Having a diminished defective sense of hearing, but not deaf is known as hard of hearing or a hearing impaired. Permanent childhood hearing impairment can have a devastating impact on communication skills, educational attainment, and quality of life with a high cost to society. Universal neonatal hearing screening has the potential to reduce the age at confirmation of congenital impairments. However, not all hearing impairments manifest themselves at birth, and screening programmes must be complemented by services that can confirm and manage cases where impairment first shows itself postnatal. No national register of hearing-impaired children exists for the United Kingdom, and accurate estimates of the prevalence of permanent childhood hearing impairment and of its profile across age and degree of impairment are unavailable. Such estimates at a time when pediatric audiology services in the United Kingdom are being transformed by the introduction of universal neonatal hearing screening and the modernization of hearing aid services. Previous studies of the prevalence of permanent childhood hearing impairment display two limitations. Firstly, they ascertained relatively small samples and so did not define the relation between prevalence, age, and degree of impairment precisely. Secondly, they did not estimate the extent of under ascertainment. We examined these issues by estimating prevalence from a total ascertainment of hearing impaired children in the United Kingdom and by employing capture-recapture analysis to adjust for under ascertainment. We estimated the prevalence of confirmed cases of permanent hearing impairment, including congenital, late onset, and acquired cases. Capture-recapture can correct for under ascertainment of confirmed cases. It does not discover cases that have not been confirmed.

Prevalence

The prevalence of permanent childhood hearing impairment rises over a wider age range and to a higher plateau than has been reported previously. In our study data collection relied on notifications from professionals in health and education, not all of who responded. However, geographical coverage was comprehensive, and the relation of our results to previously reported prevalence rates indicates that our methods of ascertainment were reliable.

Conclusion

In the United Kingdom the prevalence of confirmed cases of permanent childhood hearing impairment has raised with age to a significantly higher plateau than previous studies have estimated. These additional children would comprise some with congenital impairments who either miss neonatal hearing screening or pass the screening despite having a hearing impairment, some who acquire impairment postnatal, and others who manifest late onset or progressive impairments. Pediatric audiology and associated services will need the capacity and skills to identify and then confirm impairments in these children.

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