Missouri Newborn Hearing Screening Program: A Report on the First Two Years

1. Missouri Newborn Hearing Screening Program: A Report on the First Two Years Missouri Department of Health and Senior Services

2. Initial Hearing Screenings Used in Missouri Hospitals • AutomatedAuditory Brainstem Response(ABR) • Otoacoustic Emissions (OAE) 36% 45% 19%

3. Statistics on Initial Screening • Screening data for years 2002-2003 • 150,476 newborns screened (97.6% live births in state) • 5,613 referred to audiologists (3.7%)

4. Decline in Referrals Percent Referred From Initial Screening

5. Re-Screening • Summary level data is incomplete • Difficulties getting hospitals/clinics to send re-screening information • Technical issues with data entry on re-screening portion of hearing system

6. What happens to Newborns Who Fail their Initial Screen? 20% 39% Seen by Audiologist Unknown Outcome 41% Pass subsequent Screening Test

7. Audiologist Exam Results Newborn Hearing Screening Program collected 1,213 audiologist reports from 2002 & 2003 32.2% Were not seen within 3 months of birth 67.8% Were seen by Audiologist Within 3 months of birth

8. Audiologist Exam Results Newborn Hearing Screening Program collected 1,213 audiologist reports from 2002 & 2003 25% (299 Cases) Diagnosis of Confirmed Hearing Loss 75% (914 Cases) No Confirmed Hearing Loss

9. Confirmed Cases of Hearing Loss • 299 Confirmed Cases • Matched 287/299 records to Birth Certificate • 13 Cases infant passed initial screening but • audiologist later confirmed hearing loss diagnosis • 43 Records removed—further testing revealed • infants hearing were within normal ranges • Final data set contained 244 records

10. Confirmed Cases of Hearing Lossby Date of Birth Number of Confirmed Cases

11. Hearing Loss byGender and Race Hearing Loss Rate Per 1,000 Live Births Race Gender Missouri State Average = 1.58

12. Hearing Lossby Maternal Age Mother’s Age Missouri State Average = 1.58

13. Hearing Lossby Maternal Age Hearing Loss Rate Per 1,000 Live Births Mother’s Age Low Birth Weight All Births Regular Weight Only

14. Hearing Loss by Birth Weight Hearing Loss Rate Per 1,000 Live Births < 1,500* 1,500 – 2,500* * grams

15. Hearing Loss byAPGAR Score Hearing Loss Rate Per 1,000 Live Births After 1 Min. After 5 Min.

16. Hearing Loss &Cleft Lip/Palate Hearing Loss Rate Per 1,000 Live Births (7 Cases)

17. Hearing Loss by Degree 25 32 96 24 Mild Moderate Severe Profound Unknown 67

18. Hearing Loss by Type and Degree Degree of Hearing Loss for Sensorineural Type Loss Type of Loss 4 60 27 44 120 Cases 2 14 62 31 Sensorineural Conductive Mixed Unknown Mild Moderate Severe Profound Unknown

19. Severe and Profound Hearing Loss Type of Loss for Severe and Profound Hearing Loss 8 2 41 Cases Sensorineural Conductive Mixed Unknown 5

20. Unilateral/Bilateral Hearing Loss Unilateral/Bilateral Hearing Loss Unilateral/Bilateral for Severe or Profound Hearing Loss 1 18 124 Cases 20 35 102 Bilateral Unilateral Unknown Bilateral Unilateral Unknown

21. Days from Birth to Diagnosis Avg # Of Days Degree of Loss 3 Month Goal of Newborn Hearing Program =

22. Percent of Births MeetingThree Month Goal Degree of Loss Overall 71.4% of Missouri newborns with hearing loss diagnosed by three month goal

23. Summary • Over 97% of newborns screened • Missouri met ‘refer’ rate standards • Elevated rates for select demographic characteristics • Majority of newborns diagnosed by 3 month goal