Voluntary progress toward universal newborn hearing screening.

Objectives: This study assessed the prevalence of newborn hearing screening in Wisconsin between 1997 and 2001, and examined factors leading to establishment of programs and influencing the outcomes of universal newborn hearing screening (UNHS). The primary goal was to identify characteristics that might be important for states, provinces or countries that have not yet implemented UNHS programs and to examine some unique components of the Wisconsin UNHS program, that may provide direction to areas both with and without programs.

Methods: The study consisted of two cross-sectional surveys administered at two separate time points (2000 and 2001). Additional data was provided by the Wisconsin Sound Beginnings Early Detection and Hearing Intervention database.

Results: Between 1997 and 2001, the number of Wisconsin birthing hospitals with UNHS programs increased from two to 92 of a total of 103 and the percent of all Wisconsin newborns screened for hearing loss before 1-month of age increased from 10 to 90%. In 2001, 2.6% of screened newborns had an abnormal test requiring further audiologic evaluation, with a higher rate of referral in programs relying only on otoacoustic emission testing versus automatic auditory brainstem testing. As programs were being established, hospitals with greater number of deliveries more readily developed UNHS programs and hospitals with more deliveries were also significantly more likely to screen a greater percentage of delivered children once their programs were established. The Wisconsin Sound Beginnings program established a screening program for home birth infants in 2002 with a current screen rate of 79% for those midwives participating in this program.

Conclusions: A vast majority of Wisconsin hospitals have voluntarily implemented UNHS programs. By 2001, greater than 90% of all Wisconsin newborns were screened through a UNHS program. With education, financial support and a statewide network dedicated to UNHS it is possible to establish programs even for infants born in a setting that should be considered high-risk to miss hearing screening, such as home births and hospitals that perform relatively few numbers of deliveries per year. UNHS programs need to develop coordinated systems for linking these programs to audiologic diagnostic services and early intervention programs.