Newborn Hearing Screening Program

The Department of Health, Children’s Medical Services, administers the Newborn Hearing Screening Program. The program promotes and supports statewide newborn hearing screening and follow-up services.

New Mexico Newborn Hearing Screening Program goals are:

• All infants receive a hearing screen within the first month;
• All infants who do not pass their newborn hearing screen in one or both ears, and/or infants with risk factors for hearing loss are referred to the Newborn Hearing Screening Program;
• All infants who do not pass their newborn hearing screen, or their outpatient rescreen, are immediately referred by their medical home for a diagnostic audiological evaluation within the first three months;
• All infants with confirmed hearing loss are referred to early intervention services as soon as possible and no later than six months of age to optimize language development.

The above goals reflect the 1 – 3 – 6 national goals for state Early Hearing Detection and Intervention (EHDI) programs. The program works in collaboration with birthing hospitals, licensed midwives, parents, primary care physicians (medical home), Indian Health Services, audiologists, ENTs, and the early intervention system to assure that all infants with hearing loss are identified as early as possible and provided with timely and appropriate audiological, medical and early intervention services.

Importance of Newborn Screening

Significant hearing loss is the most common condition present at birth. About 80 New Mexico infants are born each year with a significant hearing loss. The consequences of hearing loss of any severity or type are profound for children and their families.

In 2000, the Joint Committee on Infant Hearing stated that without auditory input and the opportunity to learn language, children with hearing loss almost always fall behind their peers in language, cognition, and social-emotional development. They also have difficulties attaining the same level of academic achievement as their hearing peers. Several studies have shown that deaf children by age 8 are already 1.5 years behind their hearing peers in reading comprehension scores, and half of deaf children graduate from high school with a 4th grade reading level or less.

Early identification of hearing loss, fitting of high-quality hearing aids, cochlear implants and comprehensive early intervention services can minimize or avoid many negative outcomes experienced by children with hearing loss including improved school performance, communication skills, and speech-language development; better social skills and emotional health; decreased family stress; and improved quality of life.

Hospital Screening Programs

Since 2001, New Mexico birthing hospitals have been required by law to screen newborns prior to discharge (NMAC 7.7.2.34).

Hospitals use the Newborn Hearing Screening Referral Form to refer infants who do not pass the hearing screen or who have risk factors for hearing loss to the Newborn Hearing Screening Program. The form is faxed or mailed to the program within 24 hours of an infant’s birth.

Hospitals must also report monthly data on all births, newborn hearing screen results, newborns discharged without a hearing screen, and parents who decline the hearing screen to the Department of Health Newborn Hearing Screening Program.

The Newborn Hearing Screening Program recommends that birthing hospitals who provide outpatient newborn hearing screens schedule these during discharge to help ensure that parents bring their infants back during the first month of life.

Newborn Hearing Screening Training

• Newborn Genetic Screening blood Collection presentation
• Newborn Hearing Presentation

Midwives

Midwives have always been an integral part of New Mexico’s health care system. The New Mexico Midwives Association (NMMA) incorporated in 1977 to insure women’s access to safe and personalized care. Licensed midwives attend the births of thousands of New Mexican babies every year with excellent outcomes.

Communication and language begin developing right after birth. If a baby is born with a severe to profound hearing loss but does not have a newborn hearing screen and diagnostic hearing testing, the hearing loss will usually not be identified until the child is 2.5 years of age. Newborn hearing screening and diagnostic hearing testing are the only ways to find hearing loss early. Midwives who believe in and support newborn hearing screening are more effective in communicating with parents about why a hearing screen is critically important for their infant. The manner in which the midwife communicates this importance helps to assure that parents are truly able to give informed consent when they accept or decline a hearing screen for their newborn.

Research has shown that midwives can easily be trained to perform Otoacoustic Emissions (OAE) testing; however, the cost and sharing of equipment has to be considered.

