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Figure 1. Newborn Hearing Screening Analytic Framework

Flow chart depicts Analytic Framework: High-risk & low-risk newborn infants, screen with OAE and/or ABR to (KQ 1a,b) Earlier diagnosis & treatment of permanent, bilateral, moderate to profound hearing loss or (KQ 3) Adverse effects of screening (labeling, anxiety, overdiagnosis). Results of KQ 1a,b screening are further screened by Early intervention* to (KQ 2) Improved language & communication (preschool age) or (KQ 3) Adverse effects of early treatment. A broken line leads from KQ 2 to a box labeled 'Improved mental health, psychosocial and cognitive function, school and occupational performance throughout life.'

Notes:

*Early intervention: Hearing aids or other amplification, American Sign Language and/or English instruction, speech & language therapy, family education & support.
Numbers refer to key questions (KQ) as follows: (1a) Can UNHS accurately diagnose moderate-to-profound sensorineural hearing impairment? (1b) In UNHS programs, how many children are identified and treated before 6 months? (2) Does identification and treatment prior to 6 months improve language and communication? (3) What are the potential adverse effects of screening and early treatment?
ABR indicates auditory brainstem response; OAE, Otoacoustic emissions.

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