Oklahoma began screening the hearing of newborns in 1983. Legislation enacted in 1982 gave the Oklahoma State Department of Health (OSDH) responsibility for developing and implementing a program to identify and track infants with hearing loss. A broad-based newborn hearing screening advisory group was named to develop guidelines for the program. A questionnaire to be completed at the birthing site was devised to identify infants at-risk for hearing loss. For infants identified as “at-risk,” a state plan was established to encourage and assist families of these babies to have hearing evaluated. The Newborn Hearing Screening Program (NHSP) was established in August 1983 making Oklahoma the fifth state to institute a hearing screening program. When an “at-risk” infant was about three and one-half months old, correspondence was sent to the infant’s family recommending that hearing be evaluated; a similar notice was sent to the infant’s physician. The NHSP assisted families in locating facilities that could provide the follow-up testing.
While almost 95% of Oklahoma newborns were being screened each year with the hospital “risk” questionnaire, by the mid-1990’s it became apparent that about half of the infants ultimately diagnosed with a hearing loss were not ones who had a positive risk screen at birth. Testing and history suggested that most of these identified infants had experienced hearing loss from birth. At about the same time, advances in technology led to the development of equipment for the newborn nursery that could provide actual physiologic screening of an infant’s hearing. In January 1997, two Oklahoma hospitals began offering such screening for each newborn. With financial assistance from the Children with Special Health Care Needs (CSHCN) program in late 1997, the OSDH purchased physiologic hearing screening equipment for 18 hospitals. Additional CSHCN funding made available to the agency in 1999 allowed the purchase of screening equipment for all Oklahoma birthing facilities. Newborn hearing screening legislation was updated in 2000 requiring that every newborn be provided with physiologic hearing screening prior to discharge along with hearing “risk” screening. By March 2002, all birthing hospitals were equipped with physiologic hearing screening technology.
In 2003, the NHSP tracking system was combined with the one used by the Newborn Metabolic Disorders Screening Program (NMDSP). An infant’s hospital hearing screening results and hearing risk status are recorded on the NMDSP bloodspot specimen form. OSDH Public Health Laboratory personnel enter hearing screening results into the tracking system when they enter the infant’s demographic data. If a baby does not pass the hospital screening or is not screened prior to discharge, the enhanced system enables the NHSP to contact an infant’s family and medical home within days of the birth. The NHSP can quickly assist the family in obtaining necessary follow-up diagnostic audiological assessments, and if hearing loss is confirmed, link the family to an appropriate early intervention service provider, such as SoonerStart.
For every year since 2004, about 95% of Oklahoma babies have had hearing screened prior to hospital discharge. Ninety babies born in 2006 had confirmed hearing loss and more than 80 of them and their families were participating in intervention programs before they were six months old.