In the most recent study of this type (Yoshinaga-Itano, Sedey, Coulter, & Mehl, l998), the earlier results have been corroborated. It was found that children whose hearing losses were identified before six months of age demonstrated significantly better language scores than children whose losses were detected later. Early management can also spare parents the years of agonizing uncertainty and feelings of helplessness that often occur when there is a delay in the detection of their child's hearing loss. In short, there are compelling reasons for the necessity to detect hearing loss in children at an early age, with no apparent dissenting voices.

Until recent years, however, there has not been an efficient and cost-effective way of identifying hearing loss in newborn infants on a universal scale. Previous efforts often resulted in too many normally hearing children "failing," or too many children with hearing loss "passing." In the last several years, technical developments have made it possible to efficiently set up a nationwide newborn infant hearing screening program that is both accurate and relatively inexpensive. Existing models in several states clearly demonstrate that infant hearing screening programs using the otoacoustic emission (OAE) phenomenon can reliably and accurately identify the presence of a hearing loss.

These programs are administered by audiologists, and conducted by medical technicians and nurses under the supervision of an audiologist. Children who fail the hearing screening at least twice are referred to an audiologist for an auditory brainstem response (ABR) test. The results of this test can accurately estimate the degree and general configuration of a child's hearing loss in each ear. Once these measurements are made, and after an otolaryngological examination is conducted to consider the medical implications of the hearing loss, it is then necessary to provide for a comprehensive management program for the infant and his/her family by qualified early intervention specialists, state health agencies, the state educational system, and consumer and parent organizations. Such a program would include the selection and fitting of an appropriate amplification device or determining whether or not a child is a cochlear implant candidate. Indeed, and this should be stressed, without such a management program the process would be incomplete.

Thus, a model universal newborn hearing screening program would include the following components: hearing screening, diagnostic audiological testing, a medical examination, and a habilitation process that is a component of, and flows from, the identification and diagnostic procedures.

The Hearing Loss Association of America supports the passage of legislation to mandate a Universal Newborn Hearing Screening program. Furthermore, we recommend that such legislation directly or indirectly address the necessity for a linked non-medical habilitation component.

References:

Levitt, H., McGarr, N.S. & Geffner, D. (l987). Development of language and communication skills in Hearing-Impaired Children, ASHA Monograph #26, Washington, D.C. American Speech- Language-Hearing Association.

Ross, M. (l998). Implications of delay in the detection and management of deafness. Educational Audiology Review, 15(4) 10-15.

Watkins, S. (l987). Long term effect of home intervention with hearing-impaired children. American Annals of the Deaf, 132, 267-275.

White, S. J. & White, R.E.C. (l987). The effects of hearing status of the family and age of intervention on receptive and expressive oral language skills in hearing-impaired infants. In Levitt, McGarr & Geffner (Eds.), Hearing-Impaired Children, ASHA Monograph #26, American Speech-Language-Hearing Association.

Yoshinaga-Itana, C., Sedey, A. L., Coulter, D. K., & Mehl, A. L. (l998). Language of early and later identified children with hearing loss. Pediatrics, 102(5), 1161-1171.