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Updated: Jun 10, 2026
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Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
Evaluation of the universal newborn hearing screening and intervention program.
Shanna Shulman1, Melanie Besculides, Anna Saltzman
1Blue Cross Blue Shield of Massachusetts Foundation, Boston, Massachusetts, USA.
Pediatrics
|August 4, 2010
Summary
Universal newborn hearing screening and intervention programs have improved infant hearing loss detection. However, significant barriers hinder follow-up care for infants who screen positive, impacting early intervention success.
Area of Science:
- Public Health
- Audiology
- Pediatrics
Background:
- Universal newborn hearing screening and intervention (UNHSI) programs have expanded nationwide, increasing infant hearing loss evaluations.
- A critical challenge for UNHSI programs is the loss to follow-up among families of infants who screen positive for hearing loss.
Purpose of the Study:
- To evaluate the progress of state and territorial UNHSI programs in achieving their goals.
- To identify persistent barriers to successful follow-up care for infants with positive hearing screens.
- To document successful strategies employed by states to overcome these barriers.
Main Methods:
- Surveyed 55 state and territorial UNHSI programs.
- Conducted site visits with 8 state UNHSI programs for in-depth evaluation.
Main Results:
- While screening has advanced, significant barriers impede linking infants with positive screens to necessary follow-up services.
- Identified barriers include insufficient service-system capacity, limited provider knowledge, difficulties for families accessing services, and information gaps.
- Documented successful state-level strategies addressing these identified barriers.
Conclusions:
- Programs have made progress in infant hearing screening but require improvements in linking families to follow-up care.
- Key areas for future improvement include enhancing data systems, ensuring medical home access, expanding provider capacity, developing family support, and promoting early detection awareness.
