Authors' objectives:

This report summarises the research evidence about hearing, speech and language and vision screening.

Authors' recommendations: Child health screening focuses on the early detection of childhood disorders in order to reduce disability. This includes screening for hearing, speech and language and vision problems in pre-school children. Screening for permanent childhood hearing impairment is usually carried out by health visitors using the infant distraction test (HVDT) at 6-9 months. This test fails to detect a significant number of hearing problems sufficiently early. There is good evidence that universal neonatal hearing screening is more effective and cost-effective than HVDT at detecting significant congenital hearing loss. A significant number of pre-school children show signs of speech and language delay at some point. Delay which would not spontaneously improve can be effectively treated. However, it is not yet clear how to identify children who will fail to progress without treatment. Pre-school vision screening for refractive errors and non-obvious squints may not be beneficial because these minor conditions, by themselves, do not appear to be problematic and because the advantages of treating them have not been demonstrated. Major defects are identified without screening. The direct research evidence that amblyopia in young children is disabling and can be effectively treated is weak. However, there is strong clinical opinion that identifying and treating amblyopia at an early age produces benefits. Better research is required to provide a clearer picture of the likely benefits, harms and costs of pre-school vision screening. NHS organisations may wish to review their hearing screening in the light of this evidence but further change is not recommended in advance of the advice from the National Screening Committee and/or further research.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.york.ac.uk/inst/crd/ehcb.htm

Year Published: 1998

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: University of York

Contact Address: University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,

Contact Name: crd@york.ac.uk

Contact Email: crd@york.ac.uk

Copyright: Centre for Reviews and Dissemination