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Strengthening Early Hearing Detection and Intervention (EHDI)

We identify children who are deaf or hard of hearing (DHH) and get them the support they need. This helps them reach language and other developmental milestones.

Why are these milestones important?

Language milestones serve as benchmarks. They help us monitor and evaluate how a child develops. Children who are deaf or hard of hearing often need help reaching these milestones. By tailoring support and intervening when needed, we can help them gain strong language skills.

What contributes to better functioning systems for DHH children?

We help states, territories, families, and providers to develop coordinated systems of care.

We improve public health systems by:

  • Increasing the number of health care providers qualified to carry out the work.
  • Making sure 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.
  • Creating and fostering support systems for these families. These include programs where:
    • Families help other families, known as “family-to-family” support
    • DHH adults help families to navigate the system, known as “consumer-to-family” support.

What parts make up a state and territory EHDI system?

  • Screening
  • Diagnosis
  • Family support
  • Medical home (coordinated services across various clinical and social settings)
  • Early interventions

Why is it crucial that the system functions well?

Children have a greater chance to meet their language milestones.

What needs to happen by age?

Age Step
1 month old Screen
3 months old Diagnose as deaf or hard of hearing (DHH)
6 months old Enroll in early intervention
Ongoing Provide access to services, including family support

What have we achieved so far?

Before 1993, healthcare professionals screened fewer than 1 in 10 newborns in the US for hearing loss. Now they screen more than 98% of all newborns.

How has this screening helped?

This recent study found that in the years since universal newborn hearing and early hearing screening detection and intervention started, DHH children in one school district demonstrated progressively better outcomes in reading proficiency:

Reading Proficiency Trends Following Newborn Hearing Screening Implementation | Pediatrics | American Academy of Pediatrics (

Which groups improve the EHDI systems?

  • State and territory health departments
  • Academic institutions
  • Non-profits
  • Health and social service professionals
  • Family-based groups

Which projects contribute to system improvements?

EHDI Program

We award grants to 59 U.S. states and territories who improve the system through:

  • Making routine early and regular screening, diagnosis, and intervention
  • Training health professionals
  • Engaging, partnering, and supporting families

EHDI National Technical Resource Center (NTRC)

The NTRC trains and guides state and territory EHDI programs. It:

  • Helps them plan, develop policy, and enact quality improvement activities
  • Serves stakeholders at the national, state, territory, or local level

The NTRC identifies and explores proven and new practices that improve the EHDI system. For example, they look at how to better coordinate between family centered medical homes and early intervention services.

We awarded a cooperative agreement to the National Center for Hearing Assessment and Management (NCHAM). NCHAM serves as the Early Hearing Detection and Intervention, National Technical Resource Center (EHDI NTRC).

Family Leadership in Language and Learning Center (FL3 Center)

Families are experts in their own care. This program aims to increase family engagement, leadership, partnership, and strengthen family support.

What does the FL3 Center focus on?

  • Sharing the newest and best practices, policies, tools, and resources.
  • Increasing the number of parents and caregivers trained to serve as family leaders in EHDI systems.
  • Developing and sustaining partnerships with EHDI Program recipients and national EHDI stakeholders.

A cooperative agreement with Hands & Voices supports the FL3 Center.

Leadership Education in Neurodevelopmental and Related Disabilities (LEND) - Pediatric Audiology Trainees

The LEND program trains future leaders in a variety of disciplines.

The HRSA EHDI program also supports LEND pediatric audiology trainees.

What are the LEND’s audiology program’s goals?

  • Strengthen the focus on screening, treatment, and follow-up in infants and young children who:
    • Are deaf or hard of hearing
    • Have autism spectrum disorder (ASD) or other related neurodevelopmental disabilities (DD)
  • Increase the number of pediatric audiologists with clinical expertise and leadership skills who can deliver care to infants and young children with ASD or other DD.
  • Enroll more infants and children with ASD or other DD who are deaf or hard of hearing into early intervention programs.

This program provided supplemental funding to 12 LEND programs to support training for pediatric audiologists.

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