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Without timely hearing screening, diagnosis, and intervention, a child who is deaf or hard of hearing (DHH) may experience significant delays in speech, language, social, and emotional development. To help these children and their families, recommended Early Hearing Detection and Intervention (EHDI) benchmarks are hearing screening by 1 month of age, confirmed hearing diagnosis by 3 months of age, and enrollment in early intervention by 6 months of age among children who are DHH. Two surveillance methods that measure timeliness are the eligible population method and the population in services method, described below.
Two methods
Timeliness of hearing screening, diagnosis, and intervention can be measured in two ways. Each measure provides different but valuable information.
Eligible Population
The eligible population method looks at the number of infants who are eligible for the next phase of the EHDI system.
- This method is referred to as timeliness among the “eligible population” because it includes all children, even if they have not made progress to the next stage within the EHDI system. (1) All infants who are born are counted as eligible for newborn hearing screening. (2) All infants who do not pass their newborn hearing screening are counted as eligible for diagnostic testing. (3) All infants who are diagnosed as DHH are counted as eligible for enrollment in early intervention services.
- The information provided by this method is most useful to public health practitioners because it includes infants lost to follow-up and those lost to documentation.
Did you know?
The eligible population method includes infants lost to follow-up and lost to documentation.
Loss to follow-up occurs when an infant needs a recommended service but does not receive it.
Loss to documentation occurs when an infant receives services, but the information is not reported to the EHDI data program. This means public health professionals do not know whether these infants are receiving timely services.
Population in Services
The population in services method looks at the percentage of infants who receive the appropriate services in the EHDI process.
- This method is referred to as timeliness among the “population in services” because it includes only children who have already made progress within the EHDI system. (1) Infants who receive a newborn hearing screening are counted as the population served. (2) Infants who do not pass their hearing screening and receive a confirmed diagnosis are counted as the population served in the next phase. (3) Infants who receive a confirmed DHH diagnosis and enroll in early intervention services are counted as the population served in the final phase.
- The information provided by this method is most useful to the clinical community and shows whether they are meeting timeliness benchmarks for infants who have been seen and/or are enrolled in clinical services.
- This highlights the children who are being reached through the EHDI system and those who are making it to each phase in a timely fashion.
Data and public health
Public health surveillance extends beyond tracking receipt of clinical services alone. CDC’s goal is to account for all infants who fail their hearing screening. Therefore, beginning with 2021 EHDI data (released in January 2024), CDC reports on timeliness among only the eligible population. However, the data needed to calculate timeliness among the population in services can still be accessed on Annual Data: Early Hearing Detection and Intervention (EHDI) Program.