In a home birth, the midwife has the following responsibilities:

• Communicate the importance of newborn hearing screening to parents orally and in writing using the educational materials provided by the Newborn Hearing Screening Program. Referral forms and educational materials can be ordered by calling Children's Medical Services at 1-877-890-4692. Materials can also be obtained from this page.
• If trained, and with access to OAE hearing screening equipment, screen the newborn’s hearing during a follow-up well baby visit. The timing of the hearing screening is important. It has been documented that OAE testing has a much higher false positive rate if performed within the first 24 hours of life. The false positive rate falls to 4% by 72 hours of life (Owen, Webb & Evans, 2001). OAE equipment is portable and easy to use. The midwife inserts a small probe into the baby’s ears. Soft tones are played through the speakers in the probe, and the probe then measures the tones as they bounce back from the different parts of the infant’s ear. The computer attached to the small probes measures the results and concludes with a Pass or a Refer (did not pass) result.
• Refer the baby to an outpatient provider such as a hospital nursery, audiology office, or a pediatrician who performs newborn hearing screening.
• Use the Midwife Reporting Form or the Fillable Midwife Reporting Form to report the birth of babies delivered to the Newborn Hearing Screening Program.

The Newborn Hearing Screening Program provides midwives with orientation to the Newborn Hearing Screening Program as well as training during recertification.

Midwives outreach and training can be request by calling Abigail Reese at 505-231-6817 .

Medical Home

Since 1999, the Joint Committee on Infant Hearing has advocated for appropriate and necessary care for the infant with hearing loss to be directed and coordinated by the child’s physician within the medical home with support from appropriate ancillary services.

Families look to their baby’s physician for answers and direction at each of the stages of the newborn hearing screening process. New Mexico’s universal newborn hearing screening program is the first step, and infants who don’t pass (refer) on their newborn hearing screen must be linked in a timely manner to audiological and medical assessment. Infants with confirmed hearing loss must be referred to early intervention services.

The New Mexico Physician's Roadmap provides information to support physicians in linking infants who do not pass their newborn hearing screen to needed follow-up. Physicians also monitor infants and young children who have risk factors for delayed onset or progressive loss and provide referrals for ongoing diagnostic audiological assessment in accordance with their type of risk factors.

Audiologists

Infants with hearing loss who receive timely and appropriate diagnostic audiology services (completed as soon as possible and by three months of age) have positive communication and language outcomes.

Infants who refer on the initial hearing screen and the rescreen in one or both ears are referred by their physician for a diagnostic audiological assessment before three months of age and for ongoing audiological assessment as needed.

An infant identified with a hearing loss should be fit with hearing aids (if recommended) as soon as possible. Audiologists fax or mail the Report of Audiological Results Form to report the results of diagnostic audiological assessment to the Newborn Hearing Screening Program for children birth though age four years.

A List of Audiologists trained in infant diagnostic audiological assessment is maintained by the Newborn Hearing Screening Program.

Early Intervention

Research consistently demonstrates that infants who are deaf or hard of hearing who begin early intervention services no later than six months of age “perform as much as 20 to 40 percentile points higher on school-related measures (vocabulary, articulation, intelligibility, social adjustment, and behavior)”.

The Department of Health, Family Infant Toddler (FIT) program has had a protocol in place since September 2001 for consultation and services from the New Mexico School for the Deaf (NMSD) Early Intervention Program for infants and toddlers who are deaf or hard of hearing. The goal of this protocol is to ensure that specific expertise is available for families of deaf or hard of hearing infants and toddlers and to the other early intervention providers who may also be providing services.

The Newborn Hearing Screening Program refers children with confirmed hearing loss to the NMSD Early Intervention and Involvement Division. The Newborn Hearing Screening Program also refers families to the New Mexico School for the Deaf Early Intervention & Involvement Division when their children have a suspected hearing loss and are going through the diagnostic process. The NMSD Early Intervention and Involvement Division will provide information and support to the family until the infant’s hearing loss is either confirmed or ruled out.

The Newborn Hearing Screening Program refers children with conductive hearing loss that persists during the first few months of life and is not resolved by six months of age to their local early intervention program.

Families

The Newborn Hearing Screening Program makes phone and letter contact with families of infants who need follow-up support. The program works collaboratively with the parents and the medical home to assure that infants receive needed audiological and early intervention services and supports.

The program provides families with information, assists with scheduling audiological appointments, and makes needed referrals to early intervention services, etc.

Program Advisory Council

In collaboration with stakeholders that include but are not limited to parents, screening providers, physicians, audiologists, early intervention providers, the New Mexico Newborn Hearing Screening Program convenes this council with the purpose that is to ensure that all the children in New Mexico receive optimum services related to a statewide newborn hearing screening and intervention program.

For more information about this council, please call Reanna Garcia at 505-476-8817 or send mail to the address below.

• PO Box 26110
  1190 S. St. Francis Dr.
  Santa Fe, NM 87505