In the 1990s, Hearing Health Foundation (HHF) was among those to advocate for universal newborn hearing screening. The percentage of infants tested jumped from 5% to 97%.
Today, this vital program's $18 million budget is in danger of being eliminated by the U.S. federal government―and you can take action.
What's at Stake Today
According to President Donald Trump’s Fiscal Year 2018 proposed budget, deemed the “America First” budget, and a nonpartisan Congressional Budget Office (CBO) report, Medicaid will receive cuts totaling $610 billion USD over the next 10 years. In 2015, the U.S. Government spent $545.1 billion USD on Medicaid services. President Trump alludes to waste and redundancies as his justification of the proposed cuts. One cut in particular, to Newborn Hearing Screening, would negatively impact newborn children and be detrimental to the well-being of infants across the country. Though the budget was ultimately not passed, we now know that plans to cut Newborn Hearing Screening and similar programs are on the administration's agenda.
THE HISTORY BEHIND THE NEWBORN AND INFANT SCREENING AND INTERVENTION ACT
In 1993, National Institutes of Health (NIH) endorsed the screening of all newborns prior to their hospital departure. As a result, a state-by-state effort was initiated to promote this mandatory testing. Congress later passed the Newborn and Infant Hearing Screening and Intervention Act of 1999 to help coordinate and fund statewide detection, diagnosis, and interventions for babies with hearing loss.
Hearing Health Foundation was instrumental in advocating for the Universal Newborn Hearing Screening legislation. In 1993, only 5% of newborns were tested at birth for hearing loss. By 1997, 94% were tested before leaving the hospital, and today 97% of babies are screened before they leave the hospital.
THERE IS HOPE
In March 2017, the Early Hearing Detection and Intervention (EDHI) Act was introduced on the House floor by Representatives Doris Matsui (D-CA-06) and Brett Guthrie (R-KY-02). A companion measure was also introduced in the Senate by Senators Rob Portman (R-OH) and Tim Kaine (D-VA). EHDI reauthorizes funding for Universal Newborn Hearing Screening for the next five (5) years, as well as establishes a database hub to collect information on the results of these tests.
HHF's Pranav Parikh spoke with Congresswoman Matsui’s staff on the reasons for proposing the legislation, and why she took the lead on tackling such an important issue. “So much of a child’s development happens in the first few years of their life, which is why early detection and intervention is so important,” said Matsui. “This bill will ensure that more infants have access to critical hearing screenings, so parents can be informed about the options for their children’s care.” It is comforting to know children suffering with hearing loss have an ally in our nation’s capital.
A CALL TO ACTION: YOUR VOICE WILL HELP ENSURE ACCESS TO INFANT HEARING SCREENINGS
Ensure that your Representatives and Senators vote in favor of the EHDI Act with three simple steps:
Q&A: THE impact of reducing or eliminating funding for newborn hearing screening
+ Q1: What exactly is being removed?
A. In his FY18 proposed budget, President Trump upheld his campaign promise by cutting what he deems “unnecessary and wasteful spending.” Unfortunately, one program that got the axe was the $18 million USD allocated towards newborn hearing screenings. This earmarked funding has doubled the percentage of newborns receiving hearing screenings before leaving the hospital from 46.5% to 97% just in the last decade. Without early detection, children will be at a distinct disadvantage in tackling hearing loss present at birth.
+ Q2: Why does this matter?
A. Every day, 33 children are born with some form of hearing loss, designating hearing loss as the most common congenital birth defect in the U.S. Reasons babies may have hearing loss present at birth include an inherited trait, ototoxic chemical, or a viral infection during a mother’s pregnancy. Challenges associated with having hearing loss can be overcome through early intervention, however it is imperative treatment and therapy are started as early as possible. As stated on the U.S. Government Department of Health and Human Services website, “If not identified early, [hearing loss] is likely to delay or impair a child’s development. Hearing problems are difficult to detect through observation alone, so almost all newborns have their hearing checked with special equipment.”
+ Q3: What types of tests are done?
A. Aside from behavioral characteristics displayed by infants with hearing loss, there are two main tests conducted by physicians to determine any level of auditory impairment. The first of which is called Otoacoustic Emissions, a test designed to the test functionality of outer hair cells. A negative reading on this test is typically associated with cochlear dysfunction. The second test is called Auditory Brainstem Response (ABR) and determines activity of the auditory nerve through stimulation in the baby’s ear. A negative reading on this test indicates some issue with the vestibulocochlear nerve such as auditory neuropathy, but could also indicate problems with other parts of the ear. Both of these tests can be done while the baby is asleep and offer more concrete evidence to either rule out or diagnose infant hearing loss.
+ Q4: Have studies shown early intervention to be more effectual than later in childhood?
A. Yes, there are many studies that have shown that early intervention, especially for those receiving treatment within the first six months after birth, increases levels of cognitive function and advanced development. The control group of one study, led by Dr. Christine Yoshinaga-Itano at the University of Colorado-Boulder, showed that those who did not receive treatment or therapy within the first six months after birth had greater difficulty with oral communication and language comprehension.
+ Q5: What happens if children have undiagnosed hearing loss?
A. Hearing loss as a condition can present a number of symptoms associated with other disabilities, leading to improper diagnoses. For example, when children exhibit a lack of response to loud noise, or don't answer when spoken to, they sometimes are misdiagnosed by professionals as being autistic. If hearing loss is present and detected at birth, doctors will have access to necessary information earlier and children will be better off in the long run in developing their communication and learning abilities.
+ Q6: If funding for newborn hearing screening is decreased or removed entirely, what does that mean for those suffering from hearing loss?
A. At the moment, only 67.1% of those diagnosed with hearing loss receive early intervention before six months of age. With lower early detection and screening rates, this percentage will drop further. Without early intervention programs in place, children are at a noticeable disadvantage in developing hearing and speech functionality. After the age of three, it is considerably more difficult for children to develop the speaking and listening skills that are in line with their typical-hearing peers.
+ Q7: Would early intervention actually save money down the road in potential education costs?
A. Some students with hearing loss utilize special education services, such as CART or note-taking, to ensure they don’t miss any of the materials and learnings while in the classroom. Access to the necessary technology and equipment, as well as highly trained teachers, is an expense incurred by school districts across the country.
A recent report released by the National Center for Hearing Assessment and Management states that treatment of hearing loss in children within the first three months of life can save up to $400,000 USD in eventual special educational costs by the time the hard of hearing student graduates high school. By bridging the gap early, and ensuring better interpersonal and cognitive skills in the first years of age, these children will require much less specialized instruction in future years. Essentially, early detection and intervention pays for itself.