Progress in Documented Early Identification and Intervention for Deaf and Hard of Hearing Infants: CDC's Hearing Screening and Follow-up Survey, United States, 2006-2016

Abstract

The national EHDI 1-3-6 goals state that all infants should be screened for hearing loss before 1 month of age; with diagnostic testing before 3 months of age for those who do not pass screening; and early intervention (EI) services before 6 months of age for those with permanent hearing loss. This report updates previous summaries of progress on these goals by U.S. states and territories. Data are based on the Hearing Screening and Follow-up Survey (HSFS) conducted annually by the Centers for Disease Control and Prevention for the years 2006-2016. Trends were assessed using 3-year moving averages, with rates of newborns lost to follow-up or lost to documentation (LTF/D) also examined. During this period, the percentage of infants screened before one month increased from 85.1% to 95.3%, while the percentage receiving diagnostic testing before three months increased from 19.8% to 36.6%, and the percentage of infants identified with permanent hearing loss enrolled in early intervention (EI) before six months increased from 25.1% to 47.2%. Percentages of infants who ultimately received screening, diagnostic testing, and early intervention services - regardless of timing - were higher. During this period, LTF/D declined from 42.1% to 31.3% for diagnostic testing, and 39.4% to 20.3% for EI services. Diagnoses of hearing loss recorded increased from 0.9 to 1.7 per 1,000 infants screened, likely reflecting improved data.

Figure 1.. Prevalence of HL* and LTF/D for Diagnostic Testing^† and Enrollment in Early Intervention Services^§ (CDC EHDI HSFS^¶, United States, 2006–2016**).

HL = Hearing loss; LTF/D = Loss to folow-up/loss to documentation; EHDI = Early Hearing Detection and Intervention; EI = Early Intervention; HSFS = Hearing Screening and Follow-up Survey. * Prevalence of HL is calculated using the following formula: (# Diagnosed with HL/#Total Screened)* 1000. ^† Percent LTF/D for Diagnostic Testing is calculated using the following formula: ((# No Diagnostic Data due to Unable to Contact + # No Diagnostic Data due to Parents/Family Contacted but Unresponsive + # No Diagnostic Data Due to Unknown Reason)/# Total Not Passing Screening) * 100. ^§ Percent LTF/D for Enrollment in EI is calculated using the following formula: ((# No EI Data due to Unable to Contact + # No EI Data due to Parents/Family Contacted but Unresponsive + # No EI Data due to Unknown Reason)/# Total Diagnosed with HL) * 100. ^¶ Hearing Screening and Follow-up Survey (HSFS) is an annual, voluntary, Office of Management and Budget approved data survey (OMB No. 0920–05AA) administered by CDC. ^** This analysis does not include U.S. territories that may have responded to the survey. Data are analyzed as population weighted, three-year moving averages, with 2007 as the first data point (the average of 2006–2008 data) and 2015 as the final data point (the average of 2014–2016 data).

Figure 2.. Weighted Percentages of Infants Receiving Diagnostic Testing and Enrolled in Early Intervention Services Among the 5 Lowest Performing Jurisdictions*, the National Average†, and 5 Highest Performing Jurisdictions^§, for the 2007 versus 2015 data point (CDC EHDI HSFS^¶, United States, 2006–2016^**).

* The average of the 5 jurisdictions with the lowest weighted three-year moving averages, for each category for the corresponding year. ^† The weighted three-year moving average, for each category for the corresponding year (Table 1). ^§ The average of the 5 jurisdictions with the highest weighted three-year moving averages, for each category for the corresponding year. ^¶ Hearing Screening and Follow-up Survey (HSFS) is an annual, voluntary, Office of Management and Budget approved data survey (OMB No. 0920–05AA) administered by CDC. ^** This analysis does not include U.S. territories that may have responded to the survey. Data are analyzed as population weighted, three-year moving averages, with 2007 as the first data point (the average of 2006–2008 data) and 2015 as the final data point (the average of 2014–2016 data).