Inventory of current EU paediatric vision and hearing screening programmes
de Kroon, M.L.A.
Background: We examined the diversity in paediatric vision and hearing screening\ud programmes in Europe.\ud Methods: Themes relevant for comparison of screening programmes were derived from\ud literature and used to compile three questionnaires on vision, hearing and public-health\ud screening. Tests used, professions involved, age and frequency of testing seem to influence\ud sensitivity, specificity and costs most. Questionnaires were sent to ophthalmologists,\ud orthoptists, otolaryngologists and audiologists involved in paediatric screening in all EU fullmember,\ud candidate and associate states. Answers were cross-checked.\ud Results: Thirty-nine countries participated; 35 have a vision screening programme, 33 a\ud nation-wide neonatal hearing screening programme. Visual acuity (VA) is measured in 35\ud countries, in 71% more than once. First measurement of VA varies from three to seven years\ud of age, but is usually before the age of five. At age three and four picture charts, including Lea\ud Hyvarinen are used most, in children over four Tumbling-E and Snellen. As first hearing\ud screening test otoacoustic emission (OAE) is used most in healthy neonates, and auditory\ud brainstem response (ABR) in premature newborns. The majority of hearing testing\ud programmes are staged; children are referred after one to four abnormal tests. Vision\ud screening is performed mostly by paediatricians, ophthalmologists or nurses. Funding is\ud mostly by health insurance or state. Coverage was reported as >95% in half of countries, but\ud reporting was often not first-hand.\ud Conclusion: Largest differences were found in VA charts used (12), professions involved in\ud vision screening (10), number of hearing screening tests before referral (1-4) and funding\ud sources (8).
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