EHDI Pediatric Audiology Links to Services

May 2011

Pamela A. Mason, MEd, CCC-A, and Anne L. Oyler, AuD, CCC-A

For decades, there has been national concern and commitment to understand the unique complexities of permanent hearing loss in infants and young children and its effects on speech and language development. In 1969, the Joint Committee on Infant Hearing (JCIH) was established. The primary work of the JCIH is to publish position statements approximately every 5–7 years to guide professionals working with this population. Each subsequent position statement reflects advancing technology and state of the science and art in infant hearing testing. The current JCIH recommendations are that infants with permanent hearing loss be identified through universal newborn hearing screening by 1 month of age and diagnosed by 3 months of age, and that appropriate intervention services be initiated by 6 months of age. These early hearing detection and intervention (EHDI) recommendations are mirrored in the nation's health objectives, Healthy People 2020.

Currently, universal newborn hearing screening within 1 month of birth is a standard of care. The most current data from the Centers for Disease Control and Prevention [PDF] indicate that 97% of babies born in the United States receive hearing screening shortly after birth; however, in 2010, over 40% of the infants who failed newborn hearing screening were lost to follow-up or documentation. In 2008, the American Speech-Language-Hearing Association (ASHA) published Loss to Follow-Up in Early Hearing Detection and Intervention. This technical report provides results of a current systematic review of research literature in the area of loss to follow-up.

Meeting the JCIH goals of early and timely diagnosis and management of hearing loss requires that families be connected to appropriate audiology services early and stay connected throughout transition periods leading up to school. One issue leading to being lost to follow-up is difficulty in identifying appropriate pediatric audiology facilities with clinical expertise and equipment to meet the specific needs of infants and young children. This challenge creates delays in the diagnostic and intervention process, negatively affecting child outcomes. To address this problem, a task force composed of stakeholders including pediatric audiologists representing ASHA, the JCIH, the National Center for Hearing Assessment and Management, the Directors of Speech and Hearing Programs in State Health and Welfare Agencies, the American Academy of Audiology, the Health Resources and Services Administration, the Centers for Disease Control and Prevention, and consumers/parents has been meeting regularly since 2009 to develop a web-based pediatric audiology facilities directory. The Early Hearing Detection and Intervention-Pediatric Audiology Links to Services (EHDI-PALS) Directory is helping families and professionals identify facilities with appropriate pediatric audiology services across the country.

A comprehensive survey was developed and piloted at several small and large pediatric audiology facilities. The web-based EHDI-PALS Directory is populated with facilities that employ licensed audiologists and offer diagnostic, hearing aid, and cochlear implant services for children under age 5. The survey questions are based on best practices and allow for standardization of information across states. The site began receiving facility information on November 7, 2012. All audiologists who are members of ASHA and AAA received an invitation via e-mail. The site was made available to parents and other consumers to access in April 2013. The EHDI-PALS site houses the pediatric facility directory and helpful educational resources.

This directory is a comprehensive, user-friendly online tool designed to help guide and educate families and professionals searching for needed pediatric audiology services. The success of this important project will result in timelier access to appropriate services, leading to improved outcomes for children with hearing loss.