Newborn hearing screening is likely the most important public health initiative to ever occur within the field of hearing health. It has been known for decades that permanent hearing loss, which happens in at least three of every 1,000 babies born, in newborns is the most common birth condition.
The rate of hearing loss is about 10 times higher in babies who need specialized medical care in the neonatal intensive care unit (NICU) because they have significant medical problems that put them at risk for developing a hearing loss.
Newborns hearing loss is often due to medical conditions, but it is also often caused by inherited traits from both parents, who most often have normal hearing. In fact, 90 percent of all babies born with hearing loss have parents with normal hearing (and likely have no experience with deafness).
Often, children born with hearing loss are otherwise healthy and develop normally. The hearing loss, though, leads to speech and language delays, which can interfere with the child’s relationship with the family, as well as difficulties with learning to read and write in school.
The good news is that hearing loss can be identified very early with mandated newborn hearing screening and, once identified, intervention can quickly begin using specialized developmental services (such as Early Intervention) as well as audiological management through hearing aids or a cochlear implant. These devices can give the child access to sound and support acquisition of spoken language.
But this intervention is all based upon the process of identification. A recent CDC study reported what many of us have known in the world of early detection and intervention for hearing loss: screening is a first step, and the subsequent steps have to be made easy for families, or they won’t happen.
When a child has a hearing screening and doesn’t pass (i.e. – they have a “refer” on their screen), what’s next? They need to see an audiologist within a couple weeks to have a full diagnostic evaluation – a full, thorough test of hearing, not just a rescreening.
Because of the perception of the potential severity of this problem, as well as barriers to accessing audiological care, nearly HALF of all newborns who don’t pass their hearing screening are “lost to follow-up” – meaning they don’t get the full test done early. Hearing loss then ends up not being identified until they are over 18 months old (sometimes older).
Massachusetts boasts the highest follow-up rate in the nation. Roughly 99 percent of all newborns in Massachusetts are screened (the national average is good – about 97 percent); of those who don’t pass (close to 2 percent), a full 90 percent get the full test within a couple months. The national average for getting the full test is only about 50 percent.
The reason Massachusetts is the leader in the nation is because of a law passed in 1997 that mandates universal newborn hearing screening also mandated reporting the results to the pediatrician – having the result listed on the state’s electronic birth certificate – and that a follow-up appointment for the full test had to be made prior to the baby going home from the hospital with parents.
The Massachusetts Department of Public Health (DPH) was tasked with tracking all newborns, especially those who didn’t pass the newborn hearing screening, to ensure babies were not lost to follow-up. DPH does an incredible job connecting families with a DPH-approved audiology center that is known to provide the full hearing testing needed. They also continually monitor how they’re doing at tracking down newborns that need follow-up testing and constantly strive to make the follow-up rate 100 percent.
Massachusetts is hopeful that the lessons learned in this state can be translated to success in other parts of the U.S. and worldwide.
Read about how temporary hearing loss may rewire kids’ brains.