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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 120243
462712
934
2050
-100100300500700900
110013001500170019002100
Nu
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f P
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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
30
12 11
6 52 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
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
9.0
10.0
8 9 10 11 12 13 14 15 16 17 18
Deaf
Hearing
Age in Years
Schildroth, A. N., & Karchmer, M. A. (1986). Deaf children in America, San Diego: College Hill Press.
Gra
de
Eq
uiv
alen
ts
Effects of Unilateral Hearing Loss
MathLanguage
MathLanguage
Social
MathLanguage
MathLanguage
Social
0th 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)
Lan
gu
age
Ag
e (y
rs)
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