1. Missouri Newborn Hearing Screening Program: A Report on the First Two Years Missouri Department of Health and Senior Services

2. Initial Hearing Screenings Used in Missouri Hospitals Automated Auditory Brainstem Response(ABR) Otoacoustic Emissions (OAE) 19% 36%45%

3. Statistics on Initial Screening Screening data for years 2002-2003 150,476 newborns screened (97.6% live births in state) 5,613 referred to audiologists (3.7%)

4. Decline in Referrals Percent Referred From Initial Screening

5. Re-ScreeningRe-Screening Summary level data is incomplete Difficulties getting hospitals/clinics to send re-screening information Technical issues with data entry on re- screening portion of hearing system

6. What happens to Newborns Who Fail their Initial Screen? 20% Seen by Audiologist 41% Pass subsequent Screening Test 39% Unknown Outcome

7. Audiologist Exam Results Newborn Hearing Screening Program collected 1,213 audiologist reports from 2002 & 2003 67.8% Were seen by Audiologist Within 3 months of birth 32.2% Were not seen within 3 months of birth

8. Audiologist Exam Results Newborn Hearing Screening Program collected 1,213 audiologist reports from 2002 & 2003 25% (299 Cases) Diagnosis of Confirmed Hearing Loss 75% (914 Cases) No Confirmed Hearing Loss

9. Confirmed Cases of Hearing Loss 299 Confirmed Cases Matched 287/299 records to Birth Certificate 13 Cases infant passed initial screening but audiologist later confirmed hearing loss diagnosis 43 Records removedfurther testing revealed infants hearing were within normal ranges Final data set contained 244 records

10. Confirmed Cases of Hearing Loss by Date of Birth Number of Confirmed Cases

11. Hearing Loss by Gender and Race Hearing Loss Rate Per 1,000 Live Births Gender Race Missouri State Average = 1.58

12. Hearing Loss by Maternal Age Mothers Age Missouri State Average = 1.58

13. Hearing Loss by Maternal Age Hearing Loss Rate Per 1,000 Live Births Mothers Age Low Birth WeightAll BirthsRegular Weight Only

14. Hearing Loss by Birth Weight 1,500 – 2,500* < 1,500* * grams Hearing Loss Rate Per 1,000 Live Births

15. Hearing Loss by APGAR Score After 1 Min. After 5 Min. Hearing Loss Rate Per 1,000 Live Births

16. Hearing Loss & Cleft Lip/Palate (7 Cases) Hearing Loss Rate Per 1,000 Live Births

17. Hearing Loss by Degree Mild Moderate Severe Profound Unknown 96 67 24 32 25

18. Hearing Loss by Type and Degree Sensorineural Conductive Mixed Unknown 120 Cases 62 60 2 Type of Loss Degree of Hearing Loss for Sensorineural Type Loss Mild Moderate Severe Profound Unknown 44 31 14 27 4

19. Severe and Profound Hearing Loss Type of Loss for Severe and Profound Hearing Loss Sensorineural Conductive Mixed Unknown 41 Cases 5 2 8

20. Unilateral/Bilateral Hearing Loss Unilateral/Bilateral Hearing Loss Bilateral Unilateral Unknown 124 Cases 102 18 Unilateral/Bilateral for Severe or Profound Hearing Loss Bilateral Unilateral Unknown 35 20 1

21. Days from Birth to Diagnosis Degree of Loss Avg # Of Days 3 Month Goal of Newborn Hearing Program =

22. Percent of Births Meeting Three Month Goal Degree of Loss Overall 71.4% of Missouri newborns with hearing loss diagnosed by three month goal

23. SummarySummary Over 97% of newborns screened Missouri met refer rate standards Elevated rates for select demographic characteristics Majority of newborns diagnosed by 3 month goal