Oklahoma Newborn Hearing Screening Program

Jim Schmaelzle

Oklahoma legislation enacted in 1982 states that: A screening procedure for the detection of hearing impairments shall be required for all infants.  The State Board of Health was given responsibility for developing and administrating hearing screening procedures for infants.  The Oklahoma Newborn Hearing Screening Program (NHSP) was established at the Oklahoma State Department of Health in August 1983 and began using risk registry screening for all newborns.  Physiologic hearing screening began at two hospitals in 1997 with all birthing facilities providing such screening by 2002.  Updated legislation and Board of Health rules enacted in 2000 requires both physiologic and risk screening for all infants prior to discharge from the birthing facility and at least risk screening for infants born at home.  In 2008, hearing screening results have been collected on more than 95% of the infants born in the state.

Since January 2003, birth hearing screening results have been collected on the Newborn Screening Program blood specimen filter paper form.  Public health laboratory personnel enter the hearing screening results at the same time they enter the infant’s demographic information into the Neometrics tracking system program.  The tracking system generates appropriate correspondence to the infant’s family and primary care provider for newborns who need hearing and/or metabolic follow-up.  For infants who do not pass the birth hearing screening, both the family and the infant's physician are strongly encouraged to have a follow-up diagnostic assessment provided by an audiologist.  Program staff is available to assist families in obtaining such evaluations at low or no cost to the family and as close to home as possible.

Three taskforces established in 2000 have been of great assistance to the NHSP.  The audiology taskforce has established standardized state infant diagnostic assessment and amplification protocols.  This group has been extremely helpful in ensuring that newborns receive the appropriate assessment and are fit quickly with proper amplification.  The intervention taskforce has worked diligently to ascertain appropriate services available to infants diagnosed with hearing loss and their families.  The hospital taskforce continues to explore innovative ways to provide the NHSP with accurate demographics and to make certain that every infant is appropriately screened prior to discharge.

Like other states, loss-to-follow-up/loss-to-documentation has been a challenge for the NHSP.   In 2005, the program was not able to document the actual hearing status of about 40% of the infants who did not pass the birth hearing screening.  With funds awarded through a competitive federal grant, a newborn hearing screening follow-up coordinator was employed in September 2005.   Through the efforts of this individual and enhancements to our tacking system, loss to follow-up/documentation was cut in half in 2007.

The ONHSP is fortunate in having two of its employees serve as members of the Heartland Genetics and Newborn Screening Collaborative.  These two individuals have been extremely helpful to the NHSP in educating state physicians, audiologists, speech-language pathologists, teachers of the deaf, and other early interventionists about the importance of genetic testing and counseling for infants diagnosed with hearing loss.  Learning opportunities have been made available to the taskforces mentioned above and to clinicians attending their state professional meetings.  The Oklahoma NHSP welcomes further opportunities to work in partnership with the Heartland Collaborative.