Birth Certificate Orders and Hearing Screening Follow-Up

January 31, 2005

Principle Investigator: Judith M. Holt, PhD
AUCD Institution: Utah State University
AUCD RTOI #: 2005-04-01

The goal of this project is to improve the follow-up screening rate for Utah infants who fail their initial newborn hearing test and do not return for needed follow-up screenings. Newborn hearing screening programs are in place in all states and have aided dramatically in the early identification of children with hearing loss. However, rates of follow-up for infants who fail the initial test (and therefore need additional testing) are less than optimal, thus representing a serious health-related concern.

In Utah, approximately 20-30% of infants who are referred for a follow-up screening, do not complete this screening. This is problematic due to the deleterious consequences associated with hearing loss. If children with hearing loss are not identified early it is difficult for them to develop the language, social, and cognitive skills necessary for later life success. Early identification of such children is crucial in insuring that children receive needed intervention services.

Increasing the percentage of children who complete needed follow-up screening is of utmost importance and is the focus of this project. This goal will be accomplished through the linking of existing state databases including the Vital Records and Newborn Hearing Screening data bases in order to identify children who have not completed needed follow-up screenings. Through this linking, when parents apply for a birth certificate for their child, a notice will appear (that vital records staff can see) that indicates whether the child is in need of a follow-up hearing screening. An "alert" system will be developed so that parents are notified of the need for screening.

All parents whose child is in need of such a screening will receive a brief, standard "alert" (either via letter, e-mail, or in person depending on how the parent applies for the birth certificate). This alert will indicate the child did not pass the initial newborn hearing screening and requires follow-up. In addition to this standard alert, two different more detailed follow-up alerts will be evaluated: sending a letter to parents and phoning parents following the initial alert.

The goal is to determine which method (standard alert along, stand alert + follow-up letter, or standard alert + follow-up phone call) produces the best overall rate of children who need hearing screening. Because a high percentage of parents apply for birth certificates during the first year of their child's life, this alert system is a relatively easy way to catch a large portion of those children in need of follow-up screening.