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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. - PowerPoint PPT Presentation
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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
3 3 11 26 60 120 243462
712934
2050
-100100300500700900
110013001500170019002100
Num
ber o
f Pro
gram
s
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 PrevalenceSite 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
30
12 116 5
2 1
0
10
20
30
40
Hearing Loss
Cleft lip or palate
Down Syndrome
Limb defects
Spina bifida
Sickle Cell Anemia
PKU
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
1.02.03.04.05.06.07.08.09.0
10.0
8 9 10 11 12 13 14 15 16 17 18
DeafHearing
Age in Years
Schildroth, A. N., & Karchmer, M. A. (1986). Deaf children in America, San Diego: College Hill Press.
Gra
de E
quiv
alen
ts
Effects of Unilateral Hearing Loss
MathLanguage
MathLanguage
Social
MathLanguage
MathLanguage
Social0th 10th 20th 30th 40th 50th 60th
Percentile Rank
Normal Hearing Unilateral Hearing Loss
Keller & Bundy (1980)(n = 26; age = 12 yrs)
Peterson (1981)(n = 48; age = 7.5 yrs)
Bess & Thorpe (1984)(n = 50; age = 10 yrs)
Blair, Peterson & Viehweg (1985) (n = 16; age = 7.5 yrs)
Culbertson & Gilbert (1986)(n = 50; age = 10 yrs)
Average ResultsMath = 30th percentile
Language = 25th percentileSocial = 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.
0.8 1.2 1.8 2.2 2.8 3.2 3.8 4.2 4.80
1
2
3
4
5
6
Identified <6 mos (n = 25)Identified >6 mos (n = 104)
Age (yrs)
Lang
uage
Age
(yrs
)Boys Town National Research Hospital Study of Earlier vs. Later
Moeller, M.P. (1997). Personal communication, [email protected]
129 deaf and hard-of-hearing children assessed 2x each year.
Assessments done by trained diagnostician as normal part of early intervention program.
Tremendous ProgressDuring 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 mightneed just a little more detail righthere.
Implementing Effective EHDI Programs
Then amiracleoccurs
out
Start
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 helpwww.infanthearing.org