HRSA's Early Hearing Detection and Intervention (EHDI) programs enable states, territories, families, and providers to develop complete and coordinated systems of care. The program aims to ensure that newborns, infants and young children who are deaf or hard of hearing are identified and get the care they need when they need it. Early involvement can help these children meet age-appropriate language, social, and developmental milestones.
Across the United States and its territories, we support efforts to:
- Develop early hearing detection and intervention (EHDI) systems
- Recruit, educate, and train staff and health care providers with current knowledge, evidence-based practices, and national EHDI system goals
- Ensure families have access to information that is accurate, comprehensive, up-to-date, and evidence-based to allow families to make important decisions for their children in a timely manner, including decisions with respect to the full range of assistive hearing technologies and communication modalities
- Establish and foster family-to-family and deaf and hard of hearing consumer-to-family supports that are important after a child has been identified as deaf or hard of hearing
Support the development of state and territory programs and systems of care that identify children who are deaf or hard of hearing through newborn, infant, and young child hearing screening and deliver diagnosis and appropriate early intervention to optimize language, literacy, cognitive, social, and emotional development.
Ensure that children who are deaf or hard of hearing can access services and a family-centered medical home in their communities; that they get early and continuous screening; and that families, parents and caretakers are engaged as active partners in the care of their children.
Supporting the EHDI System
HRSA has a coordinated portfolio of programs to support the EHDI system. These programs support state and territory health departments, academic institutions, non-profit organizations, providers, and family-based organizations to develop a system of services for children who are deaf or hard of hearing and their families. We support the EHDI system with technical assistance, fostering family engagement, and deaf and hard of hearing adult involvement, workforce development and training, and working with pediatricians and health care providers.
We support the following initiatives:
The goal of the Early Hearing Detection and Intervention Program is to support the development of state and territory programs and systems of care to ensure that children who are deaf or hard of hearing are identified through newborn, infant, and early childhood hearing screening and receive diagnosis and appropriate early intervention to optimize language, literacy, cognitive, social, and emotional development. This program supports grants to 59 U.S. states and territories
The program focuses on:
- Improving access to early intervention services and language acquisition;
- Increasing health professionals' engagement in and knowledge of the EHDI system; and
- Improving family engagement, partnership, leadership, and support.
The Early Hearing Detection and Intervention National Technical Resource Center (NTRC) provides technical support to the state and territory EHDI programs and systems of care. The NTRC provides state and territory EHDI programs leadership and resources for EHDI systems of care and to stakeholders nationwide, including at the national, state/territory, and local levels. The NTRC provides training and guidance for planning, developing policy, and enacting strategies and quality improvement activities. The NTRC also identifies and explores evidence-based, innovative practices that support and enhance the EHDI system such as the coordination between family centered medical homes and early intervention services.
The NTRC is supported by a cooperative agreement with the National Center for Hearing Assessment and Management (NCHAM)
The Family Leadership in Language and Learning (FL3) Center works to ensure state and territory EHDI systems of care support families, parents, and caregivers of infants and children who have been identified as deaf or hard of hearing. The program aims to increase family engagement, leadership, partnership, and to strengthen family support. The Center will focus on 1) disseminating accurate, comprehensive, up-to-date, and evidence-based and innovative practices, policies, tools, and resources; 2) increasing the number of parents and caregivers trained to serve as family leaders in EHDI systems; and 3) developing and sustaining collaborative partnerships with EHDI Program recipients and national EHDI stakeholders.
The FL3 Center is supported by a cooperative agreement with Hands & Voices
The Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program trains future leaders in a variety of disciplines to improve the health of children who have or are at risk of developing neurodevelopmental disabilities or other similar conditions such as autism and intellectual disabilities. The Universal Newborn Hearing Screening (UNHS) program supports the clinical and leadership training of LEND program pediatric audiology trainees.
The goals are:
- Strengthen the focus on screening, treatment, and follow-up in infants and young children who are deaf or hard of hearing and who have autism spectrum disorder (ASD) and/or other related neurodevelopmental disabilities (DD);
- Increase the number of pediatric audiologists with clinical and leadership skills and expertise in delivering care to infants and young children with ASD and/or other DD, using these unique skills to work across disciplines to better serve children with hearing loss and their families; and
- Enhance the systems' capacity to increase enrollment of infants/children with ASD and/or other DD confirmed to be deaf or hard of hearing into early intervention programs.
This program provided supplements to 12 LEND programs
Before 1993, fewer than 1 in 10 newborns in the U.S. were screened for hearing loss, but now nearly all are screened. Since HRSA's Early Hearing Detection and Intervention program started, states and territories have had significant success identifying and getting services for newborns and infants with hearing loss. In 2018, data from CDC data told us that:
- 97% of all infants were screened prior to one month of age, and overall, 98.3% of all infants born in the U.S. had their hearing screened.
- 77.1% of infants received audiological evaluations and a diagnosis by three months of age. Our system continues to work to increase the number of infants identified as deaf or hard of hearing at an early age.
- 70.1% of infants were enrolled in early intervention services before six months of age.
In addition, we encourage grantees to develop an integrated EHDI health information system that allows communication and protected data sharing among care providers. Fewer infants are lost to follow-up or documentation as a result of our systems improvements.
While significant progress has been made, other parts of the EHDI system still need improvement. We continue to work toward our goals of screening all newborns, infants, and young children up to 3 years of age for hearing loss, increasing the number of newborns and infants that are enrolled into early intervention programs in a timely manner, and expanding family participation within the EHDI system.
Treeby Williamson Brown, MA
Chief, Integrated Services Branch
CDC - National Center on Birth Defects and Developmental Disabilities
NIH - National Institute on Deafness and Other Communication Disorders
ACF - Office of Early Childhood Development
Dept. of Ed - Office of Special Education and Rehabilitative Services