel, so as to ensure a proper follow up.

1. Singh V. Newborn hearing screening: Present scenario.Indian J Community Med. 2015;40:62.

2. Paul AK. Early identification of hearing loss and centralized newborn hearing screening facility-the Cochin experience. Indian Pediatr. 2011;48:355-9.