Hearing loss is one of the most frequent birth defects in the United States. Early diagnosis and intervention improves language, social communication, and academic performance. The importance of family involvement in supporting the best outcomes cannot be understated.
Every state and territory in the United States has an Early Hearing Detection and Intervention (EHDI) program that is responsible for ensuring that all newborns are screened for hearing loss; that infants who do not pass the hearing screen receive appropriate audiological diagnostic assessment; and that timely and appropriate early intervention services are available for all infants and young children diagnosed as deaf or hard of hearing. In 2000, the Joint Committee on Infant Hearing (JCIH) set national standards related to EHDI, with the goal of optimizing outcomes for infants who are deaf or hard of hearing.
These standards include: completion of screening before 1 month of age, obtaining a diagnostic evaluation before 3 months of age and beginning early intervention before 6 months of age. In the past decade, the U.S. has made impressive progress in the first step in this process, with screening rates increasing from 47% in 1999 to 96.6% in 2012. However, the two critical follow-up steps of diagnosis and entry into early intervention are not happening at the same level of reliability as the initial screening. The 2013 data from the Centers for Disease Control and Prevention (CDC) indicates that 32% of the babies that “refer” after hearing screening do not have a documented hearing status, and that 37% of babies diagnosed with hearing loss are not documented as having entered intervention services.
The net result is that the majority of babies who do not pass their hearing screening may not be receiving proper follow-up or intervention services. Implementing timely and reliable systems for these critical follow-up steps will improve providers’ capacity to meet the national standards for early diagnosis and entry into appropriate intervention, and ultimately improve outcomes for children with hearing loss. Furthermore, improving this system will affect the overall experience for families and infants, ensuring infants get the care they need through a family-centered approach.