Early Hearing Detection and Intervention Hearing Screening and Follow-up Survey (EHDI/HSFS)

Years Available
2005 to present
Mode of Collection
Surveillance data: passive data collection.
Early hearing detection and intervention (EHDI) refers to the effort to identify infants with permanent hearing loss as early as possible. It starts with screening every newborn for hearing loss, ideally before one month of age. Infants not passing the screening receive diagnostic evaluation, ideally before three months of age and if identified with a permanent hearing loss enrolled in early intervention programs, ideally by six months of age. All 50 states and the District of Columbia have EHDI laws or voluntary compliance programs related to newborn hearing screening and early identification. The EHDI HSFS is an annual survey administered by the Centers for Disease Control and Prevention (CDC) and is sent to the EHDI Program Coordinator in each state, the District of Columbia, the territories (American Samoa, Guam, Northern Mariana Islands, Puerto Rico, U.S. Virgin Islands), and 3 freely associated states (Republic of the Marshall Islands, Federated States of Micronesia, Republic of Palau). The survey requests aggregate, non-estimated information related to the receipt of hearing screening (for every birth occurring within the jurisdiction), diagnostic audiologic testing (for those not passing the screening), and enrollment in early intervention (for those identified with permanent hearing loss). The survey also requests information about why infants did not receive recommended follow-up services.
Selected Content
Number and percent of infants screened for hearing loss, diagnosed with hearing loss, enrolled in intervention programs, and receiving follow-up services.
Population Covered
Infants born in the United States.
Each year, state and territorial EHDI coordinators are asked to provide aggregate data for births that occurred in their area two years prior to the reporting year (e.g., data for 2017 births is reported in early 2019). The two-year delay is to ensure that sufficient time for all infants to complete the EHDI process had elapsed (e.g., infants born in December 2017 have had time to receive any recommended diagnostic and intervention services in 2019).
Response Rates and Sample Size
The number of jurisdictions providing data varies by year. Since 2006, at least 45 jurisdictions have reported each year; in 2017, 57 jurisdictions provided data.
Interpretation Issues
First, some jurisdictions either do not respond to the EHDI HSFS or are only able to provide limited data in one or more reporting years. Second, although data collection is standardized across jurisdictions, EHDI HSFS data are voluntarily reported and subject to being incomplete. Third, the data reported only reflect services that infants were documented to have received in a jurisdiction. Because the rules related to the reporting of EHDI data vary by jurisdiction, the percentage of infants receiving recommended services may be higher than what is reported on the EHDI HSFS.
Some respondents provided partial data or were unable to provide data for one or more reporting years, so the number of respondents for specific indicators varied for each year. Some EHDI programs could not report the age when infants received services. Birth data for 2007 - 2017 are based on jurisdiction reported Vital Records birth data. Intervention values assume that infants identified before 6 months are the same infants that were enrolled in Part C and/or non-Part C Early Intervention before six months, which cannot be confirmed with the available data.