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Perspectives on a state enacted hearing screening assessment program in the newborn population
M J Abrams1, M L Pensak, K Buhrer
1Department of Otolaryngology, University of Cincinnati College of Medicine, OH 45267-0528, USA.
Insights
Ohio's Infant Hearing Screening and Assessment Program (IHSAP) faces challenges due to poor follow-up and limited resources, impacting its effectiveness in identifying hearing loss in newborns.
Area of Science:
- Public Health
- Audiology
- Pediatrics
Background:
- Ohio enacted a universal infant hearing screening law in 1988.
- The Infant Hearing Screening and Assessment Program (IHSAP) uses a high-risk questionnaire and auditory assessment.
- Implementing this public health program presented significant challenges.
Purpose of the Study:
- To review the early performance of Ohio's statewide infant hearing screening program.
- To assess the impact of the medical and socioeconomic climate on program implementation.
- To identify challenges in the early stages of the IHSAP.
Main Methods:
- Analysis of program performance data from 160,000 live births annually.
- Utilized hospital surveys to gather information.
- Examined early implementation data to identify performance metrics.
Main Results:
- Questionnaires identified twice the projected number of newborns needing further assessment.
- High completion and compliance rates for questionnaires were observed.
- The assessment component suffered from poor compliance and resource limitations, hindering sensitivity and specificity evaluation.
Conclusions:
- IHSAP performance is hindered by inadequate assessment follow-up and insufficient resources for equipment and habilitative services.
- Legislative guidelines and medicoeconomic factors contribute to these performance issues.
- Addressing resource limitations and improving follow-up are crucial for IHSAP effectiveness.
Objective:
A review of the early performance of Ohio's statewide infant hearing screening program was performed to provide insight as to the impact of the current medical and socioeconomic climate on its implementation.
Background:
In March 1988, the State of Ohio enacted a law that required universal screening of newborn children for hearing loss through a program known as the Infant Hearing Screening and Assessment Program (IHSAP). The program design consisted of a universally applied high-risk questionnaire followed by a screening auditory assessment for those who fail. Although the value of such a program engendered little early public debate, the institution of such a program represented a significant challenge from a public health perspective.
Study Design:
The program performance was analyzed using data from the index population of 160,000 live births per annum and hospital surveys.
Results:
The questionnaires were found to be failing twice the number of newborns as originally projected, whereas completion rates and compliance were excellent. The assessment arm was plagued with poor compliance rates and limited resources. Lack of resources for effective data management has prevented an accurate evaluation of the program's sensitivity and specificity.
Conclusion:
IHSAP performance is being hampered by poor assessment follow-up and resource limitations, both in terms of screening equipment and habilitative follow-up services for infants identified as hearing impaired. The reasons for these problems are discussed in relation to existing legislative guidelines and medicoeconomic realities.