The impact of universal newborn hearing screening on long-term literacy outcomes: a prospective cohort study.

OBJECTIVE To determine whether the benefits of universal newborn hearing screening (UNHS) seen at age 8 years persist through the second decade. DESIGN Prospective cohort study of a population sample of children with permanent childhood hearing impairment (PCHI) followed up for 17 years since birth in periods with (or without) UNHS. SETTING Birth cohort of 100 000 in southern England. PARTICIPANTS 114 teenagers aged 13-19 years, 76 with PCHI and 38 with normal hearing. All had previously their reading assessed aged 6-10 years. INTERVENTIONS Birth in periods with and without UNHS; confirmation of PCHI before and after age 9 months. MAIN OUTCOME MEASURE Reading comprehension ability. Regression modelling took account of severity of hearing loss, non-verbal ability, maternal education and main language. RESULTS Confirmation of PCHI by age 9 months was associated with significantly higher mean z-scores for reading comprehension (adjusted mean difference 1.17, 95% CI 0.36 to 1.97) although birth during periods with UNHS was not (adjusted mean difference 0.15, 95% CI -0.75 to 1.06). The gap between the reading comprehension z-scores of teenagers with early compared with late confirmed PCHI had widened at an adjusted mean rate of 0.06 per year (95% CI -0.02 to 0.13) during the 9.2-year mean interval since the previous assessment. CONCLUSIONS The benefit to reading comprehension of confirmation of PCHI by age 9 months increases during the teenage years. This strengthens the case for UNHS programmes that lead to early confirmation of permanent hearing loss. TRIAL REGISTRATION NUMBER ISRCTN03307358.