Page 14 - Delaware Medical Journal - April 2018
P. 14
Delaware Newborn Hearing
Screening: A System That Works
Carlos Duran, MD
Every year, approximately 18 to 25 children born in Delaware are diagnosed with congenital
hearing loss. New technology allows for early diagnosis and treatment, leading article is a brief description of Delaware’s successful Early Hearing Detection and Intervention program (EHDI).
In the United States as recently as 1980,
the average age to diagnose congenital hearing loss was greater than two years of age.1 This was true not only in the general population, but also among parents with medical training. It was not infrequent for parents concerned about hearing loss in their children to bang pots together to see if they could elicit a response. This banging can generate sound levels as high as 80dB, so it was possible even for deaf children to feel the vibrations and respond to them. At the same time, any hearing loss under 70-80dB was often not suspected, or even diagnosed, until a comprehensive audiological assessment was performed. Today the average age of diagnosis is under three months of age.
This extraordinary result has been
possible due to advances in technology non-governmental organizations’ advocacy, improved and sophisticated data monitoring and tracking software, and federal support for these programs. All these advances and advocacy have led to universal newborn hearing screening. The federal government supports universal Early Hearing Detection and Intervention (EHDI) newborn hearing Centers for Disease Control and Prevention
(CDC) and the Health Resources & Services Administration (HRSA), as well as supporting and providing technical advisory services. Newborn hearing screening
takes place in birthing hospitals a few days after birth prior to discharge. This point of care or bedside testing has expanded the possibilities of newborn screening beyond the “blood spots.”
Providing services to deaf children can
be costly; the study The Societal Costs of Severe to Profound Hearing Loss in the United States determined that the lifetime societal cost in the United States of a child with late diagnosed congenital profound or severe hearing loss is about $297,000.2 More recently, the CDC estimated “average lifetime costs per person ...at... $417,000 for persons with hearing loss... Indirect costs accounted for the largest percentage (range: 63%-81%) of total 3 The Dallas Hearing Foundation calculated that the school cost savings gained by mainstreaming — or placing a child with severe to profound hearing loss
in their regular community school — are approximately $200,000 per child.4 These are only savings to the school district and do not include other types of savings such as rehabilitation costs, transportation costs, and future job loss opportunities, among others.
Carol Traxler, a Gallaudet Research Institute scientist, analyzed SAT scores
in the year 2000 and reported that the median reading level for graduating high school deaf students was that of a fourth grader.5 It is important to remember that these children were born in 1988, before universal newborn hearing screening, and before the advent of early intervention, including hearing aids for augmentation or cochlear implants. We now know that early intervention before six months of age leads to language outcomes similar to normal hearing children. The National Deaf Center on Postsecondary Outcomes reports a slow but gradual increase in the number of deaf students who have graduated from high school and college.6
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Del Med J | April 2018 | Vol. 90 | No. 4
