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Am J Perinatol 2024; 41(S 01): e694-e710
DOI: 10.1055/a-1932-9985
Original Article

Provider Perspectives: Identification and Follow-up of Infants who Are Deaf or Hard of Hearing

Robyn A. Cree 
1   Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
2   Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities (NCBDDD), U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
,
Rebecca Bitsko
2   Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities (NCBDDD), U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
,
Cheri Grimm
3   Texas Early Hearing and Detection Intervention Program (TEHDI), Texas Department of State Health Services (TDSHS), Austin, Texas
,
Ashley Nash
2   Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities (NCBDDD), U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
4   Oak Ridge Institute for Science Education (ORISE), Oak Ridge, Tennessee
,
Eric S. Cahill
2   Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities (NCBDDD), U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
,
Eugenia Dunham
3   Texas Early Hearing and Detection Intervention Program (TEHDI), Texas Department of State Health Services (TDSHS), Austin, Texas
,
Naeemah Logan
1   Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
5   Division of Global HIV and TB, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
,
Susannah L. McKay
1   Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
6   Division of Viral Diseases, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia
,
David R. Martinez
3   Texas Early Hearing and Detection Intervention Program (TEHDI), Texas Department of State Health Services (TDSHS), Austin, Texas
,
Marcus Gaffney
2   Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities (NCBDDD), U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
› Author Affiliations Funding This project was supported in part by cooperative agreement no.: NUR3DD0000520 (U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities) from the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS; for C.G., E,D., and D.R.M.'s contributions). This work was also supported in part by an appointment to the Research Participation Program at the CDC administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the U.S. Department of Energy and CDC (for A.N.'s contributions). The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the official position CDC, HHS, ORISE, or the Texas Department of State Health Services.
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Abstract

Objective Without timely screening, diagnosis, and intervention, hearing loss can cause significant delays in a child's speech, language, social, and emotional development. In 2019, Texas had nearly twice the average rate of loss to follow-up (LFU) or loss to documentation (LTD; i.e., missing documentation of services received) among infants who did not pass their newborn hearing screening compared to the United States overall (51.1 vs. 27.5%). We aimed to identify factors contributing to LFU/LTD among infants who do not pass their newborn hearing screening in Texas.

Study Design Data were collected through semistructured qualitative interviews with 56 providers along the hearing care continuum, including hospital newborn hearing screening program staff, audiologists, primary care physicians, and early intervention (EI) program staff located in three rural and urban public health regions in Texas. Following recording and transcription of the interviews, we used qualitative data analysis software to analyze themes using a conventional content analysis approach.

Results Frequently cited barriers included problems with family access to care, difficulty contacting patients, problems with communication between providers and referrals, lack of knowledge among providers and parents, and problems using the online reporting system. Providers in rural areas more often mentioned problems with family access to care and contacting families compared to providers in urban areas.

Conclusion These findings provide insight into strategies that public health professionals and health care providers can use to work together to help further increase the number of children identified early who may benefit from EI services.

Key Points

  • Infants with suspected hearing loss may not receive timely diagnosis or early intervention.

  • We interviewed healthcare providers in Texas along the hearing care continuum.

  • Findings suggest strategies to increase the number of children with hearing loss identified early.

Keywords

infant hearing - early detection - early intervention - newborn hearing screening


Publication History

Received: 16 February 2022

Accepted: 12 August 2022

Accepted Manuscript online:
29 August 2022

Article published online:
28 October 2022

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