Table 4 Characteristics and key recommendations of the included childhood hearing screening guidelines

1

England [33]

Audiology and Health

2017

Early identification of deafness in childhood (following newborn hearing screening) position statement

4–7 years of age

/

/

1. Data should be collected locally and nationally

2. Include local audit and clinical governance arrangements

3. Obtain parental consent before hearing screening

2

International [34]

World Health Organization

2016

Childhood Hearing Loss Strategies for prevention and care

Preschool– and school-aged children

/

/

Integrate ear and hearing screening in school health programs and develop links for provision of suitable medical, surgical, and rehabilitative care

3

America [8]

Hall JW

2016

Effective And Efficient Pre-School Hearing Screening: Essential For Successful Early Hearing Detection And Intervention (EHDI)

All pre-school children from the age of 6 months to 5 years

Include DPOAE, tympanometry, acoustic reflex for broadband noise signal, otoscopy, and pure tone hearing screening at 20 dB HL

Six months to 4 years

Tympanometry, acoustic reflex for broadband noise signal, and otoscopy for secondary screening

 ≥ 4 years

Tympanometry, acoustic reflex for broadband noise signal, and otoscopy for children who do not pass DPOAE

2. Pure tone hearing screening at 20 dB HL for children who have normal tympanograms

DPOAEs as the primary tool for hearing screening of all pre-school children from the age of 6 months to 5 years

4

China [12]

National Health and Family Planning Commission of the People's Republic of China

2013

The Technical Specification for Children's Ear and Hearing Care

0–6 years of age

Include: Ear appearance examination, auditory behavioral observation, portable auditory

assessment instrument, and OAE

Referral for diagnosis:

1. Positive results on any of the auditory behavioral observation method screening tools

2. Positive results on any of the audiological assessment instrument screening tools

3. Failure of OAE screening

1. After hearing screening in the neonatal period, children aged 0–6 years are managed in the health care system

2. Ear and hearing care is provided in conjunction with health screening

3. The priority ages for hearing screening are 6, 12, 24, and 36 months of age

5

Europe [35]

Skarżyński H et al

2012

Screening for hearing problems in pre-school and school-age children: European Consensus Statement

All children aged 4–7 years

/

/

1. Defining the role of pre-school and school screening programs in identifying and treating hearing problems;

2. Identifying the target population;

3. Recognizing the need for a quality control system in screening programs

6

America [11]

American Academy of Audiology

2011

Childhood Hearing Screening Guidelines

Pre-school; kindergarten; and grades 1, 3, 5 and either 7 or 9

Include: pure tone screening, tympanometry, acoustic reflex and reflectometry, screening with Speech Stimuli Materials and OAEs

1. Fail pure tone or OAE and tympanometry: Rescreening in 8–10 weeks

2. Fail pure tone only: no rescreening, do not wait for second-stage screening

Pure tone screening:

1. Perform a pure-tone sweep at 1000, 2000, and 4000 Hz at 20 dB HL

2. Present a tone more than once but not more than four times if a child fails to respond

3. Only screen in an acoustically appropriate screening environment

4. Failure is indicated by a lack of response at any frequency in either ear

Tympanometry screening:

1. Employ a second‐stage screening method after failure of pure tone or OAEs

2. Use defined tympanometry screening and referral criteria

3. The target should be young children