Technology that can detect the mildest hearing loss in infants, that was pioneered at the Health Center on high-risk infants, will soon be used on all babies born there. Universal newborn hearing screening using the same test, or another like it, will soon be used with newborns in hospitals across the state, thanks to a state law that will take effect in July. The screening will result in early discovery of a silent disability that often leads to profound social and emotional problems.

The Health Center was among the first health care organizations in the state to offer one of the new hearing screening tests and one of the first in the country to use the technology for research with infants. "We know that discovering hearing loss early in life makes a tremendous difference in our ability to help children," says Marjorie Jung, M.S., audiologist and assistant professor with the Department of Surgery's division of otolaryngology. Jung is helping the Health Center gear up for the expanded testing.

"Traditionally, hearing tests have been performed only on babies with risk factors, like a family history of deafness, low birth weight, head and face anomalies or specific illnesses," says Jung. "Unfortunately, about 50 percent of all children born with significant hearing loss don't have any of those risk factors. We missed those babies because we didn't test them," she adds.

"New technology has given us efficient, cost-effective methods of screening babies, so now it's realistic to test every newborn," says Jung. Universal screening of all newborns will identify nearly all babies with any hearing loss, she says.

Antonia Brancia Maxon, a professor of communications sciences, chaired the Connecticut infant hearing task force. She and Jung find the law a successful culmination of several years' work on the task force. The group was formed in 1993, after the National Institutes of Health recommended screening all infants for hearing loss within the first three months of life, and preferably before being discharged from the hospital.

The Health Center will soon begin screening all newborns, well ahead of the state's July 1, 1999, deadline. At the same time, Health Center and other UConn faculty and staff are working with hospitals and agencies to help ensure smooth implementation of the practice across the state.

Connecticut is one of 10 states in the country to require universal hearing screening for all newborns, after Hawaii, Rhode Island, Mississippi, Colorado and Virginia.

"With the tools available today, we can identify babies with mild to profound hearing loss," says Maxon, "and we can find them easily. We don't have to test for long periods of time and we don't have to use staff with years of specialized training," she says.

The screening process is relatively simple. Most babies sleep through the entire procedure, which involves placing a small probe in the ear or fitting tiny earphones gently over the ears. The screening costs between $25 and $60 per baby, depending on the equipment and the staff used to perform the test.

"Infancy is crucial for the acquisition of speech and language" says Marilyn Sanders, a neonatalogist and associate professor of pediatrics, who also served on the state task force. "The chances of getting optimal results are better if the hearing loss is identified before the child is 18 months old," she says.

Under the current system, a child with severe to profound hearing loss in both ears is usually not identified by health care professional s until two years of age. A child with a mild hearing loss is usually not identified until closer to four years of age. Yet, says Maxon, "the mildest degree of hearing loss has a negative impact on language acquisition, and the longer it goes undetected the greater the problems."

Detecting the hearing loss is just the first step. The babies need hearing aids and assistance with language development, and their families need support. Through Birth-to-Three programs around the state this is happening. A hearing services program in the communication sciences department, known as CHIP, is one of three Birth-to-Three programs specifically for infants and toddlers with hearing loss in Connecticut. That program, under the direction of Diane Brackett, provides ongoing assessment and management services for babies with hearing loss, many of whom have been identified in universal newborn hearing screening programs.

As the deadline for implementing universal screening approaches, hospital staffs around the state are researching equipment and staffing needs.

Hospitals from around the state are requesting information and assistance. Maxon has been conducting pediatric grand rounds to address their needs. In addition, Jung has developed a continuing education plan.

"This is where the Health Center can play a significant role," says Jung, who is preparing a videotape series on hearing screening in newborns. The videos, which have specific information on equipment, tracking hearing impaired babies and making the referrals for necessary services, are aimed at providing essential information to both parents and health care professionals.

"The Health Center was the first in the state to offer one of the new screening technologies, and we were one of the first in the country to do research on infants using the technology," Jung says. "With our background and expertise, and our teleconferencing and multimedia capabilities, we can play a crucial role in training health care professionals."

Kristina Goodnough