ICF consideration in early hearing detection and intervention outcomes: a systematic review

This systematic review mapped existing literature on early hearing detection and intervention (EHDI) outcomes using Fitzpatrick’s conceptual framework, which includes communication, life skills, process, and family outcomes. It offers a broad synthesis of EHDI programs, extending beyond traditional speech and language metrics and aligns with the International Classification of Functioning, Disability and Health (ICF). A structured search across seven databases from 1990 to 2024 identified 182 articles. After screening, 41 peer-reviewed studies (2001–2024) were included and categorized by outcome domain. The studies reflected global diversity in EHDI implementation. Communication outcomes appeared in 15 studies (37%), mostly from high-income countries, highlighting improved language and literacy with early identification. Life skills were addressed in 9 studies (22%), focusing on self-identity, academics, and social integration. Process outcomes were most common (34 studies, 83%), covering screening coverage, referral rates, and loss to follow-up (LTFU), with challenges in low- and middle-income settings. Family outcomes were reported in 32 studies (78%), emphasizing family-centered care, parental involvement, and access to support. Findings highlight the importance of evaluating EHDI through a multidimensional lens. While process outcomes dominate, greater focus on life skills and family experiences is needed. Reducing disparities in accessto early intervention, and LTFU is essential for improving EHDI effectiveness.