Infant Hearing Screening in the US, 2001: Results from the ECLS-B Study

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Infant Hearing Screening in the US, 2001
Results from the ECLS-B Study

• May S. Chiu, B.S.
• Magdaliz Gorritz, B.S.
• Howard J. Hoffman, M.A.
• National Institute on Deafness and Other
  Communication Disorders (NIDCD)
• National Institutes of Health (NIH)
• Bethesda, Maryland 20892

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Faculty Disclosure Information

• In the past 12 months, I have not had a
  significant
• financial interest or other relationship with the
• manufacturer(s) of the product(s) or provider(s)
  of
• the service(s) that will be discussed in my
• presentation.
•  
• This presentation will (not) include discussion
  of
• pharmaceuticals or devices that have not been
• approved by the FDA or if you will be discussing
• unapproved or off-label uses of pharmaceuticals
  or
• devices.

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Sponsoring Agencies

• U.S. Department of Education,
• National Center for Education Statistics
• U.S. Department of Health and Human Services
• National Center for Health Statistics, CDC
• National Institute of Child Health and Human
  Development
• National Institute on Deafness and Other
  Communication Disorders
• Health Resources and Services Administration -
• Maternal and Child Health Bureau
• Office of Minority Health
• Other Federal agencies

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Early Childhood Longitudinal Study

• Multi-dimensional study focusing on the early
  home and educational experiences of children
  through first 6 years of life
• Birth cohort (ECLS-B), 2001
• Nationally representative sample

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ECLS Conceptual Model
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Study Design of ECLS-B

• N10,688
• Oversamples
• Minorities
• Very low birth weight (lt1500 g)
• Moderately low birth weight (1500 - 2499 g)
• Twins
• Household surveys conducted by trained personnel
  at 9 months
• Bayley exams (modified for ECLS-B) conducted at 9
  months and 2 years

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Early Childhood Longitudinal Study
For more information visit
http//nces.ed.gov/ecls/index.asp
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EHDI vs. ECLS-B, 2001

• EHDI
• Annual data collection
• State-level outcome data
• Hearing screening
• Hearing loss Dx
• Enrollment in intervention program
• Global screening rate 65 before
  discharge

• ECLS-B
• One year (2001) births only
• Person-level outcome data
• Hearing screening
• Hearing loss Dx
• Receiving hearing services
  
• Global screening rate 70 before
  discharge
• 78 by 9 months

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Why ECLS-B?
Additional information is available, for example
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ECLS-B

• Analysis of Variables Related to Hearing Screening

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Demographics (n10,531)
Region Screened OR 95 CI
Northeast 76 1.00
Midwest 75 0.92 0.55 1.53
West 70 0.70 0.46 1.08
South 86 1.87 1.19 2.95
Source 9-month composite variables
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Demographics (contd)
County Pop. Size Screened OR 95 CI
lt 100,000 82 1.00
100,000-250,000 76 0.72 0.47 1.11
250,001-500,000 85 1.30 0.83 2.04
500,001-1,000,000 76 0.71 0.46 1.11
1,000,000 72 0.40 0.40 0.78
Source birth certificate data
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Demographics (contd)
Gender Screened OR 95 CI
Male 78 1.03 0.89 1.19
Female 78 1.00
Source 9-month composite variables
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Demographics (contd)
Race Screened OR 95 CI
Non-Hispanic White 79 1.00
Non-Hispanic Black 82 1.20 0.94 1.54
Hispanic/Latino 73 0.71 0.57 0.90
Other 77 0.87 0.68 1.11
Source 9-month composite variables
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Family Information
Household Income Screened OR 95 CI
15,000 78 1.00
15,001-30,000 77 0.91 0.77 1.07
30,001-50,000 76 0.87 0.72 1.05
50,001-100,000 79 1.04 0.85 1.28
gt100,000 80 1.09 0.79 1.49
Source 9-month parent CAPI instrument and parent
questionnaire
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Family Information (contd)
Mothers Education Screened OR 95 CI
College graduate 84 1.00
Some college 79 0.74 0.58 0.96
High school diploma 76 0.62 0.47 0.82
No high school diploma 75 0.60 0.45 0.80
Source 9-month composite variables
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Other Significant Factors
Mother Medical Risk Factor Screened OR 95 CI
Pre-Eclampsia
Yes 92 3.40 1.50 7.74
No 78 1.00
Uterine bleeding
Yes 96 7.67 3.06 19.20
No 78 1.00
Source Birth certificate data
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Infant Information
Birth Weight Screened OR 95 CI
Normal ( 2500 g) 77 1.00
Moderately low (1500 2499 g) 84 1.51 1.27 1.78
Very low (lt 1500 g) 94 4.97 3.55 6.97
Source 9-month composite variables
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Infant Information (contd)
Gestational Age Screened OR 95 CI
20 27 wks 97 8.16 4.46 14.94
28 30 wks 88 2.20 0.98 4.94
31 33 wks 85 1.68 1.04 2.71
34 36 wks 81 1.22 1.02 1.47
Term 37 wks 77 1.00
Source Birth certificate data
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Infant Information (contd)
Child Condition Screened OR 95 CI
Failure to thrive Dx
Yes 93 4.07 1.33 12.42
No 78 1.00
Home apnea monitor prescribed
Yes 90 2.54 1.51 4.29
No 78 1.00
Source 9-month parent CAPI instrument and parent
questionnaire
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Infants Receiving Hearing Services at 9 Months
(n105) ? Univariate Associations
Characteristic OR 95 CI
Twin 2.7 1.5 4.9
Very low birth weight 24.2 13.1 44.6
Moderately low birth weight 3.8 1.9 7.5
Gestational age lt27wks 27.7 13.4 57.2
Gestational age 28-30 wks 10.2 5.1 20.3
Longer stay in hospital 14.7 6.7 32.2
Difficulty seeing 71.8 27.1 190.5
Cleft lip 66.3 16.3 268.9
Heart defect 5.4 2.8 10.3
Problem using hands 74.8 26.8 209.0
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Infants Receiving Hearing Services at 9 Months
(n105)
Other Services OR 95 CI
Vision services 8.8 3.7 21.0
Physical therapy 4.8 2.1 10.8
Social work services 4.0 2.0 7.9
Home services 7.0 3.2 15.3
Parent support/training 3.7 1.8 7.6
Source 9-month parent CAPI instrument and parent
questionnaire
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Summary of Findings

• Lower screening rate for Hispanic/Latino infants
• Lower mothers education associated with lower
  screening rate
• Infants with low birth weight and associated
  conditions have a higher rate of screening
• Infants receiving hearing services at 9 months
  also receive many additional services

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Prospectus

• EHDI
• Annual data collection allows trend analysis to
  document increase in newborn hearing screening
• Anticipate more extensive data will come in
  future years
• ECLS-B
• Longitudinal study allows tracking of children
  with hearing problems (9 months of age this
  study)
• Future data will be collected for children when
  2, 4, 5 (kindergarten), and 6 (first grade)
  years old

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Any Questions?