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Newborn hearing screening follow-up: factors affecting hearing aid fitting by 6 months of age
Lynn Spivak1, Heidi Sokol, Charles Auerbach
1Long Island Jewish Medical Center, Hearing and Speech Center, 430 Lakeville Road, New Hyde Park, NY 11042, USA. spivak@lij.edu
Insights
Timely hearing aid fitting for infants is crucial but not always achieved. Infants with unilateral hearing loss face significant delays or loss to follow-up, hindering early intervention goals.
Area of Science:
- Pediatric audiology
- Early hearing detection and intervention
Background:
- Early intervention for hearing loss is critical for infant development.
- The established goal is hearing aid fitting by six months of age.
Purpose of the Study:
- To assess the achievement rate of the six-month hearing aid fitting goal.
- To identify barriers impacting timely infant hearing aid fitting.
Main Methods:
- Analysis of screening and follow-up records from 114,121 infants over six years.
- Categorization of infants with permanent hearing loss based on fitting timeliness (on time, late, lost to follow-up).
- Identification of seven potential barriers to timely intervention.
Main Results:
- 91% of referred infants attended follow-up.
- Only 39% of infants requiring amplification were fit on time; 61% were fit late or lost.
- Unilateral hearing loss, late diagnosis, conductive hearing loss, and Medicaid coverage were significant predictors of delayed fitting or loss to follow-up.
Conclusions:
- High follow-up rates do not guarantee timely hearing aid fitting by six months.
- Infants with unilateral hearing loss are particularly vulnerable to being lost to follow-up, underscoring a critical gap in intervention.
Purpose:
To determine the extent to which the goal of hearing aid fitting by 6 months of age is being achieved and to identify barriers to achieving that goal.
Method:
Screening and follow-up records from 114,121 infants born at 6 hospitals were collected over a 6-year period. Infants diagnosed with permanent hearing loss requiring amplification were categorized as fit on time, fit late, or lost to follow-up. Seven factors were empirically identified as potential barriers to timely intervention.
Results:
Ninety-one percent of referred infants returned for follow-up evaluation. Hearing aids were fit on 107 of the 192 infants requiring amplification. Thirty-nine percent were fit on time, and 61% were fit late or lost to follow-up. Unilateral hearing loss and late diagnosis were statistically significant (p < .0001) predictors for late fitting and loss to follow-up. Conductive hearing loss and coverage by Medicaid were also statistically significant (p < .0001) predictors for loss to follow-up.
Conclusion:
High return rate for follow-up does not ensure hearing aid fitting by 6 months of age. Infants with unilateral hearing loss are at particular risk of being lost to follow-up.
