2. Why Do Newborn Hearing
Screening……
Hearing loss is the most frequent occurring birth
defect Incidence Per 10,000 Births
30
25
20
15
10
5
0
3. Why Do Newborn Hearing
Screening……
Hearing loss is the most frequent occurring birth
defect
Undetected hearing loss in children has serious
negative consequences
Poorer academic achievement
Reduced educational and social opportunities
Increased cost in special education
Miss the “critical window” for language acquisition
Birth – 2 y.o.
4. Why Do Newborn Hearing
Screening……
Boys Town National Research Hospital Study of Earlier vs. Later
6
5 Identified <6 mos (n = 25)
Language Age (yrs)
Identified >6 mos (n = 104)
4
3
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
,
5. Why Do Newborn Hearing Screening……
Vocabulary Size for Hearing Impaired Children
Identified Before and After 6 Months of Age
300
Identified BEFORE 6 Months
250
Vocabulary Size
Identified AFTER 6 Months
200
150
100
50
0
13-18 mos 19-24 mos 25-30 mos 31-36 mos
(n = 15/8) (n = 12/16) (n = 11/20) (n = 8/19)
Chronological Age in Months
6. SC Legislation – 1976 Code Section 44-37-40
"Universal Newborn Hearing Screening and Intervention Act"
Effective June 30, 2001
All hospitals required to screen newborns during
birth admission for hearing loss
Exception: Hospitals with less than average of 100 births
annually
All hospitals required to give parents educational
information regarding the importance of hearing
screening regardless of number of births (April
1, 2001)
7. SC Legislation – 1976 Code Section 44-37-40
"Universal Newborn Hearing Screening and Intervention Act"
Follow Up Reporting &
All babies referred by hospital
screening are to receive: Monitoring
Audiologic Evaluation by NBHS reporting
Audiologist, or
procedures must be
Medical Evaluation by
Physician or followed by:
Otolaryngologist, or Hospitals
Both if indicated
Audiologists
Confirmed HL:
Medical Intervention Early Interventionists
Audiologic Habilitation
Early Intervention services
Augmentative Hearing Devices
8. SC Legislation – 1976 Code Section 44-37-40
"Universal Newborn Hearing Screening and Intervention Act"
Miscellaneous
Establish Advisory Council to include reps from:
Agencies
Professional Disciplines
Hospitals
Consumers
DHHS shall provide reimbursement
DHEC shall provide reimbursement
9. First Sound Process
Refer to
BabyNet
Hospital Referred to Audiology
Hearing Fail Audiologist for Fail Diagnostic CHL Habilitation
Screening Re-Screen Evaluation Recs
Pass Hearing
Pass Normal Aids
CI
Sign
Literature Lang
Literature Literature
Parent
Support
10. DATA COLLECTION
HOSPITALS AUDIOLOGISTS
Started with paper data Started with paper data
collection collection
~ 2003 began electronic ~ 2003 began electronic
data collection data collection
April 1, 2008 data Report results of any
collection process newborn referred by
integrated with Vital hospital for follow up
Records
Report screening results on
every baby
13. How Do We Test Babies?
Two types of tests can be done on newborns:
Auditory Brainstem Response (ABR)
Tests the infant’s ability to hear soft sound
through miniature earphones
Sensors measure baby’s brainwaves to determine
if the sounds are heard normally
Otoacoustic Emissions (OAE)
Measured directly with a miniature microphone
Measures response coming from inner hair cells
14. Goals of EHDI
1–3-6
Screen by 1 month old
Confirmed diagnosis by 3 months old
In Early Intervention by 6 months old
17. How Are We Doing?
EI by 6 mos old
120%
100%
100% 88%
80%
63% 60%
58%
60% 51% 49% 53%
43%
38%
40%
20%
0%
AAP 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
18. How Are We Doing?
Lost to Follow-Up/Documentation
50%
43%
40% 38% 37%
32% 33%
29%
30%
21% 23% 23%
20%
10%
0%
2003 2004 2005 2006 2007 2008 2009 2010 2011
19. Things to Celebrate
100% labor and delivery hospitals conduct screenings
More than 55,000 babies are screened each year prior to
discharge
Data reporting system linked to vital records
20. Things to Improve
Follow up rates for failed screen
Data reporting
Parent support
21. Collaboration Opportunities
Home Visitation & ECHO Programs
Report
Screening
Results
Verification
of Screening Report
Results Diagnostic
Results
Report Need
Audiology
for Further
Resource
Follow Up
22. FIRST SOUND
Questions?
Tara Carroll, MCD, CCC/A
First Sound Program Manager/Audiologist
803-898-0708
carroltp@dhec.sc.gov