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Newborn hearing screening and follow-up: are children receiving recommended services?
Marcus Gaffney1, Denise R Green, Claudia Gaffney
1centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA 30333, USA. MGaffney@cdc.gov
Insights
Newborn hearing screening is widespread, but many infants who don't pass are lost to follow-up. Improving documentation and intervention is crucial for early hearing loss detection.
Area of Science:
- Public Health
- Pediatrics
- Audiology
Background:
- Newborn hearing screening programs are established nationwide to identify infant hearing loss and prevent developmental delays.
- The Centers for Disease Control and Prevention (CDC) monitors these programs to track progress towards national objectives.
- Early Hearing Detection and Intervention (EHDI) initiatives aim to ensure timely diagnosis and support for infants with hearing impairments.
Purpose of the Study:
- To summarize findings from the CDC's EHDI Hearing Screening and Follow-up Survey (HSFS) for 2005-2006.
- To assess progress in identifying infants with hearing loss in the U.S.
- To evaluate the effectiveness of current screening and intervention pathways.
Main Methods:
- The HSFS collected aggregate data on screening, diagnosis, intervention, and demographics from U.S. EHDI programs.
- Data from 2005 and 2006 were analyzed to evaluate progress toward national hearing screening goals.
- The survey focused on tracking infants through the screening and diagnostic process.
Main Results:
- Over 90% of infants were screened for hearing loss in 2005 and 2006.
- Approximately 2% of infants did not pass their final screening.
- A significant challenge identified was the high rate (two-thirds) of infants not documented with a diagnostic finding, largely due to loss to follow-up/loss to documentation (LFU/LTD).
- While most infants with confirmed hearing loss received intervention, over 30% were lost to follow-up/documentation, hindering service confirmation.
Conclusions:
- The HSFS provides valuable data on the progress of infant hearing screening programs.
- Despite high screening rates, substantial improvements are necessary to reduce loss to follow-up/documentation.
- Meeting national benchmarks requires enhanced efforts to ensure all infants receive timely diagnosis and intervention for hearing loss.
Objectives:
Newborn hearing screening programs have been implemented by all 50 states and most U.S. territories to detect hearing loss in infants and prevent delays in speech, language, and social and emotional development. To monitor progress toward national goals, the Centers for Disease Control and Prevention (CDC) collects data from state and territorial programs. This article summarizes findings from the CDC Early Hearing Detection and Intervention (EHDI) Hearing Screening and Follow-up Survey (HSFS) and provides a summary of recent efforts to identify infants with hearing loss in the U.S.
Methods:
The HSFS was sent to representatives of U.S. EHDI programs to gather aggregate screening, diagnostic, intervention, and demographic data for 2005 and 2006. We analyzed these data to evaluate progress toward national goals.
Results:
In 2005 and 2006, more than 90% of infants were screened for hearing loss. Of these infants, 2% in both years did not pass their final screening. Out of those not passing the final screening, approximately two-thirds were not documented as having a diagnostic finding. In both years, the reason reported for the majority of infants was loss to follow-up/loss to documentation (LFU/LTD). Although the majority of infants with permanent hearing loss were receiving intervention, more than 30% were classified as LFU/LTD and could not be documented as receiving intervention services.
Conclusions:
The HSFS enables the collection of more complete data that highlight the progress in screening infants for hearing loss. However, data indicate improvements are needed to reduce LFU/LTD and meet the national benchmarks.
