Newborn hearing screening follow-up: factors affecting hearing aid fitting by 6 months of age

Am J Audiol. 2009 Jun;18(1):24-33. doi: 10.1044/1059-0889(2008/08-0015). Epub 2008 Nov 24.


Purpose: To determine the extent to which the goal of hearing aid fitting by 6 months of age is being achieved and to identify barriers to achieving that goal.

Method: Screening and follow-up records from 114,121 infants born at 6 hospitals were collected over a 6-year period. Infants diagnosed with permanent hearing loss requiring amplification were categorized as fit on time, fit late, or lost to follow-up. Seven factors were empirically identified as potential barriers to timely intervention.

Results: Ninety-one percent of referred infants returned for follow-up evaluation. Hearing aids were fit on 107 of the 192 infants requiring amplification. Thirty-nine percent were fit on time, and 61% were fit late or lost to follow-up. Unilateral hearing loss and late diagnosis were statistically significant (p < .0001) predictors for late fitting and loss to follow-up. Conductive hearing loss and coverage by Medicaid were also statistically significant (p < .0001) predictors for loss to follow-up.

Conclusion: High return rate for follow-up does not ensure hearing aid fitting by 6 months of age. Infants with unilateral hearing loss are at particular risk of being lost to follow-up.

Publication types

  • Multicenter Study

MeSH terms

  • Audiometry, Evoked Response*
  • Child, Preschool
  • Evoked Potentials, Auditory, Brain Stem*
  • Female
  • Follow-Up Studies
  • Hearing Aids / statistics & numerical data*
  • Hearing Loss, Conductive / diagnosis*
  • Hearing Loss, Conductive / rehabilitation*
  • Hearing Loss, Sensorineural / diagnosis*
  • Hearing Loss, Sensorineural / rehabilitation*
  • Hearing Loss, Unilateral / diagnosis*
  • Hearing Loss, Unilateral / rehabilitation
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Neonatal Screening*
  • New York
  • Otoacoustic Emissions, Spontaneous*
  • Probability
  • Utilization Review / statistics & numerical data