Background: Newborn hearing screening has been nationally implemented, but longitudinal cohort follow-up is required to inform Children's Hearing Services of the requirements for postneonatal care pathways.
Methods: A 10-year cohort of 35 668 births enrolled into a Universal Neonatal Hearing Screen was followed up until the children had completed the first year of primary school.
Results: There were 3.65/1000 children with a permanent hearing impairment of any degree embarking on their education. 1.51/1000 had a moderate or worse bilateral deafness but only 0.9/1000 with this degree of deafness had been identified by newborn screening. Postneonatal care pathways were required to identify those with congenital impairments missed by the screen (0.11/1000), those moving into the district (0.25/1000) and those with late onset deafness (0.25/1000). An additional postneonatal yield of 1.2/1000 had mild or unilateral impairments. When all degrees of impairment were considered 51% of the children with a permanent hearing impairment had required identification by postneonatal care pathways.
Conclusions: Despite the success of the newborn hearing screen, the provision of postneonatal pathways remains essential for identifying deafness in early childhood.