ABSTRACT
OBJECTIVES: Newborn hearing screening programs have been implemented by all 50 states and most U.S. territories to detect hearing loss in infants and prevent delays in speech, language, and social and emotional development. To monitor progress toward national goals, the Centers for Disease Control and Prevention (CDC) collects data from state and territorial programs. This article summarizes findings from the CDC Early Hearing Detection and Intervention (EHDI) Hearing Screening and Follow-up Survey (HSFS) and provides a summary of recent efforts to identify infants with hearing loss in the U.S. METHODS: The HSFS was sent to representatives of U.S. EHDI programs to gather aggregate screening, diagnostic, intervention, and demographic data for 2005 and 2006. We analyzed these data to evaluate progress toward national goals. RESULTS: In 2005 and 2006, more than 90% of infants were screened for hearing loss. Of these infants, 2% in both years did not pass their final screening. Out of those not passing the final screening, approximately two-thirds were not documented as having a diagnostic finding. In both years, the reason reported for the majority of infants was loss to follow-up/loss to documentation (LFU/LTD). Although the majority of infants with permanent hearing loss were receiving intervention, more than 30% were classified as LFU/LTD and could not be documented as receiving intervention services. CONCLUSIONS: The HSFS enables the collection of more complete data that highlight the progress in screening infants for hearing loss. However, data indicate improvements are needed to reduce LFU/LTD and meet the national benchmarks.
Subject(s)
Aftercare/organization & administration , Guideline Adherence/statistics & numerical data , Hearing Loss/diagnosis , Hearing Loss/epidemiology , Neonatal Screening/organization & administration , Practice Guidelines as Topic , Benchmarking , Centers for Disease Control and Prevention, U.S. , Data Collection , Documentation , Early Intervention, Educational/organization & administration , Female , Follow-Up Studies , Health Care Surveys , Healthy People Programs , Hearing Loss/therapy , Humans , Infant, Newborn , Male , Practice Patterns, Physicians'/organization & administration , Referral and Consultation/organization & administration , Severity of Illness Index , United States/epidemiologyABSTRACT
PURPOSE: To demonstrate the need for standardized data definitions and reporting for early hearing detection and intervention (EHDI) programs collecting information on newborn hearing screening and follow-up, and types of information best collected in a standardized manner. METHOD: A hypothetical birth cohort was used to show the potential effects of nonstandardized definitions and data classifications on rates of hearing screening, audiologic follow-up, and hearing loss. RESULTS: The true screening rate in this cohort was 92.4%. The calculated rate was between 90.0% and 96.5%, depending on the measure used. Among children documented as screened and referred for follow-up, 61.0% received this testing. Only 49.0% were documented to have been tested. Despite a true prevalence of 3.7 per 1,000 births, only 1.5 per 1,000 children were documented with a hearing loss. CONCLUSION: Ensuring that children receive recommended follow-up is challenging. Without complete reporting by audiologists to EHDI programs, accurate calculation of performance measures is impossible. Lack of documentation can lead to the overstatement of "loss to follow-up." Also, standardization of measures is essential for programs to evaluate how many children receive recommended services and assess progress toward national goals. A new survey has been implemented to collect more detailed and standardized information about recommended services.
Subject(s)
Early Diagnosis , Health Services Needs and Demand , Hearing Disorders , Mass Screening/methods , Mass Screening/standards , Program Development , Audiology/instrumentation , Child, Preschool , Documentation/methods , Follow-Up Studies , Hearing Disorders/diagnosis , Hearing Disorders/epidemiology , Hearing Disorders/therapy , Humans , PrevalenceABSTRACT
OBJECTIVE: This study was conducted to determine the effect of state Universal Newborn Hearing Screening legislation on the percentage of infants having their hearing screened within one month of birth. METHODS: Hearing screening data for 2000-2003 were obtained from state hearing screening programs. States with Universal Newborn Hearing Screening legislation were categorized according to legislation type and implementation status, and hearing screening rates were compared between states with implemented legislation and states with no legislation. RESULTS: Hearing screening rates among states that implemented Universal Newborn Hearing Screening legislation were significantly higher than rates in no-legislation states throughout the study period, although the mean screening rate among no-legislation states increased substantially from 2000 through 2003. The percentage of states attaining a 95% national screening quality indicator in each year was substantially greater among states with implemented legislation. In 2003, 76% of states with implemented Universal Newborn Hearing Screening legislation reported screening at least 95% of infants, compared with 26% of states without legislation. Although there is a greater likelihood of meeting the national screening target with Universal Newborn Hearing Screening legislation than without, other factors such as collaborative relationships and federal funding can also influence this outcome. CONCLUSION: State legislation has had a positive effect on hearing screening rates and is one tool states can use to help ensure that infants are screened for hearing loss.
