Audit of the distraction test of hearing at about 8 months of age: results of a survey of Scottish health boards.

The distraction test of hearing at 8 months is offered in all Scottish health boards and is a recommendation of the Hall Report 'Health for all Children'. As part of a Scotland-wide project to assess the feasibility of an audit of pre-school surveillance programmes using routinely collected data, all boards were asked for information about this screening test. The results showed that all boards regarded it as a worthwhile screening test in the present circumstances for early detection of sensorineural hearing loss (SNHL). The limitations on the reliability of the test were recognized by many boards. The quality elements of the whole screening process were examined, including screening technique, recording of results, provision of equipment and suitable test conditions, and staff training. The results showed variations in the attention given to quality standards. The results also showed a number of gaps in availability of data on coverage, results, and outcomes. Only one board was realistically able to audit the distraction test at all stages using routinely collected data. Availability of data will improve with the introduction of the national computerized Pre-school Child Health Surveillance Programme (CHSP) into the majority of health boards. The reliability and validity of audit results whether at board level or Scotland-wide level will depend on maintenance and adherence to quality standards in performing the test, in recording of results and also in ensuring adequate coverage.