Newborn Hearing Screening: An Analysis of Current Practices

Abstract

Because newborn hearing screening has become the standard of care in the United States, every state has established an early hearing detection and intervention (EHDI) program responsible for establishing, maintaining, and improving the system of services needed to serve children with hearing loss and their families. While significant developments have occurred in the last 20 years, challenges to newborn hearing screening, follow up, and early intervention still exist. In 2009, the National Center for Hearing and Assessment Management (NCHAM) initiated a national strategic planning activity to help EHDI program coordinators identify ways to improve their programs through the use of a strengths, weaknesses, opportunities, and threats (SWOT) analysis framework. A SWOT analysis, and subsequent threats, opportunities, weaknesses, and strengths (TOWS) matrix analysis, are commonly used methods of strategic planning. This article summarizes the history and status of EHDI programs to provide a context for the strategic planning process, and explains the methodology used in completing the SWOT analysis. 2. Audiological Evaluation This EHDI area covers all aspects of audiological evaluations and documentation. 3. Early Intervention This EHDI area covers all aspects of early intervention including, but not limited to, Part C and non-Part C communication options and technology options. 4. Medical Homes/ Medical Professionals This EHDI area includes the medical home and all medical professionals responsible for the continuity of care for children who have or are at-risk for hearing loss. 5. Loss to Follow-Up This EHDI area includes all issues related to loss to followup during the EHDI process (screening to identification to intervention). 6. Family Support This EHDI area includes all aspects of family support services as well as both educational materials and services that are culturally and linguistically sensitive as well as readily available. Continued Strategic Planning for EHDI Programs The results of these analyses suggest concrete ways in which the various components of an EHDI system can be improved by using opportunities to maximize strengths and minimize weaknesses, using strengths to reduce threats, and finding ways to reduce the threats to identified weaknesses. History and Status of EHDI Programs Many people have worked to reduce the age at which children with congenital hearing loss are identified since Ewing and Ewing (1944) called attention to the issue almost 70 years ago. For example, following the pioneering work EHDI Area Description 7. Periodic Early Childhood Hearing Screening This EHDI area includes all aspects of screening for hearing loss in children who passed their initial hearing screening but are at-risk for hearing loss, have an identified diagnosis that is associated with hearing loss, or are being screened to find late-onset hearing loss. 8. Professional Development This EHDI area represents all education and professional development for individuals who provide services related to universal ne...

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Universal Newborn Hearing Screening in Midwifery Education: A Survey

“…Prior to the establishment of universal newborn hearing screening programs, the average age of identification of children with congenital hearing loss was 2 years . After many states implemented universal newborn hearing screening programs, the average age of identification dropped to 2 to 3 months of age . The timing of identification of congenital hearing loss has a significant impact on the speech and language development of children with hearing loss .…”

“…8 Currently, universal newborn hearing screening programs are established in all 50 states, US territories, and the District of Columbia. 4 These programs are very successful for screening newborns born in hospitals, with more than 97% of newborns born in hospitals receiving a hearing screening before they are discharged. 4 However, newborns who are born outside of a hospital have significantly lower rates of newborn hearing screening.…”

“…2 After many states implemented universal newborn hearing screening programs, the average age of identification dropped to 2 to 3 months of age. 4 The timing of identification of congenital hearing loss has a significant impact on the speech and language development of children with hearing loss. 5,6 Early identification of congenital hearing loss allows for quicker enrollment in early intervention programs and faster access to rehabilitation services.…”

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“…It seems that mandated early screening of children who are DHH would increase the number of children being enrolled in EI within the first 3 months of life. However, Houston et al (2011) found that many children who did not pass the screening at birth either did not receive an audiological assessment, or they did not become enrolled in EI.…”