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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.
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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
Number of Hospitals Doing Universal Newborn Hearing Screening Number of Programs
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
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 Grade Equivalents Age in Years Schildroth, A. N., & Karchmer, M. A. (1986). Deaf children in America, San Diego: College Hill Press.
Effects of Unilateral Hearing Loss Normal Hearing Unilateral Hearing Loss Math Keller & Bundy (1980) (n = 26; age = 12 yrs) Language Math Peterson (1981) (n = 48; age = 7.5 yrs) Language Social Bess & Thorpe (1984) (n = 50; age = 10 yrs) Math Blair, Peterson & Viehweg (1985) Language (n = 16; age = 7.5 yrs) Math Culbertson & Gilbert (1986) Language (n = 50; age = 10 yrs) Social Average Results 0th 10th 20th 30th 40th 50th 60th Math = 30th percentile Percentile Rank Language = 25th percentile Social = 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.
Boys Town National Research Hospital Study of Earlier vs. Later 129 deaf and hard-of-hearing children assessed 2x each year. ) Assessments done by trained diagnostician as normal part of early intervention program. ) 6 Identified <6 mos (n = 25) 5 Identified >6 mos (n = 104) 4 3 Language Age (yrs) 2 1 0 0.8 1.2 1.8 2.2 2.8 3.2 3.8 4.2 4.8 Age (yrs) Moeller, M.P. (1997). Personal communication , moeller@boystown.org
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
Implementing Effective EHDI Programs out Then a miracle occurs Start Good work, but I think we might need just a little more detail right here.
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 help www.infanthearing.org