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Objective: Completion of newborn hearing screening (NBHS) is recommended by 1 month old. Delays and loss to follow-up and documentation (LTF/LTD) after failed NBHS are common. Committees of experts have established hospital guidelines to reduce LTF/LTD. We aimed to identify maternal and infant factors associated with LTF/LTD and determine if adherence to hospital guidelines is associated with timely completion of follow-up screening., Methods: We conducted a retrospective study of all infants born in Colorado hospitals who failed the newborn admission hearing screening from 2007 to 2012 and a cross-sectional survey of NBHS coordinators at Colorado birthing hospitals. Neonatal intensive care unit infants were excluded. Outcomes included documented completion of the follow-up NBHS and completion by 1 month. Data sources comprised the electronic birth record, infant hearing integrated data system, and NBHS coordinator survey. Data were analyzed by logistic regression., Results: A total of 13,904 newborns did not pass the newborn admission hearing screening from 2007 to 2012, and 11,422 (82%) had documentation of a completed follow-up screening. A total of 10,558 (76%) completed follow-up screening by 1 month. All 53 NBHS coordinators completed the survey. Maternal age, education, smoking, and birth country; and payer, race, birth order, and population density were associated with completion of follow-up hearing screening. Maternal education, payer, population density, birth weight, and cleft lip were associated with completion by 1 month of age. Only birth in a facility that charges a rescreening fee was associated with completion of follow-up screening., Conclusions: Low-income, rural, and minority infants are at risk for LTF. Further studies are needed to determine if adherence to guidelines can overcome barriers to follow-up., (Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)

Purpose: The purpose of this study was to define the information currently collected by state and territory Early Hearing Detection and Intervention (EHDI) coordinators and to determine whether best practice guidelines are used., Method: A multiple-choice electronic survey querying areas of diagnostic assessment, amplification, early intervention (EI) and medical information regarding hearing loss was sent to all state and territory EHDI coordinators., Results: Seventy percent of surveys were completed. Diagnostic, amplification, and Part C services were tracked by the majority of respondents. Additionally, medical prenatal and postnatal risks were collected., Conclusion: Data collected on audiologic screening and diagnostic evaluations has increased. On the basis of these results, it is difficult to discern whether best practices are being used for each child. A delay in reporting a confirmed hearing loss was observed. Amplification results suggest that systems are not in place to ensure consistency and accountability for fitting amplification in infants. The results of this survey identified audiologic and EI information tracked by states to help provide a framework to monitor quality care in the future.

Background: Children's language and developmental delays can result from a late diagnosis of hearing loss. To improve population-based prevention efforts to reduce such delays, Colorado's early hearing detection and intervention program examined the determinants of receiving timely newborn hearing screening to better support early identification and treatment of hearing loss., Methods: In 2006-2007, data were examined from the state's electronic birth certificate regarding hospital, infant, and maternal characteristics. From January 2002 through December 2004, there were 204,694 hospital births; 98% of newborns were screened for hearing loss. Of those receiving a positive (failed) result, 82% then received outpatient follow-up screening., Results: Newborns with normal Apgar scores were ten times more likely than infants with low Apgar scores to receive initial hearing screening; newborns with normal birth weights were four times more likely than newborns with low birth weights to receive initial hearing screening. Outpatient follow-up screening was associated with hospitals' screening performance and mothers' education. One urban safety-net hospital substantially reduced the state's follow-up screening disparities., Conclusions: While newborns with low Apgar scores and birth weights are more likely to have a higher risk of hearing loss than infants with normal Apgar scores and birth weights, they are substantially less likely to receive screening to identify it.

Though the health and economic issues in developing countries may create situations in which the development of early hearing detection and intervention (EHDI) programs could seem insurmountable, developing countries have some resources that are not easily available to those in the developed world. Developing countries often have well-organized communities in which members work together for the benefit of the individuals within their communities as well as a willingness to learn strategies that can improve the lives of individuals in their communities. Paradoxically, there also exists societal intolerance for disabilities that can result in stigmatization and ultimate isolation of affected families. Hopefully, education within these communities can begin to overcome historical intolerance. While some might argue that sufficient financial resources are the key to the development of an EHDI system, the Colorado system, although grateful for all financial resources, is dependent, first and foremost upon the human resources. This article provides information about the history of the Colorado system in the hopes that lessons learned will provide valuable input to others facing similar challenges.