A survey of strategies for the early diagnosis of hearing loss in infants: a scoping review.

Abstract

Purpose: To map the strategies used for the early diagnosis of hearing loss in infants.

Research strategies: A comprehensive literature search was conducted in PubMed/MEDLINE, Scopus, Embase, Web of Science, LILACS, Google Scholar, and ProQuest, with no restrictions on language or publication period. The search was initially performed in October 2024 and updated in January 2026. Controlled descriptors (DeCS/MeSH) and keywords related to hearing loss, newborn hearing screening, and early diagnosis were used. The protocol was registered in the Open Science Framework.

Selection criteria: Primary studies addressing strategies for the early diagnosis of hearing loss in children up to two years of age were included. Secondary studies, case reports, guidelines, duplicate publications, and studies without full-text availability were excluded. Study selection was performed independently by reviewers, with disagreements resolved by consensus.

Data analysis: Extracted data included study design, population, diagnostic instruments, strategies, and care setting. A descriptive and narrative synthesis was conducted, grouping evidence according to diagnostic approaches.

Results: Of the 16,946 records identified, 58 studies published between 1991 and 2025 met the eligibility criteria. Universal Newborn Hearing Screening (UNHS) predominated, particularly protocols combining otoacoustic emissions and automated auditory brainstem response. Complementary strategies included two-stage screening, early retesting, community-based programs, genetic screening, and additional electrophysiological assessments. Variability in protocol implementation and persistent structural inequalities were observed.

Conclusion: UNHS remains the cornerstone of early diagnosis of hearing loss in infants, with effectiveness dependent on well-organized care pathways and integration between screening, diagnosis, and follow-up.