Are we missing children with mild hearing loss?

Any degree of hearing loss can adversely affect development if not identified early. The national goals for Early Hearing Detection and Intervention (EHDI), the 1-3-6 plan include: hearing screened by 1 months of age; hearing loss identified by 3 months of age; and enrollment into EI by 6 months of age. However, infants with mild degrees of hearing loss are not always identified. This study examines the relationship between degree of hearing loss, age of diagnosis, and age of enrollment in EI among 295 children with hearing loss from the National Early Intervention Longitudinal Study (NEILS) which has a nationally representative sample of 3,338 children and families who entered EI programs for the first time between 1997 and 1998.

Results indicate that children identified with hearing loss after 6 months of age were more likely to have mild hearing loss compared with children identified before 6 months of age (56% vs. 39%, p<0.05). Age of enrollment in EI was associated with degree of hearing loss; children enrolled in EI who were diagnosed with hearing loss after 6 months of age had a higher percentage of mild hearing loss compared with children who were enrolled at older ages (52.9% vs. 28.4%, p<0.05).

These findings suggest that infants with milder degrees of hearing loss might be missed by newborn hearing screening because screening equipment can detect only moderate or greater degrees of hearing loss, the perception that milder degrees of hearing loss have little impact on development, and lack of documentation.