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Trends in age of identification and intervention in infants with hearing loss
Melody Harrison1, Jackson Roush, Jennifer Wallace
1University of North Carolina School of Medicine, Chapel Hill 27599-7190, USA. melody_harrison@med.unc.edu
Insights
Newborn hearing screening significantly reduces the age of identification and intervention for infants with hearing loss. Early screening helps children meet developmental timelines, especially those with severe or unknown causes of hearing impairment.
Area of Science:
- Pediatric audiology
- Public health screening programs
- Neonatal care
Background:
- Newborn hearing screening (NHS) implementation expanded significantly in the US from 1993 to 2000.
- Previous identification and intervention ages for hearing loss often exceeded two years.
- The Joint Committee on Infant Hearing (JCIH) established guidelines for timely diagnosis and intervention in 2000.
Purpose of the Study:
- To assess trends in the age of identification and intervention for hearing loss in infants and young children.
- To compare identification and intervention ages between screened and unscreened infants.
- To identify barriers to timely diagnosis and intervention for pediatric hearing loss.
Main Methods:
- Survey of 151 parents of children under six years with confirmed hearing loss, born between 1996-2000.
- Data collected from parents across 41 states regarding hearing screening status, age of identification, and intervention.
- Analysis focused on comparing outcomes for screened versus unscreened infants and identifying barriers.
Main Results:
- Approximately 50% of surveyed children were screened for hearing loss at birth.
- Infants screened at birth showed earlier identification and intervention compared to unscreened infants.
- Children with severe hearing loss or unknown causes, when screened at birth, tended to meet JCIH 2000 guidelines.
Conclusions:
- Implementation of newborn hearing screening is associated with a trend toward earlier identification and hearing aid fitting.
- NHS demonstrably lowers the age of diagnosis and intervention for infants with hearing loss.
- Despite limitations (literate, English-speaking respondents), the study supports the effectiveness of NHS.
Objective:
In 1993, 11 hospitals in the United States were known to screen more than 90% of newborns for hearing loss. By 2000, approximately 1,000 hospitals reported screening at least 90% of their babies. This study was designed to identify trends in the age of identification and intervention for infants and young children with hearing loss in light of expanded implementation of newborn hearing screening.
Design:
Parents of children under 6 yr of age with a confirmed hearing loss were surveyed. The survey instrument was designed to investigate three questions: 1) is the age of identification and intervention earlier for babies whose hearing is screened at birth compared with those whose hearing is not screened; 2) when hearing is screened at birth, do ages of diagnosis of hearing loss and intervention meet the guide-lines established in 2000, by the Joint Committee on Infant Hearing (Reference Note 1), and 3) what are the barriers to timely identification and intervention? Six hundred fifty-seven parents received the mailing.
Results:
Responses of 151 parents of children with hearing loss, born between 1996 and 2000, were analyzed. Parents from 41 states provided information. Approximately half the children reported on were screened for hearing loss at birth. Age of identification and hearing aid fitting varied substantially based on degree of hearing loss and whether the cause of hearing loss was known or unknown; however, diagnosis and intervention occurred at an earlier age for infants screened at birth. Findings indicate that when hearing is screened at birth, infants with more severe degrees of hearing loss and an unknown cause tend to be identified and receive intervention within the 2000 timelines proposed by the Joint Committee on Infant Hearing. Barriers to timely identification and intervention are discussed.
Conclusions:
Before widespread implementation of newborn hearing screening, age of identification and intervention were consistently reported to exceed 2 yr of age. The results reported here indicate a trend toward earlier identification and hearing aid fitting with the implementation of newborn hearing screening. Although limited to literate and English speaking respondents, the study provides supporting evidence that newborn hearing screening lowers the ages of identification and intervention.