Progress in identifying infants with hearing loss—United States, 2006-2012
Insights
Early Hearing Detection and Intervention programs are improving infant hearing screening and diagnosis rates. Continued efforts are needed to enhance documentation and reduce infants lost to follow-up for timely intervention.
Area of Science:
- Public Health
- Pediatrics
- Audiology
Background:
- Congenital hearing loss impacts infant development, necessitating early detection and intervention.
- Early Hearing Detection and Intervention (EHDI) programs aim to screen, diagnose, and provide early intervention (EI) services for infants with hearing loss.
- Inconsistent reporting of diagnostic testing and EI enrollment data poses challenges for tracking infants and identifying those lost to follow-up (LFU)/lost to documentation (LTD).
Purpose of the Study:
- To analyze Early Hearing Detection and Intervention (EHDI) surveillance data from 2006-2012 to assess progress in identifying infants with hearing loss.
- To evaluate trends in screening, diagnostic testing (DX), and early intervention (EI) enrollment rates.
- To determine the reduction in infants classified as lost to follow-up/lost to documentation for both diagnostic testing and EI enrollment.
Main Methods:
- Analysis of Early Hearing Detection and Intervention (EHDI) surveillance data collected by the CDC between 2006 and 2012.
- Inclusion of data from an increasing number of reporting jurisdictions (49 to 57).
- Examination of key performance indicators including screening rates, referral rates, diagnosis rates, EI enrollment rates, and LFU/LTD rates for DX and EI.
Main Results:
- Increased screening rates from 95.2% to 96.6% and diagnosis rates from 4.8% to 10.3%.
- Improved early intervention (EI) enrollment for diagnosed infants, rising from 55.4% to 61.7%.
- Decreased rates of infants lost to follow-up/lost to documentation (LFU/LTD) for both diagnostic testing and EI enrollment.
Conclusions:
- Sustained progress has been made in screening, identifying, and enrolling infants with hearing loss in early intervention services.
- Despite improvements, challenges persist in the consistent provision and documentation of EHDI services.
- Continued efforts are necessary to further reduce LFU/LTD rates and ensure all infants receive timely audiological and developmental support.
Abstract:
Congenital hearing loss affects one to three of every 1,000 live born infants and negatively impacts children through delayed speech, language, social, and emotional development when undetected. To address this public health issue, jurisdiction-based Early Hearing Detection and Intervention (EHDI) programs are working to ensure all newborns are screened for hearing loss, receive follow-up diagnostic testing (DX) if they do not pass the screening, and are enrolled in early intervention (EI) services if diagnosed with a permanent hearing loss. Although substantial progress has been made in the provision and documentation of services, challenges remain because, unlike screening results, diagnostic test results and enrollment in EI are not consistently reported to the EHDI programs. Therefore, it is difficult for states and territories to know if infants received recommended follow-up services (diagnostic testing and/or EI services), often resulting in infants being classified at either stage as lost to follow-up (LFU)/lost to documentation (LTD). To assess progress toward identifying children with hearing loss and reducing LFU/LTD for DX (LFU/LTD-DX) and EI enrollment (LFU/LTD-EI), CDC analyzed EHDI surveillance data for 2006-2012. Results indicated that the number of jurisdictions reporting data increased from 49 to 57, rates of screening increased from 95.2% to 96.6%, rates of referral from screening decreased from 2.3% to 1.6%, rates of diagnosis among infants not passing their final screening increased from 4.8% to 10.3%, and enrollment in EI among children diagnosed with hearing loss increased from 55.4% to 61.7%, whereas rates for both LFU/LTD-DX and LFU/LTD-EI declined. These findings show sustained progress toward screening, identification, and enrollment in EI as well as highlighting the need for continued improvements in the provision and documentation of EHDI services.
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