Hearing loss, the most common sensory impairment in children, can have a significant impact—particularly on a child’s communication and language development—if not addressed early on.

Today, there have been significant advances in the screening and management of neonatal hearing loss in children. These advances help reduce the impact of hearing loss on communication and language development, and consequently on academic performance. A national program for universal screening of permanent neonatal hearing loss was therefore established by the Ministry of Health in 2014.
Its goal is to detect hearing loss in children as early as possible, to enable early intervention and thereby limit the impacts of this condition. It takes place in two phases following parental information and consent: a screening phase in the maternity ward (or neonatal unit) consisting of two automated, rapid, and painless tests; and a diagnostic phase at a specialized facility if hearing loss is suspected following the first phase. The rollout of the screening program is being evaluated by Santé publique France with the objectives of proposing ways to improve the implementation of this screening in France and of informing the general public.

Evaluation of the rollout of the neonatal hearing screening program at the national level

The Ministry of Health had set a national target of 90% screening coverage by the end of the first two years of implementation. Furthermore, given that in the absence of screening, the average age at diagnosis ranges from 12.5 to 36 months, the Haute Autorité de Santé (HAS) recommended offering an intervention program before the age of one for deaf children.
The task entrusted to Santé publique France was therefore to evaluate the quality of the implementation of this screening program at the national level during the two years following its launch.

To this end, a list of indicators based on aggregated data provided by the regional health agencies was defined, in collaboration with the various stakeholders involved in the screening program (ARS, screening operators, ENT specialists). A web application to calculate these indicators in each of France’s regions was developed at the request of Santé publique France. Called SpF-Surdité, this application was made available to the ARS and screening operators to standardize the calculation of these indicators and thereby facilitate the work of the ARS and operators in the field.
In addition, the ARS Bretagne has requested support from Santé publique France Bretagne to produce the indicators needed to monitor program activity and evaluate the program’s implementation.

Results of screening for permanent neonatal hearing loss

Regional indicators for children born in 2015 and 2016 were submitted by the regions and analyzed by Santé publique France.
Similarly, aggregated data organized by month of birth for each facility in Brittany were analyzed by the Brittany Regional Unit and enabled a more precise description of the various screening and diagnostic phases in this region.

In both reports, areas for improvement were identified (particularly regarding data from the diagnostic phase) and will ultimately allow for a meaningful assessment of the effectiveness of the neonatal hearing screening program.