Irish School Entry Screening referral trends and cohort comparison with preschool specialist referrals

Objective: To analyse referral cohorts from School Entry Screening, Hearing (SHS) and Vision Screening (SVS) before and after documented changes. To compare referrals to pre-school specialists with subsequent group SHS outcomes. Design: Randomized cohort, audit analysis of Community Nursing Developmental and SES records (CHRs), plus Audiology file review for SHS referrals. Study sample: Six hundred and sixty-eight mainstream pupils’ CHRs were analysed in four birth cohorts, post-SES, using coded anonymized records. Results: Significant referral rate differences existed between SHS and SVS. SHS, not SVS, referrals were impacted by nursing staff changes but not by SHS protocol changes. Preschool Audiology referrals outnumbered SHS referrals. All PCHI children with amplification were detected prior to SHS. SHS program yielded conductive hearing loss only. Similar SHS referral rates occurred for pre-school Speech Language Therapy referrals compared to children not referred; just 16% of pre-school Speech Language Therapy primary referrals were referred on to Audiology. Conclusions: SHS referral percentage fell slightly; SVS referral percentage remained unchanged. Low referral rates and low SHS hearing loss yield has modest impact upon Audiology services, but audiometrically screened referrals deserve higher priority. UNHS children born after 2011 create bigger Audiology service impact. International comparisons and European SHS research collaboration are encouraged.