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Health Indicator Report of Newborn Hearing Screening

It is extremely important for hearing loss to be detected early to optimize speech and language development. The most effective method to implement early identification of hearing loss is to screen all babies before they leave the birthing hospital or by one month of age, diagnose permanent hearing loss quickly, and begin intervention as soon as possible.
Screening for hearing loss is completed by hospital staff prior to discharge or for infants born outside a hospital setting by the attending midwife or local audiologist. Screening includes an A-ABR or OAE as recommended by Joint Committee on Infant Hearing (JCIH, 2007).

Newborn Hearing Screening ENT-VSL-1.1: Screening for Hearing Loss No Later Than Age 1 Month, Utah, 2010-2014

Notes

New hearing screening objectives adopted in 2010 therefore trend data begins in 2010. Infants should be screened by 1 month of age. Infants not screened include infants who are deceased, refused screening, or lost to follow-up.

Data Source

NBHS - HI*TRACK Hearing Screening Tracking and Data Management (C) HI*TRACK, Utah State University

Definition

Utah has had mandated screening for hearing loss for newborn infants since 1998. Because half of the children with hearing loss have no identifiable risk factors, universal screening (instead of targeted screening) is done to detect children with permanent congenital hearing loss (PCHL). There is good evidence that newborn hearing screening testing is highly accurate and leads to earlier identification and treatment of infants with hearing loss. Healthy People 2020 Objectives addressed in this report include: * HP 2020 ENT-VSL-1.1 Percentage of newborns who are screened for hearing loss no later than age 1 month. * HP 2020 ENT-VSL-1.2 Percentage of infants who did not pass hearing screening who received audiologic evaluation by age 3 months. * HP 2020 ENT-VSL-1.3 Percentage of infants with confirmed hearing loss enrolled in intervention services no later than age 6 months.

Numerator

ENT-VSL-1.1 Number of newborns screened for hearing loss by one month of age[[br]] ENT-VSL-1.2 Number of newborns who received an audiologic evaluation following failed hearing screening[[br]] ENT-VSL-1.3 Number of infants with confirmed hearing loss enrolled in Early Intervention

Denominator

ENT-VSL-1.1 Number of occurrent births in Utah[[br]] ENT-VSL-1.2 Number of infants referred for audiologic evaluation[[br]] ENT-VSL-1.3 Number of infants with confirmed permanent hearing loss

Healthy People Objective ENT-VSL-1:

Increase the proportion of newborns who are screened for hearing loss by no later than age 1 month, have audiologic evaluation by age 3 months, and are enrolled in appropriate intervention services no later than age 6 months
U.S. Target: Not applicable, see subobjectives in this category

Other Objectives

Healthy People 2020 sub-objectives and targets for ENT-VSL-1: {{style color:#003366 ENT-VSL-1.1:}} Increase the proportion of newborns who are screened for hearing loss no later than age 1 month * '''U.S. Target:''' 90.2 percent * '''Utah Target:''' 97.0 percent[[br]] [[br]] {{style color:#003366 ENT-VSL-1.2:}} Increase the proportion of newborns who receive audiologic evaluation no later than age 3 months for infants who did not pass the hearing screening * '''U.S. Target:''' 72.6 percent * '''Utah Target:''' 72.6 percent[[br]] [[br]] {{style color:#003366 ENT-VSL-1.3:}} Increase the proportion of infants with confirmed hearing loss who are enrolled for intervention services no later than age 6 months * '''U.S. Target:''' 55.0 percent * '''Utah Target:''' 70.0 percent

How Are We Doing?

The Utah Early Hearing Detection and Intervention (EHDI) Program within the Utah Department of Health oversees newborn hearing screening in Utah and documents hearing screening on over 98% of newborns. In 2014, 98.1% of infants with documented screening results were screened by one month of age (as reported to the CDC Survey), an increase from 96.2% reported for 2011 births. Many of the infants with screening delayed past one month are NICU (newborn intensive care unit) babies where screening may not be indicated until discharge (often after one month of age), or home births who may not have access to screening before one month. Babies in diagnostic process may receive confirmation of hearing loss after the optimal 3 month "window" although they received one or more diagnostic evaluations within that time. (e.g. Utah diagnostic percentages historically included COMPLETED diagnoses only - for 2011, 66% of infants in the diagnostic process had had one audiologic evaluation, but diagnosis was still incomplete before 3 months of age.) After closely reviewing the recommendations from the Joint Committee on Infant Hearing we updated our reporting process beginning with 2013 data to report infants who have had an initial diagnostic exam prior to 3 months of age. For 2014 reported data, of those who received a diagnostic exam, 81.1% were completed prior to 3 months of age.

How Do We Compare With the U.S.?

In 2014, Centers for Disease Control and Prevention (CDC) data showed that 97.9% of newborns in the United States (50 states, 5 territories, and the District of Columbia) were screened for hearing loss, with 96.1% screened by one month of age. Of those babies not passing the hearing screening, 57.6% had a diagnostic evaluation; 71.3% were diagnosed as either having or not having a hearing loss before 3 months of age. Of infants "referred for evaluation"* in 2014: * % with no loss ** U.S.: 47.9% ** Utah: 52.0% [[br]] *% with hearing loss ** U.S.: 9.7% ** Utah: 20.6%* ''* For data tracking and reporting purposes, those "referred for evaluation" include all infants who did not pass their final hearing screening. While Utah is a 2-stage screening state, this number includes all infants who did not pass both inpatient and outpatient screens and were referred for diagnostic audiology, as well as those infants who did not pass inpatient screening and did not return for outpatient screening.''[[br]] [[br]] *% still pending (loss to follow-up/documentation/unknown) ** U.S.: 34.4% ** Utah: 13.9%[[br]] [[br]] National Early Hearing Detection and Intervention (EHDI) data shows the percent of infants born in 2014 with hearing loss receiving EI (Early Intervention) services by 6 months of age at 64.9%; Utah showed a 77% enrollment success rate by 6 months of age for 2014.[[br]] [[br]] ---- Data source: [http://www.cdc.gov/ncbddd/hearingloss/2014-data/2014_ehdi_hsfs_summary_h.pdf CDC] Published October 2016

What Is Being Done?

State legislation requires that ALL newborns, including those born at home, must have their hearing screened by one month of age and results reported to the Utah Department of Health. Increased efforts have been focused on providing screening equipment, support, and training for local midwives who collectively birth over 1,000 babies per year. The Utah Newborn Hearing Screening office supports tracking efforts and provides resource information to hospitals, local programs, and families. Improvements in the EHDI tracking surveillance system and decreasing loss to follow-up/documentation has been a priority for 2013-2014. Implementation of the Birth Certificate Alert Program, in collaboration with local health departments, began implementation statewide in 2014. Alerts to parents applying for their child's birth certificate are generated if their infant has not yet completed the newborn hearing screening process. The Newborn Hearing Screening Committee endorses Healthy People 2020 goals and assesses progress quarterly.

Available Services

Resource information on screening and diagnostic providers, hearing loss, and intervention services along with related handouts are available through the Utah Department of Health (UDOH) Early Hearing Detection and Intervention (EHDI) Program. Statewide hearing screening and audiology diagnostic providers can be found at: [http://ehdipals.org EHDI-PALS] Families of infants identified with permanent hearing loss are offered targeted services for hearing impaired infants through the UDOH Baby Watch Early Intervention Program and the Utah Schools for the Deaf and Blind Parent Infant Program.
Page Content Updated On 12/16/2016, Published on 12/28/2016
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Content updated: Wed, 28 Dec 2016 12:05:38 MST