A child health record audit of outcome comparisons for school screening referrals in Ireland

Abstract

This study sought to make use of existing child health records to assess recent changes in school entry screening (hearing and vision) in Ireland. The study aims were to analyse screening protocol and staff changes; estimate newborn and school hearing screening yields; and summarise pre-school specialist referrals against later school screen outcomes. The findings included that specialist school public health nurses (PHNs) had lower hearing screen but similar vision screen referral rates compared to area public health nurses. Approximately 1% of school hearing screens had persistent otitis media, justifying audiology referral priority. Over a quarter of pre-school records audited showed a specialist referral, many with ‘speech-only delay’; this sub-group had average referral rates from later school (hearing) screening. This study found that by employing specialist school PHNs to manage school screening, audiology referrals were reduced. Additionally, pre-school speech delay without other relevant risk factors should not need automatic audiology referral.