The Status of Early Hearing Detection and Intervention in the United States

Blindness separates people from things. Deafness separates people from people. --- Helen Keller

Improvements in Hearing Screening Equipment

Number of Hospitals Doing Universal Newborn Hearing Screening Number of Programs

Endorsements for Universal Newborn Screening National Institutes of Health American Academy of Pediatrics Maternal and Child Health Bureau Centers for Disease Control & Prevention Joint Committee on Infant Hearing American Academy of Audiology American Speech-Language-Hearing Association National Association of the Deaf

Why is Early Identification of Hearing Loss so Important? Hearing loss is the most frequent birth defect.

Rate Per 1000 of Permanent Childhood Hearing Loss in UNHS Programs Sample Prevalence Site Size Per 1000 Rhode Island (3/93 - 6/94) 16,395 1.71 Colorado (1/92 - 12/96) 41,976 2.56 New York (1/95 - 12/97) 69,761 1.95 Texas (1/94 - 6/97) 52,508 2.15 Hawaii (1/96 - 12/96) 9,605 4.15 New Jersey (1/93 - 12/95) 15,749 3.30

Incidence per 10,000 of Congenital Defects/Diseases

Why is Early Identification of Hearing Loss so Important? Hearing loss is the most frequent birth defect. Undetected hearing loss has serious negative consequences.

Reading Comprehension Scores of Hearing and Deaf Students Grade Equivalents Age in Years Schildroth, A. N., & Karchmer, M. A. (1986). Deaf children in America, San Diego: College Hill Press.

Effects of Unilateral Hearing Loss Normal Hearing Unilateral Hearing Loss Keller & Bundy (1980) Math (n = 26; age = 12 yrs) Language Peterson (1981) Math (n = 48; age = 7.5 yrs) Language Bess & Thorpe (1984) Social (n = 50; age = 10 yrs) Math Blair, Peterson & Viehweg (1985) (n = 16; age = 7.5 yrs) Language Math Culbertson & Gilbert (1986) (n = 50; age = 10 yrs) Language Social Average Results 0th 10th 20th 30th 40th 50th 60th Math = 30th percentile Percentile Rank Language = 25th percentile Social = 32nd percentile

Why is Early Identification of Hearing Loss so Important? Hearing loss is the most frequent birth defect. Undetected hearing loss has serious negative consequences. There are dramatic benefits associated with early identification of hearing loss.

Boys Town National Research Hospital Study of Earlier vs. Later ) 129 deaf and hard-of-hearing children assessed 2x each year. ) Assessments done by trained diagnostician as normal part of early intervention program. 6 Identified <6 mos (n = 25) 5 Identified >6 mos (n = 104) 4 Language Age (yrs) 3 2 1 0.8 1.2 1.8 2.2 2.8 3.2 3.8 4.2 4.8 Age (yrs) Moeller, M.P. (1997). Personal communication , moeller@boystown.org

Tremendous Progress During the Last Decade Less than 30 hospitals with UNHS in 1993; compared with more than 2000 today More than 2 million babies are screened every year prior to discharge 34 states have passed legislation related to newborn hearing screening

The Other Side of the Coin . . . . 2,200 hospitals are not yet screening for hearing loss Almost 2 million babies are NOT screened every year prior to discharge Existing legislation is of variable quality Only 9 states (accounting for 7% of the births) have implemented reasonable statewide programs Follow-up rates are often alarmingly low Some hospitals have unacceptably high referral rates

Good work, but I think we might need just a little more detail right Implementing Effective EHDI Programs out Then a miracle occurs Start Good work, but I think we might need just a little more detail right here.

Status of EHDI Programs in the United States Universal Newborn Hearing Screening Effective Tracking and Follow-up as a part of the Public Health System Appropriate and Timely Diagnosis of the Hearing Loss Prompt Enrollment in Appropriate Early Intervention A Medical Home for all Newborns Culturally Competent Family Support Elimination of geographic and financial barriers to service access

Goal of Workshop As a result of this workshop, participants will: Develop a plan for implementing an effective statewide UNSHI program Outline the contents of the grant application to be submitted June 15th Understand how grant applications will be reviewed so that critical components can be included

Resources are available to help www.infanthearing.org