2023 Early Hearing Detection & Intervention Conference
March 5-7, 2023 • Cincinnati, OH
Examining Barriers to Early Hearing Diagnosis in Ohio
Although the national benchmark for Early Hearing Detection and Intervention (EHDI) is to complete screening by 1 month, diagnosis by 3 months, and early intervention by 6 months, multiple barriers exist that hinder families throughout the EHDI process. This study evaluated socioeconomic factors that impact EHDI in the state of Ohio. Between 2018 and 2021, around 3,000 newborns were referred to Nationwide Children’s Hospital (NCH) for evaluations due to the risk of hearing loss; 76% received a diagnosis within 3 months of birth, 12% received a diagnosis by six months, and 12% were loss-to-follow-up (LTFU). This study was completed to identify family and system-level barriers affecting the facilitation of EHDI in central Ohio.
Known barriers of diagnostic assessments include age at referral and at first diagnostic test, middle ear involvement, race/ethnicity, insurance type, and location-based family access to follow-up centers. These factors’ influence on LTFU were examined based on whether diagnosis occurred on time (by 3 months), delayed (by 6 months), or not at all (LTFU). Overall, age at referral was later for infants who were delayed or LTFU. A larger proportion of infants who had delayed diagnosis experienced middle ear involvement (76%) compared to those who were diagnosed on time (14%). When examining race/ethnicity, families who identified as non-hispanic, black, or bi/multi-racial were more often delayed in diagnosis or LTFU. Lastly, infants with public insurance were more likely to experience delayed diagnosis or LTFU than infants with private insurance or self-pay.
This retrospective study provides information regarding the socioeconomic factors affecting LTFU rates in central Ohio. Knowing which populations are at risk for LTFU and what barriers prevent appointment completion can help create targeted interventions to facilitate EHDI, which in turn will help maximize outcomes in children with hearing loss. Potential interventions and outcomes of implementation will be discussed.
- 1. Attendees will be able to identify barriers to timely early hearing detection and intervention.
- 2. Attendees will be able to examine differential effects of barriers on timely vs. delayed diagnosis and loss-to-follow-up.
- 3. Attendees will be able to list potential interventions to address identified barriers.
Poster:
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Presenter: Ursula Findlen
Ursula M. Findlen, Ph.D., is the Director of Audiology Research in the Division of Clinical Therapies- Audiology Department at Nationwide Children’s Hospital and an Assistant Professor-Clinical at The Ohio State University College of Medicine, Department of Otolaryngology- Head and Neck Surgery. Dr. Findlen engages in clinical practice and research endeavors related to pediatric (re)habilitative audiology, particularly in regards to a multidisciplinary team approach to family-centered care. Her research interests include infant diagnostics and improving outcomes of children with hearing loss through systematic quality improvement and population health endeavors.
ASHA DISCLOSURE:
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No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Madeline is a current 3rd-year student in The Ohio State University's Doctor of Audiology program. She graduated from OSU in 2019 with a B.A. in Speech and Hearing Science. She hopes to complete her externship at a pediatric hospital and become a pediatric audiologist upon completion of her doctorate of audiology degree.
ASHA DISCLOSURE:
Financial -
Nonfinancial -