More than 90% of newborns in the United States are now being screened for hearing loss. A large fraction of cases of unilateral hearing loss and mild bilateral hearing loss are not currently identified through newborn hearing screening. This is of concern because a preponderance of research has demonstrated that unilateral hearing loss and mild bilateral hearing loss can lead to developmental delays and educational problems for some children. To help address this probable underidentification of unilateral hearing loss and mild bilateral hearing loss among infants and children, the Centers for Disease Control and Prevention Early Hearing Detection and Intervention program and the Marion Downs Hearing Center convened a workshop in Breckenridge, Colorado, in July 2005. During this workshop, several issues related to screening and diagnosing unilateral hearing loss and mild bilateral hearing loss were identified, as well as recommendations for future research in this area. Issues identified included the lack of standardized definitions for permanent unilateral hearing loss and mild bilateral hearing loss; the use of screening protocols that are primarily designed to identify bilateral and unilateral hearing losses of a moderate degree or greater (eg, above 40 dB); calibration of screening equipment; availability of facilities that can provide the full range of audiologic, diagnostic, and management services to this pediatric population; and an overall lack of awareness by many professionals and families about the potential effect of unilateral hearing loss and mild bilateral hearing loss. Suggestions for future research, such as identifying ways to improve the identification of cases of unilateral hearing loss and mild bilateral hearing loss, were also discussed.

Some children with unilateral hearing loss or mild bilateral hearing loss are at risk for developmental delays, educational difficulties, and other adverse effects. However, these children face several challenges in receiving services that can prevent such problems. Many do not meet existing eligibility requirements for early intervention services in their state. Information disseminated to professionals and parents often does not convey the significance of unilateral and mild bilateral hearing loss. Some professionals indicate that there are insufficient guidelines defining appropriate intervention services for these children. Factors that influence developmental outcomes in this population are not well understood, making it difficult to determine which children can benefit from intervention services. Additional data are needed about how to minimize or prevent adverse outcomes in these children. This article presents suggestions for intervention and future research that were developed by participants of the 2005 National Workshop on Mild and Unilateral Hearing Loss.