Arkansas Infant Hearing Program

Mille Sanford

The Arkansas Infant Hearing Program (IHP) at the Arkansas Department of Health serves as the state Early Hearing Detection and Intervention Program.  The IHP is located in the Center for Health Advancement, Family Health Branch, as part of the Child and Adolescent Health Section.  The Department of Health programs that collaborate with the IHP are also housed in the Family Health Branch and include the Metabolic Newborn Screening (housed in the Child & Adolescent Health Section), Lay Midwifery reporting and licensing, and the Sudden Infant Death Syndrome Program.

The Arkansas IHP is in its eighth year of Universal Newborn Hearing Screening. The Rules and Regulations Pertaining to the Universal Newborn/Infant Hearing Screening, Tracking, and Intervention Program promulgated from the passage of Act 1559 of 1999 became effective September 2000.  These Rules and Regulations mandated that birthing hospitals in the state with fifty or more births per year provide or arrange for a bilateral physiological hearing screening before hospital discharge.  The Universal Newborn Hearing Screening, Tracking and Intervention Advisory Board, created by Act 1559, is composed of 7 members appointed by the Governor:

• One (1) audiologist at-large;
• One (1) audiologist from the Department of Health;
• One (1) audiologist from Arkansas Children’s Hospital;
• One (1) speech-language pathologist;
• One (1) pediatrician-neonatologist or ear, nose, and throat physician;
• One (1) adult who is deaf or hard-of-hearing to represent consumer organizations for deaf and hard-of-hearing persons; and
• One (1) consumer of services who is a parent of a child or children with hearing loss.

The focus of the IHP is to ensure quality developmental outcomes for infants identified with hearing loss.  The program’s objectives center around the Centers for Disease Control and Prevention’s (CDC) goals listed below:

• All newborns will be screened for hearing loss before one month of age, preferably before hospital discharge.
• All infants who screen positive will have a diagnostic audiologic evaluation before 3 months of age.
• All infants identified with hearing loss will receive appropriate Early Intervention services before 6 months of age (medical, audiological, and Early Intervention).

The IHP works with hospitals, Early Intervention programs, parents and stakeholders to assure the provision of hearing screening to newborns and follow-up services for those identified with hearing loss.

Each hospital has designated a person to be responsible for its newborn hearing screening program and must ensure that all screening personnel are appropriately trained to carry out the newborn hearing screening using appropriate technology. The IHP provides site visits to each birthing hospital for the provision of technical assistance and quality assurance through a combination of observation and interaction with hospital staff and the assessment of hospital programs. 

Each hospital disseminates brochures provided by the IHP and screening results to the parent prior to the discharge.  An At-Risk Screening Questionnaire for Infant Hearing Loss form is used for recording the results.  Written results or parent refusal of the hearing screening are provided by the hospital to the child’s primary care physician.  Hospitals have the option of faxing hearing screen results to the IHP secure (HIPAA compliant) fax machine or to send these to the IHP by mail no later than the 15th day of the month following the month in which the test was conducted.  While current hearing screen reporting is paper based, the IHP is in the process of working with the Arkansas Department of Health (ADH) Health Statistics/Vital Records Section toward the implementation of an electronic birth certificate and newborn hearing screen system.

The Arkansas IHP maintains a comprehensive tracking database system to assure that:

• All newborns are screened for hearing loss before hospital discharge;
• Infants are tracked for timely follow-up evaluations;
• Infants identified with hearing loss are enrolled in Early Intervention;
• Families have access to family-to-family support; and
• Children with confirmed hearing loss are linked to a medical home.

Newborns that do not pass or that do not receive a hearing screen before hospital discharge are tracked by the IHP for return screening/evaluation.  The 2007 IHP data for hearing screening and diagnostic testing revealed that 98% of infants received hearing screening before discharge from Arkansas’ hospitals. Diagnostic evaluations for those infants having failed the screen and rescreen revealed 82 children with a confirmed, permanent hearing loss.  

The infants “lost-to-follow-up” is a major area that the IHP is striving to improve with specific strategies.  While the “lost to follow-up” data reveals gradual improvement over time, the overall numbers remain less than satisfactory. To look at “lost-to-follow-up” challenges specific to Arkansas, the IHP has initiated a third-party needs assessment for identification of family challenges in obtaining follow-up services. The barriers identified and recommendations from this study will be used to determine future program goals. 

For more information about the Arkansas Infant Hearing Program, please contact Millie Sanford, Infant Hearing Program Coordinator at Millie.Sanford@arkansas.gov.