The Iowa Early Hearing Detection and Intervention Program

Erin Tokheim Kongshaug

The Iowa Early Hearing Detection and Intervention (EDHI) program is a collaboration of the Iowa Department of Public Health (IDPH) and Child Health Specialty Clinics (CHSC).  The IDPH receives funding from the Centers for Disease Control and Prevention to focus on screening and surveillance.  CHSC receives funding from the Health Resources and Services Administration to focus on follow-up and family support.  The two programs work closely together to make sure all children are screened and receive the follow-up they need.

The Iowa Early Hearing Detection and Intervention law went into effect on January 1, 2004.  It requires that all children born in Iowa receive a newborn hearing screening.  The screening must be conducted before discharge for babies born in hospitals.  Provisions are also included for babies born at home or in birth centers.  In addition, screening and diagnostic facilities are required to report hearing screening, rescreen, and diagnostic results for children under age three. Most hospitals report results to the Iowa Department of Public Health via eScreener Plus (eSP), the EHDI data system.  Two hospitals that deliver fewer than 50 babies per year report via paper reporting forms.  Other screening facilities also report via eSP or paper reporting forms.  The Iowa EHDI program will work to move more outpatient screening and diagnostic facilities to electronic reporting as it becomes feasible.

When children miss or do not pass their newborn hearing screenings, the EHDI program refers them to Early ACCESS (Iowa’s Individuals with Disability Education Act Part C System).  If Early ACCESS is not able to get the child in for follow-up, the EHDI program sends a final letter to the family and physician recommending follow-up.  This process has resulted in a lost-to-follow-up rate that is about half the national average, but which is still larger than is acceptable.  The EHDI program is working through several avenues to decrease the lost-to-follow-up rate.  It is important that all health care providers working with young children know that hearing screening follow-up needs to be done as soon as possible.  Children who receive early intervention services before six months of age have better outcomes than those who do not.

Iowa also has family support available for families of young children with hearing loss.  The Iowa EHDI program has partnered with Iowa Hands & Voices to bring the Guide By Your Side (GBYS) program to Iowa.  GBYS provides families with unbiased support and information from GBYS guides.  Guides are parents of children with hearing loss and/or adults who are deaf or hard-of-hearing.  The GBYS program is free to families. 

The Iowa EHDI program relies on our Advisory Committee to provide input from the viewpoints of parents, consumers and professionals.   Members provide guidance to the EHDI program staff on issues such as reducing the lost-to-follow-up rate, the lack of audiologists qualified to serve infants and young children, and the work load and limited budget of the EHDI staff.  These issues are currently our biggest challenges.

In Iowa, the EHDI program and the Center for Congenital and Inherited Disorders are not formally linked.  However, we are located in the same bureau within the Iowa Department of Public Health.  We work together to address barriers to screening and follow-up and to identify primary care providers for children who need follow-up.

For more information about the Iowa EHDI program, visit our web site: http://www.idph.state.ia.us/iaehdi/default.asp.