United Kingdom school-entry hearing screening: current practice.

OBJECTIVE: To determine if the school-entry hearing screening (SEHS) programme continues to make a useful contribution to the identification of childhood hearing impairment in the light of the recent implementation of universal newborn hearing screening, and thereby to inform future policy development. DESIGN: Postal questionnaire survey to determine current implementation and effectiveness of SEHS SETTING: 244 school health services managed within primary care and acute trusts throughout the UK. PARTICIPANTS: 229 SEHS service leads approached; 195 responded. MAIN OUTCOME MEASURE: Details of implementation; positive predictive value of the screening test and its referral criteria. RESULTS: Implementation of the SEHS is variable, and there is no national approach to data collection, audit and quality assurance. Less than 10% of services had available robust data. The yield from screening ranges from 0.05% to 0.59% for permanent sensorineural hearing impairment and from 0.07% to 0.44% for permanent conductive hearing impairment. The positive predictive values from screen referral vary from 0.62% to 12.16% for permanent sensorineural hearing impairment and 1.24% to 17.56% for permanent conductive hearing impairment. CONCLUSION: This comprehensive survey provides a previously unavailable national examination of the SEHS. The few available data on yield indicate that the SEHS may have a small but important role to play in identification of childhood hearing impairment, but the overwhelming conclusion is the urgent need for national guidelines on implementation of this screening programme to determine its value since the implementation nationally of universal newborn hearing screening.