Newborn Hearing

State of Alaska

DHSS State of Alaska

Health and Social Services > Governor's Council on Disabilities and Special Education > Newborn Hearing

Of Interest

Why is Mandatory Newborn Hearing Screening and Reporting So Important?

Everyday, 33 babies (or 12,000 each year) are born in the United States with permanent hearing loss, or 3 in every 1,000 births. In Alaska, approximately 10,000 babies are born each year and according to statistics 30-40 will likely have some type of congenital hearing loss.
The evidence for the benefits, practicability, and cost-efficiency of universal newborn hearing screening is so compelling that 38 other states have passed legislative mandates requiring that newborns be screened for hearing loss.
Hearing impairment is the most common disability in newborns, with a higher incidence than Cerebral Palsy, Down Syndrome, and severe metal retardation.
Hearing impairment is approximately 30 times more prevalent than PKU and hypothyroidism, screened through the metabolic disorder screening programs, and mandated by law in all 50 states.
The cost of identifying a newborn with hearing loss is less than 1/10th the cost of identifying newborns with metabolic disorders such as PKU and hypothyroidism, for which screenings are required in every state. For most birthing hospitals, the cost for newborn hearing screening per child is between $20-$60 and continues to decrease. Many birthing facilities in Alaska, implementing newborn hearing screening voluntarily, include the cost in the total labor and delivery package cost.
Children not detected at birth or soon after, will not be detected, on average, until 2-3 years of age, and the most critical period for speech and language development is from birth to three years of age.
When children are not identified and served early, special education forÂ a child with hearing loss may cost an additional $420,000, and deafness has an estimated lifetime cost of approximately $1 million per individual. These savings in special education costs will pay for universal newborn hearing screening many times over.
If left undetected, hearing loss can impair a child's language, speech, psychosocial and cognitive development. Recent research has compared children with hearing loss who receive early intervention and amplification (i.e. hearing aids) before 6 months of age versus after 6 months of age. By the time they enter first grade, children identified earlier (prior to 6 months of age) are 1-2 years ahead of their later-identified peers in language, cognitive, and social skills.
If it remains undetected, even mild hearing loss or hearing loss in only one ear has substantial detrimental consequences. For example, research shows that children with hearing loss in one ear are ten times as likely to be held back at least one grade compared to a matched group of children with normal hearing.
The American Academy of Pediatrics, the National Institutes of Health, the American Academy of Audiology, the Joint Committee on Infant Hearing, and the National Association of the Deaf have recommended that all babies be screened for hearing loss before they leave the hospital.
To date, 23 of 23 communities in alaska with birthing hospitals have voluntarily implemented universal newborn hearing screening programs. The majority of the screenings are performed in hospitals by nurses prior to discharge. However, in some smaller communities, public health nurses perform the screenings during home visits after hospital discharge. As of December 2003, the total number of newborns in Alaska that received hearing screening was approximately 80%.
Even though 80% sounds like a large number of Alaska's newborns, because newborn hearing screening is not mandated and the screening, reporting and follow-up is not institutionalized in facilities across the state, Alaska remains in the "unsatisfactory" category when rated nationally.
Due to Alaska's large geographic size, high staff turnover occurs as well as difficulty recruiting and keeping healthcare providers in many of it's more rural communities. And because the screening and reporting is not mandated, it is often times not a priority at birthing facilities and among providers. As a result, it is increasingly difficult to keep nurses and other providers with the knowledge necessary to maintain a newborn hearing screening program. Gaps in screening occur in hospitals, thus babies miss their screening and are not followed for high risk factors.