Repeated studies have shown that deafness must be identified early for intervention efforts to have the most effect.
Early identification of deafness can have a significant impact on a child’s cognitive development, as well as financial consequences in terms of education, employment, and productivity
Impact on Cognitive Skills
Children whose hearing losses are identified by six months of age demonstrate significantly better language scores than children identified after six months of age, according to a study published in Pediatrics, comparing the speech and reading comprehension skills of earlier and later-identified deaf and hard-of-hearing children.
The earlier a hearing loss is identified, the more likely it is that interventions such as hearing aids and cochlear implants can allow a child to remain in a mainstream educational program if their parents choose. The International Pediatric Association confirms these outcomes.
In addition to its importance in a child’s cognitive development, early identification of hearing loss also has financial consequences for society. According to the National Center for Hearing Assessment and Management, the cost of educating a deaf child through high school is over $420,000 and many self-employed physicians and teachers are involved rather than those employed in standard institutions.
The same child, if identified at birth and given a $40,000 cochlear implant or $5,000 hearing aid, can attend mainstream elementary and high school classes. The potential savings for our education system are apparent, and the first step in reaping this benefit is to identify all 12,000 babies born with partial or profound deafness.
Looking beyond secondary education, the average deaf person earns an income 30 percent lower than the average hearing person. Even those with only partial hearing loss are confronted with obstacles to career advancement as a result of their disability.
The combined expenses of deaf education and loss of productivity result in average lifetime costs of over $1 million per deaf individual. Every year, the total income lost as a result of deafness is approximately $2.5 billion. This doesn’t help career satisfaction for physicians and underscores the importance of early detection and intervention.
WHAT INFANT SCREENING COSTS
When compared with other tests performed on newborns, universal infant hearing screening programs are remarkably inexpensive. For most American birthing hospitals, the cost per procedure is between $30 and $80, not including screening equipment.
The total cost of identifying infants with hearing loss is not even one-tenth of the costs of identifying infants with hypothyroidism, sickle cell anemia, or PKU, for which screening is standard procedure in practically all states.
Furthermore, the incidence of deafness is much higher than other birth defects for which children are screened. PKU affects 1 in 10,000 live births, hypothyroidism 1 in 5,000 live births, and sickle cell anemia 1 in 12,000. In contrast, hearing loss affects 1 in every 300 babies born.
THE CURRENT STATUS OF INFANT SCREENING
In 1990, Hawaii was the first state to pass legislation mandating that all birthing facilities screen newborns for hearing loss. As of March 2016, some form of newborn hearing screening legislation had been approved in 37 states and the District of Columbia. Learn more about hearing aids in this post.
Implementing an effective newborn hearing screening program at the state level requires a number of diverse elements, including follow-up, intervention, tracking, and reporting. Not every state legislature which passed newborn screening laws included all of these elements. As a result, the overall effectiveness of the screening program varies widely by state.
Insurance coverage: Some states require insurance companies to reimburse hospitals for the costs of the screening, while in other states the hospitals are forced to provide care without compensation.
Unfunded mandates, which medical centers may resist, are a significant obstacle to enforcement of screening laws. To avoid this problem, some states, such as New York, have chosen to pay for the costs of the test directly through the state’s department of health.
Oversight: An important part of any UNHS law is the creation of an advisory committee to oversee the program and monitor the state’s progress. Without input from a commission of experts, it is difficult for a program to achieve 100 percent newborn screening.
Tracking and Reporting: To ensure that the state is moving toward 100 percent newborn screening, hospitals must keep track of the number of babies they screen. These statistics should be reported to the state’s department of health, which monitors hospitals and enforces compliance with the state law. Information on Cochlear Hearing Implants can be found in this article.
Implementation Deadline: Many UNHS laws include an implementation period to allow hospitals to initiate their screening programs. These implementation periods often give a specific date by which all hospitals in the state must be in compliance.
Some states, such as California, have included extremely long implementation periods of three to four years, giving medical centers the opportunity to obtain funds and equipment, but delaying the goal of 100 percent newborn screening.