Early Detection of Pediatric Permanent Hearing Loss: A Population-Based Retrospective Cohort Study

Evidence has indicated that Early Hearing Detection and Intervention (EHDI) programs have lowered the age of identifying permanent hearing loss (PHL) in childhood, a first step to intervention. However, limited research has compared the age of diagnosis before and after implementation in one jurisdiction across the full range of PHL. Methods: Children diagnosed with PHL in Ottawa, Canada were identified from the Child Hearing Lab database at the Children’s Hospital of Eastern Ontario and linked to Ontario health administrative data. Age of identification of PHL of children born in the pre-infant hearing program (IHP) era (1991-2002) was compared to those born in the decade after it (2003-2013), employing a regression discontinuity design. Results: Age at identification of PHL declined more rapidly in the post-IHP era compared to the pre-IHP period (β estimate of IHP*Time -2.12, 95% CI -0.59 to -3.65, P=0.007). This association remained when interactions between IHP, time, and severity of hearing loss were included (β IHP*Time -6.05, 95% CI -2.59 to -9.51, P<0.001). Discussion: Implementation of Ontario’s EDHI program was associated with earlier diagnosis of PHL compared to the era before its implementation. This finding provides direct evidence of effectiveness across the range of PHL in one jurisdiction.