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Receipt and Timeliness of Newborn Hearing Screening and Diagnostic Services Among Babies Born in 2017 in 9 States
Xidong Deng1, Suhana Ema, Craig Mason
1National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Deng, Nash, and Carbone, Ms Ema, and Mr Gaffney); and College of Education and Human Development, University of Maine, Orono, Maine (Dr Mason). Dr Nash is now with Task Force for Global Health, Decatur, Georgia.
Insights
Timely newborn hearing screening is common, but diagnosis delays persist for some groups. Targeted follow-up and education for underrepresented populations can improve early hearing detection and intervention (EHDI) outcomes.
Area of Science:
- Pediatrics
- Public Health
- Audiology
Background:
- Early identification of hearing loss is crucial for children's language development.
- The Early Hearing Detection and Intervention (EHDI) process aims to minimize adverse effects of delayed diagnosis.
Purpose of the Study:
- To evaluate the timeliness of key events within the EHDI process.
- To identify disparities in EHDI timeliness across different populations.
Main Methods:
- Retrospective, cross-sectional study design.
- Analysis of pooled EHDI data from 9 states for infants born in 2017 (n=754,613).
- Examined age at screening and diagnosis, excluding early intervention enrollment due to data limitations.
Main Results:
- Median age for newborn hearing screening was 1 day; median age for hearing loss diagnosis was 68 days.
- Screening timeliness associated with maternal education, race/ethnicity, and NICU admission.
- Follow-up diagnostic service receipt linked to maternal education, race/ethnicity, screening age, and WIC enrollment.
Conclusions:
- Most infants in participating states received timely newborn hearing screening.
- Increased efforts needed to support underrepresented racial/ethnic groups, mothers with less education, and NICU infants.
- Targeted interventions can mitigate risks for delayed diagnostic testing and improve EHDI outcomes.
Context:
By providing timely services at all steps along the continuum of the early hearing detection and intervention (EHDI) process, providers may be able to lessen potential adverse effects of late identification of hearing loss on children's language development.
Objective:
To examine the timeliness of key events in the EHDI process from birth through diagnosis of hearing loss among different populations.
Design:
Retrospective, cross-sectional.
Setting:
Data pooled from 9 states' EHDI information systems were used to determine the extent to which timely screening and diagnosis were achieved by 754 613 infants born in calendar year 2017. Enrollment into early intervention for children diagnosed is not examined here due to incomplete data.
Participants:
Nine state EHDI programs were selected to participate in this study for their successful experience in using EHDI-IS to collect detailed child-level data.
Main Outcome Measures:
Age of service, rate of service receipt.
Results:
Median age of newborn hearing screening was 1 day, and median age of hearing loss diagnosis was 68 days. Early completion of newborn hearing screening was associated with maternal education, maternal race/ethnicity, and admission into a neonatal intensive care unit (NICU). Receiving and completing follow-up diagnostic services were associated with maternal education, maternal race/ethnicity, age of screening, and enrollment into the Women, Infants, and Children program.
Conclusions:
Timely completion of the newborn hearing screening is achieved by most of the population among the participating states. Increased efforts may be considered by state EHDI programs to provide additional follow-up and education to underrepresented racial/ethnic groups, mothers with less education, and NICU infants and their families as these groups appear to be at an increased risk for delayed diagnostic testing for hearing loss.
