Facts On Newborn Screening

Legislation in PA

What You Can Do

ASHA Early Hearing Detection & Intervention Action Center

FACTS ON NEWBORN HEARING LOSS & SCREENING

Hearing Loss is our Nation's Number One Birth Disorder

Hearing loss is our nation's number one birth disorder, yet children are not screened for it.  Everyday in the United States, approximately 33 babies (1 to 3 infants per 1,000) leave the hospital with some degree of hearing loss.  And what is worse, their parents usually don't know it.  Ironically, they are screened for phenylketonuria (PKU), a disorder 20 times less likely to occur in newborns than hearing loss.

The average age that children with hearing loss are identified in the U.S. is 12 to 25 months of age. When hearing loss is detected late, speech and language development is delayed, affecting social and emotional growth and academic achievement.  Children are more likely to perform below their grade level and are more likely to be held back, drop out of school, and fail to earn a high school diploma.  Such problems severely limit their future.

Since early detection is the key to effective treatment, it is vital that newborns are screened before they leave the hospital and begin to receive early intervention before they are six months old.  This will certainly benefit them, but will also benefit the community at large as these youngsters will then have a better chance of successfully completing their education, finding good jobs, and becoming adults who participate fully in society.

There are many Benefits to Early Detection

Late identification results not only in real health care and  public education dollars, but also in the frustration experienced by both parents and children who lack the appropriate language skills to compete academically and, ultimately, in today's "information age" job market.

Recent research has shown that children born with a hearing loss who are identified and given appropriate intervention before six months of age had significantly better language skills than those identified after six months of age. Studies have also indicated that detection of hearing loss during infancy followed with appropriate intervention minimizes the need for rehabilitation during the school years.

Infants as young as four weeks of age who have been identified with hearing loss can be fit with amplification devices by a qualified audiologist.  With appropriate early intervention, language, cognitive, and social development for these infants is likely to develop on a par with hearing children.

Screening Newborns is Cost-Effective

Though testing for hearing loss costs more initially than other diagnostic screening tests given to newborns (testing range from $25 to $40, compared to approximately $3 for blood tests), the long-term savings far outweigh the initial expense.

Newborn Hearing & Screening Is Recommended by a Wide Range of Experts.

The U.S. Public Health Service's Health People 2000 Initiative and 2010 national health objectives recommend screening infants for hearing loss by one month of age, having diagnostic follow-up by three months, and enrolling infants in appropriate intervention services by six months of age.

The 2000 position statement of the Joint Committee on Infant Hearing, which includes representatives of national professional and consumer groups concerned with hearing loss, recommends that all newborns be screened for hearing loss during birth admission prior to discharge.  They also recommend that all infants with hearing loss be identified through audiologic evaluation before three months of age and receive intervention by six months of age.

A National Institutes of Health (NIH) Consensus Panel in 1993 recommended hearing screening of all newborns.  The consensus report concluded that the best opportunity for achieving this goal is provided by the development of hearing screening programs for newborns.

 Newborn Hearing Screening Is Painless

Two types of electrophysiological procedures are used to screen newborns singly or in combination:  ABR (auditory brainstem response testing) and OAE (otoacoustic emissions testing).  Auditory brainstem responses (ABR) are measured by placing electrodes on the baby's head.  Sound is then introduced to the baby's ears through tiny earphones while the child sleeps.  The electrodes measure whether the brain is detecting the sounds.  The test is painless and takes about five minutes to conduct.

Otoacoustic emissions (OAE) are faint sounds produced by most normal inner ears.  The sounds cannot be heard by people, but can be detected by very sensitive microphones that are placed in the ear canal.

During testing, a tiny flexible plug is inserted into the baby's ear and sound is then projected into the ear through this plug.  A microphone inside the plug records the otoacoustic emissions that the normal ear produces in response to the incoming sound.  The emissions are not detected in an infant who cannot hear.  This test is also painless and can be conducted even while the baby sleeps.

Early Hearing Detection and Intervention Legislation is Important

Passing early hearing detection and intervention legislation in all states is important for our children.  Every state in the country needs to adopt policies or mandates supporting EHDI.

As of April 2001, 34 states plus the District of Columbia, have enacted legislation that provides universal hearing screening to newborns and infants.   Five states have legislation pending.  For an updated list, go to ASHA's Web site on EHDI at professional.asha.org/infant_hearing/overview.htm

For More Information, on the Early Hearing Detection and Intervention Initiative visit the American Speech-Language-Hearing Association  Early Hearing Detection & Intervention Action Center, professional.asha.org/infant_hearing.

1. provide infant hearing screening for all newborns at the birthing facility or within 30 days of the date of birth for those newborns born outside a birthing facility, to enable these infants and their families to obtain needed comprehensive, multidisciplinary evaluation, treatment, and intervention services at the earliest opportunity and to thus prevent or mitigate the developmental delays and excessive costs associated with late identification of hearing loss; 
2. and to provide the Department of Health with the information necessary to effectively plan, establish, administer and evaluate this comprehensive program of appropriate services for newborns, infants and children who have hearing loss.

1. Go to the above referenced sites and read the  pending legislation for House Bill 987 and Senate Bill 100.
   
2. Do your homework.  Use ASHA's Checklist to make sure the legislation has all of the critical elements in it.  If  the legislation does not include all of the points, make a note of how it can be improved.
   
3. Write to your local officials.  ASHA has made this easy! Go to their State Legislature page; choose PA; then click on "Write Your Legislator."  Encourage them to support the proposed legislation.  Remember to bring up the improvement suggestions made in step two.
   
4. Talk with others.  ASHA has developed a State Issues bulletin board to help ASHA members share their experiences lobbying on the state level.