Validity of large scale standardised behavioural screening.

A nation-wide screening programme in the Netherlands is described. 86% of all children are invited at the age of 9 months for the three-stage Ewing screening: 94% participate. The screening procedure is standardized in very great detail, including test, registration, training and guidance. The objective of the screening programme is to detect moderate to severe sensorineural hearing loss as well as long-standing conductive hearing loss. Tympanometry studies clearly show that the selection process of conductive hearing loss is associated with otitis media with effusion (OME) lasting 3 months or more. Studies on two cohorts of children with sensorineural hearing loss show test standardization and training to be vital elements of behavioural screening. All studies show validity parameters of 85% or more.