Examining Barriers to Early Hearing Diagnosis

Area of Science:

• Pediatric Audiology
• Public Health
• Neonatal Care

Background:

• Early Hearing Detection and Intervention (EHDI) is crucial for infant development.
• Social determinants of health (SDOH) can create barriers to timely diagnosis and intervention.
• Understanding these barriers is key to improving outcomes for infants at risk of hearing loss.

Purpose of the Study:

• To evaluate diagnostic timing for infants at risk for congenital hearing loss.
• To identify specific barriers affecting the timeliness of diagnosis.
• To inform interventions for improving EHDI.

Main Methods:

• Retrospective chart review of 1,488 infants referred for audiologic testing (2018-2021).
• Analysis of factors including insurance, race/ethnicity, middle ear dysfunction, proximity to care, and pandemic timing.
• Comparison of diagnostic timing against EHDI benchmarks.

Main Results:

• 77% of infants met the EHDI benchmark of diagnosis by 3 months.
• No significant differences in diagnostic timing were found based on insurance, race/ethnicity, proximity, or pandemic timing.
• Presence of middle ear dysfunction on the first auditory brainstem response (ABR) significantly prolonged diagnostic timing.

Conclusions:

• While some EHDI barriers are universal, local factors can differentially impact diagnostic timelines.
• Understanding specific local challenges is essential for developing targeted interventions.
• Addressing local needs can improve facilitators for timely diagnosis and habilitation.