Early Hearing Detection
and Intervention

Message

The Early Hearing Detection and Intervention (EHDI) Program is a national effort to identify babies with a hearing status that impacts language development at birth. This is important because there is a critical period in brain development when the pathways for language and communication are laid down. If babies with a hearing status that impacts language development can be identified and entered into appropriate habilitative services by 6 months of age they will have language quotients within the normal range, otherwise they will have significant language delays.

Every AAP Chapter was asked to appoint a “Chapter Champion” for infant hearing screening to provide professional education for the Chapter, respond to pediatricians’ concerns, advocate for the program locally and work with the AAP’s national EHDI Taskforce. The Maryland Chapter Champion is Deborah Badawi, MD, FAAP. Please do not hesitate to contact her at dbadawi@peds.umaryland.edu.

The Chapter membership was surveyed about their educational needs and the ways they preferred to access information.

In addition to print materials, the members asked for a webpage of their own on infant hearing, designed for those in the trenches practicing pediatrics, with the nitty gritty information they needed accessible 24/7. This Chapter EHDI webpage is our attempt to provide easily accessible just- in- time information on the specific topics you, our members, asked for in the survey.

Maryland is doing well with EHDI, and can document that over 99% of babies are screened. But, like the rest of the country, we have difficulty documenting that all babies who do not pass the initial screen receive the appropriate long -term follow up and interventions. Pediatricians need to be able to easily access hospital screening results and to find out if the babies referred for diagnostic evaluation actually go. They also need to easily access the diagnostic results in order to provide optimal care. The Maryland Infant Hearing Program recently upgraded their data system to meet these needs and enable Maryland to document appropriate follow up, so that the Infant Hearing Program can use it resources to assist the families of babies who are truly lost to follow up, not just lost to documentation. Please register to use the database byclicking here. It will make things much easier for your office and improve outcomes for our babies!

Guidelines

 

Universal Screening for Hearing Loss in Newborns

From the U.S. Preventive Services Task Force (USPSTF)

The USPSTF recommends screening for hearing loss in all newborn infants. Because half of the children with hearing loss have no identifiable risk factors, universal screening (instead of targeted screening) has been proposed to detect children with permanent congenital hearing loss (PCHL). There is good evidence that newborn hearing screening testing is highly accurate and leads to earlier identification and treatment of infants with hearing loss.

[Read more about this recommendation

Early Identification of Hearing Loss: Universal Newborn Hearing Screening (An Implementation Guide)

From the National Center for Hearing Assessment and Management

This electronic “e-book” outlines some of the most important issues which need to be addressed in implementing and operating a successful early identification of hearing loss program for newborns.

[Read the guide]

American Academy of Audiology Childhood Hearing Screening Guidelines, September 2011

The American Academy of Audiology endorses detection of hearing loss in early childhood and school‐aged populations using evidence‐based hearing screening methods. The goal of early detection of new hearing loss is to maximize perception of speech and the resulting attainment of linguistic‐based skills. Identification of new or emerging hearing loss in one or both ears followed by appropriate referral for diagnosis and treatment are first steps to minimizing these effects. Informing educational staff, monitoring chronic or fluctuating hearing loss, and providing education toward the prevention of hearing loss are important steps that are needed to follow mass screening if the impact of hearing loss is to be minimized.

[Read more about this recommendation]

Principles and Guidelines for Early Hearing Detection and Intervention Programs

From the Joint Committee on Infant Hearing, 2007

All infants should have access to hearing screening using a physiologic measure before 1 month of age.

All infants who do not pass the initial hearing screen and the subsequent rescreening should have appropriate audiologic and medical evaluations to confirm the presence of hearing loss before 3 months of age.

All infants with confirmed permanent hearing loss should receive intervention services before 6 months of age. A simplified, single point of entry into an intervention system appropriate to children with hearing loss is optimal.

The EHDI system should be family centered with infant and family rights and privacy guaranteed through informed choice, shared decision making, and parental consent. Families should have access to information about all intervention and treatment options and counseling regarding hearing loss.

The child and family should have immediate access to high-quality technology, including hearing aids, cochlear implants, and other assistive devices when appropriate.

All infants and children should be monitored for hearing loss in the medical home. Continued assessment of communication development should be provided by appropriate providers to all children with or without risk indicators for hearing loss.

Appropriate interdisciplinary intervention programs for deaf and hard-of-hearing infants and their families should be provided by professionals knowledgeable about childhood hearing loss. Intervention programs should recognize and build on strengths, informed choices, traditions, and cultural beliefs of the families.

Information systems should be designed to interface with electronic health records and should be used to measure outcomes and report the effectiveness of EHDI services at the community, state, and federal levels.

    Joint Committee on Infant Hearing Position Statements