Screening for Hearing Loss Among Preschool Children in San Francisco

Hearing loss is the most common sensory impairment in babies, and puts them at significant risk for permanent speech, language and developmental delays if not identified early.

One in 500 babies is born with hearing loss, a prevalence that more than doubles by the time children enter school. Though all babies are screened for hearing loss at birth, there is no regular hearing screening until at least age 4. Screening for hearing loss in preschools can be a critical safety net for early identification of hearing loss, but it can be very difficult to screen preschoolers effectively, particularly those from vulnerable populations.

The Office of Childhood Hearing in the San Francisco Department of Public Health (SF DPH) performs hearing screenings for over 1,700 low-income preschoolers across San Francisco. The Department of Otolaryngology – Head and Neck Surgery at the University of California, San Francisco (UCSF OHNS) has partnered with SF DPH for the past 8 years to improve and track the screening program. The study was led by UCSF OHNS residents Kara Brodie, MD, MPhil, and Abel David, MD, in collaboration with Hayley Kriss, lead audiometrist at SF DPH, under the supervision of Dylan Chan, MD, PhD, in the Pediatric Otolaryngology division.

In this study of nearly 7,000 preschoolers, a combination of behavioral and non-behavioral hearing screening was 99.6% effective. The researchers found that 3.1% of children were identified with hearing loss, which enabled them to be subsequently managed by their pediatrician, audiologist and/or otolaryngologist. Children suspected by their preschool teachers of having hearing, speech or language problems were 10 times more likely to actually have hearing loss, highlighting the importance of following up on teacher's concerns with a hearing test.

The processes established by Ms. Kriss and her team at SF DPH are a model for large-scale preschool hearing screening, and we look forward to future collaboration that will help establish more large-scale screening across the region and country.

Read more about the study here.

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