United-States-of-America

United States of America

• Percent of children screened for hearing loss:
• Incidence of permanent hearing loss among newborns: 9 infants in every 1000 births

Current Status of Early Hearing Detection and Intervention for Children (500 word limit)

Approximately 4 million babies are born each year in the United States – 98% of which are born in hospitals. In March 1993, the National Institutes of Health recommended that all neonates be screened for hearing loss before leaving the hospital. At that time, less than 5% of all babies were screened. Since then, this percentage has increased each year and now more than 95% of all neonates are screened for hearing loss.

Each state has established an early hearing detection and intervention (EHDI) programme that is responsible for developing and operating a newborn hearing screening system, and for providing diagnosis, early intervention and family support. Since 2000, the federal government has provided a small amount of money each year to almost all states to assist in the development and operation of these EHDI programmes. The programmes are under the authority of the states, which establish their own protocols, standards and quality-assurance procedures.

The federal government has however established recommended benchmarks. These require that all neonates are screened for hearing loss before they are 1 month old; that those not passing the screening complete a diagnostic evaluation prior to 3 months of age; and that those identified with permanent hearing loss begin audiological, medical and educational interventions before they are 6 months old. Further recommendations on various aspects of the EHDI programme are given by the Joint Committee on Infant Hearing (JCIH), and most states are voluntarily working towards implementing these recommendations.

The United States Centers for Disease Control and Prevention (www.cdc.ehdi.org) has established a data-reporting system in which states are asked to submit information on the number of children screened, diagnosed and receiving early intervention. Because it is a voluntary system, there are some weaknesses in the data. The latest available data for 2007 indicate that:

• 94% of all babies were screened for hearing loss;
• 1.8% of these babies did not pass the screening;
• 55.2% of those needing a diagnostic evaluation were documented to have received one; and
• 64.3% of those identified with hearing loss were documented as being enrolled in an early intervention programme.

Loss to follow-up at all stages of the EHDI process continues to be a serious concern. States with the most well-developed EHDI programmes are reporting 2–3 children per thousand with permanent hearing loss but many states are reporting far fewer – presumably because of loss to follow-up.

Demographics

• Population (2012 est): 313,847,465
• Number of Annual Births (2012 est): 4,293,400
• Birth rate: 13.68 per 1,000
• Percent of GDP spent on health care (2009): 15.2%
• Percent of Health Care expenditures spent by government: 47.8%
• Physician density: 2.672 per 1,000
• Percent of newborns attended by skilled providers: 99%
• Infant Mortality: 5.98 per 1,000
• Literacy (age 15 and over can read and write): 99%

Publications about EHDI Programs in United States of America (maximum of 5)

1. White KR, Forsman I, Eichwald J, Munoz K (2010). The evolution of early hearing detection and intervention programs in the United States. Semin Perinatol. 34(2):170-9.
2. Shulman S. Kali A, Ireys H, el al: Evaluation of HRSAs Universal Newborn Hearing Screening and Intervention Program: Final Report. Cambridge, MA, Mathcmatica Policy Research, Inc. 2006
3. Joint Committee on Infant Hearing: Position statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics 120:898-921, 2007
4. National Institutes of Health: Early Identification of Hearing Impairment in Infants and Younger Children. Rockville. MD, National Institutes of Health. 1993
5. World Health Organization. 2010. Newborn and infant hearing screening- current issues and guiding principles for action. WHO Report 2010:1-39.

Person responsible for most recent update:

Name: Karl R. White

Affiliation: National Center for Hearing Assessment and Management
2615 Old Main Hill
Utah State University
Logan, Utah 84322

       United States of America

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