Widespread screening leads to early hearing-loss detection

From: Penn Live, PA Oct. 22, 2002

By TINA MOORE
The Associated Press

PHILADELPHIA (AP) -- Tahira Skeeters waited nervously as her infant daughter had her hearing tested again. Denaysha was only a few weeks old and had no known risk factors for hearing loss, but doctors had already detected a problem: hearing loss in her right ear.

"I was hoping they were wrong," Skeeters, 26, said this week.

Denaysha's testing was part of a national movement to use routine screening to check every baby's hearing at birth, a movement that doctors say has led to getting more babies treated earlier.

Universal screening has been made possible by advances in technology, and 37 states and the District of Columbia now have screening policies or mandates. Previously, only high-risk children were tested at infancy, primarily those who were born prematurely.

"The earlier the better," said Jennifer Anthony, who is responsible for newborn hearing screening at Children's Hospital of Philadelphia, where Denaysha is now working with specialists in a variety of fields, including otolaryngology, genetics, ophthalmology and audiology.

One in 300 babies is born with some type of hearing loss and 4,000 are profoundly impaired. The National Campaign for Hearing Health lists hearing loss as the No. 1 birth defect in the country.

Before widespread testing, the average age for diagnosis was 2� years, according to the American Speech-Language-Hearing Association.

"We see these kids that are 2�, 3 years of age that are coming in and they have significant delays in their speech and hearing development," Anthony said.

The mandates requiring testing across the country often were not accompanied by funds, however, and some hospitals are finding themselves without money for staff increases and training.

A lack of training can lead to another problem: failure to follow up on results with families, said Paul Kileny, professor and director of audiology at the University of Michigan.

As a result, 20 percent to 30 percent of children who fail initial hearing tests never get follow-up evaluations, Kileny said.

Such follow-up in his program is closer to 90 percent, he said, "but in general you really have to work very hard to establish a 100 percent follow-up rate. It's not enough to just give the parent a follow-up sheet," he said of the program he has run since 1985.

The tests, in which newborns are connected to a machine that can analyze the response of their brain waves to a series of clicking noises, usually cost between $35 and $50 per child, he said. Some health care plans cover the tests, but many hospitals have had to absorb the cost into the overall testing of newborns.

At Abington Memorial Hospital, which delivers 4,500 babies each year in the northwest suburbs of Philadelphia, hospital administrators are looking for new funding.

The hospital started performing routine screening of all newborns before legislation mandating testing was enacted in Pennsylvania. The hospital funds the testing itself.

"The state requirements have now put an additional hardship (on us)," said Dr. Stephen Shapiro, chairman of the Department of Pediatrics.

He said the hospital is considering ways to cut costs, including hiring an outside company to perform the screening, organize follow-up and handle the paperwork.

And funding for the programs soon could get tighter.

President Bush eliminated $13 million in federal funding in the 2003 budget. The money previously was used to purchase equipment and monitor testing.

National Campaign for Hearing Health Director Elizabeth Thorp testified in Washington, D.C., in favor of universal testing. In August, the Senate Appropriations Committee put the money back in the budget, funding that now needs Bush's approval.

"We're cautiously optimistic that it won't be totally unfunded for the year," said Thorp, whose own hearing loss was diagnosed when she was 8.

Denaysha, Tahira Skeeters' 3-month-old daughter, now wears hearing aids in both ears.

"I'm glad they started the hearing testing at a young age. A couple children I know, their parents didn't find out until 2 years or 3 years and they wondered why the kids weren't talking or walking," said Skeeters, who also has three other children.

"This way all her motor skills will be on time. She'll be able to walk and talk and do everything on time," she said.

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On the Net:

National Campaign for Hearing Health: http://www.hearinghealth.net/

Children's Hospital of Philadelphia: http://www.chop.edu

Copyright 2002 Associated Press.