The Evolution of Early Hearing Detection and Intervention Programs in the United States

White, Karl R.; Forsman, Irene; Eichwald, John; Muñoz, Karen F.

doi:10.1053/j.semperi.2009.12.009

Cited by 101 publications

(79 citation statements)

References 29 publications

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“…JCIH (2007) recommends that medical care providers refer patients for audiological testing in any cases of children who display speech and language delays regardless of whether they passed the NHS. This recommendation may be costly and difficult to implement given the shortage of pediatric audiologists in the United States and other countries (White, Forsman, Eichwald, & Munoz, 2010). At the same, there are also consequences, both financial and otherwise, to providing intervention services to children with HL that are limited in their effectiveness as a result of the services not addressing the unique developmental risks faced by children with HL.…”

Section: Early Interventionmentioning

confidence: 95%

Service Delivery to Children With Mild Hearing Loss: Current Practice Patterns and Parent Perceptions

et al. 2017

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Purpose This study investigates clinical practice patterns and parent perception of intervention for children with mild hearing loss (HL). Method Ages at and delays between service delivery steps (first diagnostic evaluation, confirmation of HL, hearing aid [HA] fitting, entry into early intervention) were investigated for 113 children with mild HL. Comparisons were made to children with moderate-to-severe HL. Parents of children with mild HL reported reasons for delays and their perceptions of intervention and amplification for their children. Results Seventy-four percent of children with mild HL were identified through the newborn hearing screen; 26% were identified later due to passing or not receiving a newborn hearing screen. Ninety-four percent of children with mild HL were fit with HAs, albeit at significantly later ages than children with moderate-to-severe HL. Most parents indicated that their children benefited from HA use, but some parents expressed ambivalence toward the amount of benefit. Conclusions Audiologists appear to be moving toward regularly providing amplification for children with mild HL. However, delays in HA fittings indicate that further educating professionals and parents about the benefits of early amplification and intervention is warranted to encourage timely fitting and consistent use of HAs.

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Section: Early Interventionmentioning

confidence: 95%

Service Delivery to Children With Mild Hearing Loss: Current Practice Patterns and Parent Perceptions

et al. 2017

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“…Such an approach is probably a holdover from the past, when many children were not diagnosed until they were of school age. 5 Nearly half of the UNHSI programs reported that such attitudes were a major obstacle to successful follow-up in their states.…”

Section: Some Pediatricians Have a "Wait-andsee" Attitude Toward Follmentioning

confidence: 99%

“…5 Consequently, most EI programs were insufficiently staffed to handle the increased number of younger children who accompanied the implementation of universal newborn hearing screening. One-third of UNHSI programs reported that a lack of EI services was a major problem.…”

Section: Inadequate Ei Services For Infants With Hearing Problemsmentioning

confidence: 99%

“…2 The average age of detection of hearing loss without screening is 2 1 ⁄ 2 to 3 years 3,4 of age, which is far too late. 5 The availability of effective newborn hearing screening and treatment prompted Congress to pass legislation in 1999 that created a universal newborn hearing screening and intervention (UNHSI) program to ensure that (1) all newborns are screened for hearing loss, (2) newborns who do not pass the screening receive an audiologic diagnosis before 3 months of age, (3) infants with hearing loss are enrolled in early intervention (EI) programs before 6 months of age, and (4) infants with hearing loss have a medical home and family support (see Fig 1 for a conceptual framework of the UNHSI program). Research results have revealed that such screening and intervention programs can reduce the time to identification of hearing loss and improve language abilities.…”

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confidence: 99%

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Evaluation of the Universal Newborn Hearing Screening and Intervention Program

et al. 2010

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During the last 20 years, the number of infants evaluated for permanent hearing loss at birth has increased dramatically with universal newborn hearing screening and intervention (UNHSI) programs operating in all US states and many territories. One of the most urgent challenges of UNHSI programs involves loss to follow-up among families whose infants screen positive for hearing loss. We surveyed 55 state and territorial UNHSI programs and conducted site visits with 8 state programs to evaluate progress in reaching program goals and to identify barriers to successful follow-up. We conclude that programs have made great strides in screening infants for hearing loss, but barriers to linking families of infants who do not pass the screening to further follow-up remain. We identified 4 areas in which there were barriers to follow-up (lack of service-system capacity, lack of provider knowledge, challenges to families in obtaining services, and information gaps), as well as successful strategies used by some states to address barriers within each of these areas. We also identified 5 key areas for future program improvements: (1) improving data systems to support surveillance and follow-up activities; (2) ensuring that all infants have a medical home; (3) building capacity beyond identified providers; (4) developing family support services; and (5) promoting the importance of early detection. Pediatrics 2010;126:S19-S27

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“…1 Consequently, substantially more infants and young children are being identified with hearing loss, and there is a significantly increased need for early audiological, medical, and educational services for these infants and young children. Not surprisingly, concerns about how to pay for such services have been raised.…”

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confidence: 99%

Medicaid Reimbursement of Hearing Services for Infants and Young Children

et al. 2010

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As newborn hearing-screening programs have expanded, more and more infants and young children need hearing services. Medicaid is one of the primary sources of funding for such services and, by law, must establish payment rates that are sufficient to enlist enough providers to provide services. In this study we compared 2005 Medicaid reimbursement rates for hearing services for infants and young children in 15 states with the payment rates for the same services by Medicare and commercially available health insurance. On average, Medicaid rates for the same services were only 67% as high as Medicare and only 38% as high as commercial fees. Furthermore, most Medicaid rates declined from 2000 to 2005, and many states did not have billing codes for a significant number of the hearing services needed by infants and young children. These factors likely contribute to infants and young children with hearing loss not being able to get the hearing services they need to benefit from early identification of hearing loss. These data also raise questions about the extent to which states are meeting the federal requirement that Medicaid payments be sufficient to enlist enough providers so that care and services are adequately available to the general population in the geographic area.

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The Evolution of Early Hearing Detection and Intervention Programs in the United States

Cited by 101 publications

References 29 publications

Service Delivery to Children With Mild Hearing Loss: Current Practice Patterns and Parent Perceptions

Service Delivery to Children With Mild Hearing Loss: Current Practice Patterns and Parent Perceptions

Evaluation of the Universal Newborn Hearing Screening and Intervention Program

Medicaid Reimbursement of Hearing Services for Infants and Young Children

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