AAP Voices Blog

My oldest son is a college honors student in engineering. My middle son is a high school senior in consideration for an honors scholarship to college. My youngest son is a high school freshman and sits at or near the top of his class.

I share this not to boast (although, of course, my wife and I are very proud of all of them), but because two of my sons were identified as deaf during their newborn hearing screenings. Their success stories need not be unusual.

Our sons received the necessary intervention and are on par with their peers. My eldest has moderate to severe hearing differences and uses hearing aids and my youngest has severe to profound hearing differences and has a cochlear implant.

The importance of early hearing screening and follow-up cannot be overstated, but it still sometimes gets overlooked.

National Deaf History Month is celebrated every year from March 13 to April 15 to recognize the accomplishments of people who are deaf and hard of hearing. It is a month that goes largely unrecognized because deafness often is assumed to be a rare condition.

In reality, deafness is the number one birth condition identified in the perinatal period, with an incidence that exceeds that of cleft lip and palate, limb defects, sickle cell anemia, spina bifida, and Phenylketonuria (PKU). The Joint Committee on Infant Hearing was founded in 1969, and since that time, the NIH, CDC, public health departments and the AAP have created policies for the identification of deafness in children.

Conducting newborn hearing screenings has been the standard of care in newborn care since 1994. The Joint Commission on Infant Health made revisions to the guidelines for newborn hearing screening in 2007 and 2019. The Early Hearing Detection and Intervention program, in which I have served as the Illinois AAP Chapter Champion since 2014, provides resources and education to primary care physicians and others who care for children who may be diagnosed as deaf at a young age.

My wife, a speech pathologist, and I were devastated by the news of our sons’ hearing screenings, but we had no idea how incredibly successful our children would become because of the early intervention services that took place after the initial hearing screening. Guided by the Early Hearing Detection and Intervention 1-3-6 algorithm, we and our therapists were able to provide our sons with the support they needed.

The algorithm advises screening of all newborns for hearing differences by 1 month of age, diagnosing by 3 months of age, and enrolling the child who is deaf or hard of hearing in early intervention services by the age of 6 months. We were well-versed in these guidelines, and due to the nature of our careers coupled with knowledge and vigilance, our boys received the necessary interventions and continued to meet language and developmental milestones parallel to those of their hearing peers.

Most children are not in the ideal position in which my family found itself. Pediatric health care providers who do not know about the importance of the newborn hearing screening and following up during well-child visits run the risk of having their patients fall behind in speech and language development.

“Delays in speech and language make it hard to communicate and leave children at a severe disadvantage.”

Delays in speech and language make it hard to communicate and leave children at a severe disadvantage, often leading to lack of communication with their classmates and caregivers and may leave them disabled permanently as a result.

In contrast, my sons’ experiences are a great example of successful interventions that led to positive outcomes.

I hope to increase awareness and vigilance about the completion and follow-up of newborn hearing screening. Children used to be diagnosed as deaf between 3 and 5 years of age. Having a diagnosis as late as that creates severe deprivation in those children, in childhood and adulthood.

Great progress has been made. About 98% of newborns now are tested before they are 1 month old, according to the National Institute on Deafness and Other Communication Disorders. Following up is vital when hearing problems are detected during initial screening. This also saves money. The CDC’s Early Hearing Detection and Intervention Program estimates that newborn hearing screening saves $200 million in education costs each year.

Technology and access to therapy can keep children on equal footing with their classmates. Be aware also that sign language and other language options can provide similar opportunities. Deaf people, who often have historically been underestimated and thought to be “inferior” to others, achieve great things, as anyone can.

Respect and recognition of the hard work and accomplishments of the deaf community is what National Deaf History Month is about. It is our job as pediatricians to lay the foundation by providing the opportunities and support for deaf children to do so.

*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.