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New law to strengthen early hearing screening program for infants and children

On October 18, 2017, President Trump signed into law S. 652, the Early Hearing Detection and Intervention (EHDI) Act (PL 115-71). The law amends the Public Health Service Act to reauthorize until 2022 a federal program administered by the U.S. Department of Health and Human Services (HHS). Three HHS agencies—the Health Resources and Services Administration (HRSA), the Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH)—will continue a long-standing partnership to coordinate and advance a national program for the early identification and diagnosis of hearing loss and intervention services for deaf and hard-of-hearing newborns and infants. In addition, the law authorizes specific changes to the federal program, such as expanding the program to include young children who are at risk of losing their hearing during childhood from infection, harmful noise exposure, or genetic causes.

A newborn baby with its eyes closed.Prior to the establishment of a federal universal newborn infant hearing screening program in 1999, less than 10 percent of newborns in the U.S. were screened for hearing loss. As a result, 47 percent of children born with hearing loss were not diagnosed until their third birthday or later, missing a crucial period for language acquisition. In fact, children begin learning speech and language in the first six months of life, which is why early identification of hearing loss is critical. Research suggests that children with hearing loss who get help early develop better language skills than those who don’t.

According to the CDC, currently around 98 percent of newborns are screened for hearing loss in the U.S. annually. Since 2005, more than 50,000 infants who are deaf and hard-of-hearing have been identified within the first year of life and have had the opportunity to receive early intervention services that can help them reach their full potential.

The 2017 EHDI law reauthorizes HRSA to continue funding awards to states, territories, and healthcare providers to support continuous improvement of EHDI programs. These projects help to identify effective strategies to address screening, loss to follow-up diagnosis and services, enrollment into early intervention services, and family engagement. Project grants are also awarded to organizations to improve family-to-family support systems and to educate healthcare professionals who provide services to children who are deaf or hard-of-hearing.

EHDI reauthorization allows CDC to continue providing funding and direct assistance to states and territories to support the development and use of state data systems. Under the new law, CDC will also be responsible for collecting and reporting on data from state-level programs. This data will improve program efficiency by helping the three HHS agencies to evaluate progress, guide research and policy development, and plan future activities, such as identifying where gaps in follow-up services are affecting children the most.

The law also encourages EHDI research programs at NIH through projects supported by the National Institute on Deafness and Other Communication Disorders (NIDCD). The NIDCD is committed to supporting biomedical research to improve both early hearing detection and intervention and hearing loss management, including screening, treatment, and rehabilitation. The law will allow for continued support of research on hearing aids, cochlear implants, speech perception and production, and language (both spoken and signed).

Collectively, HRSA, CDC, and NIH will enhance coordination so that the federal EHDI program continues to ensure that infants who are deaf or hard-of-hearing are identified as early as possible and receive effective and timely interventions. These collaborations are critical to improving outcomes for affected children. HHS agencies will continue to promote essential services in order to minimize the negative impact that undiagnosed hearing loss can have on children’s speech, language, academic, social, and emotional development.

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