The impact of universal newborn hearing screening on long-term literacy outcomes: a prospective cohort study.

<bold>Objective: </bold>To determine whether the benefits of universal newborn hearing screening (UNHS) seen at age 8 years persist through the second decade.<bold>Design: </bold>Prospective cohort study of a population sample of children with permanent childhood hearing impairment (PCHI) followed up for 17 years since birth in periods with (or without) UNHS.<bold>Setting: </bold>Birth cohort of 100 000 in southern England.<bold>Participants: </bold>114 teenagers aged 13-19 years, 76 with PCHI and 38 with normal hearing. All had previously their reading assessed aged 6-10 years.<bold>Interventions: </bold>Birth in periods with and without UNHS; confirmation of PCHI before and after age 9 months.<bold>Main Outcome Measure: </bold>Reading comprehension ability. Regression modelling took account of severity of hearing loss, non-verbal ability, maternal education and main language.<bold>Results: </bold>Confirmation of PCHI by age 9 months was associated with significantly higher mean z-scores for reading comprehension (adjusted mean difference 1.17, 95% CI 0.36 to 1.97) although birth during periods with UNHS was not (adjusted mean difference 0.15, 95% CI -0.75 to 1.06). The gap between the reading comprehension z-scores of teenagers with early compared with late confirmed PCHI had widened at an adjusted mean rate of 0.06 per year (95% CI -0.02 to 0.13) during the 9.2-year mean interval since the previous assessment.<bold>Conclusions: </bold>The benefit to reading comprehension of confirmation of PCHI by age 9 months increases during the teenage years. This strengthens the case for UNHS programmes that lead to early confirmation of permanent hearing loss.<bold>Trial Registration Number: </bold>ISRCTN03307358. [ABSTRACT FROM AUTHOR]