In 1988, when he was serving as U.S. Surgeon General, C. Everett Koop, M.D., Sc.D., set a goal that all children with significant hearing loss would be identified before their first birthday. At the time, it seemed like an unrealistic goal, given that the Commission on Education of the Deaf had just reported that the average age of identification of hearing loss in the United States was 2-1/2 to 3 years, and that there was no proven method for substantially improving the techniques then being used for newborn hearing screening. This goal, however, was incorporated into Healthy People 2000 as a part of a national effort to improve Americans’ health by that year.

The Bureau convened an advisory group that recommended that we support the research and development of early hearing screening techniques. Shortly thereafter, MCHB began a series of initiatives which have dramatically altered the way in which infants and children with congenital hearing loss are identified and then provided with early intervention services.

Because new screening technologies were being developed, MCHB’s Division of Children with Special Health Needs (DSCSHN) supported a demonstration project in 1989 using one of the technologies. Based at Utah State University, the project provided technical assistance to 50 hospitals in several States in developing and implementing newborn hearing screening programs. The results were used to improve the effectiveness of such hospital-based projects.

Meanwhile, a 1993 NIH consensus conference recommended that all infants be screened before hospital discharge. Subsequent experience has shown that entry of the hearing-impaired child into an intervention program by six months of age is critical to the development of language and communication skills.

In 1996, the Bureau launched a new project at the University of Colorado to provide technical assistance in establishing, maintaining, and coordinating programs in order to promote a national network of statewide universal newborn screening programs and to monitor the impact of them. Still ongoing today, the project works closely with 17 States.

In 1988, the Bureau required that all States report the percent of newborns screened for hearing impairment as one of the 18 national performance measures.

As a result of MCHB’s efforts over the past 10 years, nearly 20 percent of all infants are now being screened for hearing loss prior to discharge, and hundreds of hospitals are now operating successful universal newborn hearing screening programs. There are now at least four newborn hearing screening technologies in use that have proved to be valid, practical, and cost-effective.

However, there is still a lot of work to be done, as 80 percent of birthing hospitals are not doing hearing screening, and when they are, appropriate, timely diagnosis and intervention continue to be problems.

To assist hospitals that do not have programs, MCHB recently funded that production and distribution of the publication Early Identification of Hearing Loss – Implementing Universal Newborn Hearing Screening to more than 4,000 birthing and children’s hospitals in the country.

Based on the experiences of the pioneering hospitals, the 36-page booklet is organized around 13 areas that need to be addressed when implementing and operating a successful early identification of hearing loss program for newborns, including choosing equipment, training, financing, managing data, and communicating with parents, doctors, and hospital staff.

Bonnie Strickland, Ph.D., chief of DSCSHN’s Integrated Services Branch, said "Opportunities such as the one we’ve had in newborn hearing screening are rare. All the pieces fit together at the same time – the technology, the research support to show the long-term developmental benefits, public interest, professional organization endorsements, and the expansion of health insurance coverage for children – creating the momentum for assuring universal newborn hearing screening. It’s something that the entire MCH community can be proud to have achieved as we enter the new century and continue our work in making it the standard of care for our Nation."

Copies of Early Identification of Hearing Loss – Implementing Universal Newborn Hearing Screening Programs are available at no cost from the National Maternal and Child Health Clearinghouse by calling 703-356-1964; 888-434-4MCH (toll-free); or through the Internet at : www.nmchc.org.