August 2, 2000: Column on Newborn Hearing Screening

Talking It Over

Hillary Rodham Clinton

August 2, 2000

Yesterday, the Office of the First Lady had a special visitor. Five-year-old Matthew came to work with his mother, a member of my staff.

Like many 5-year-olds, Matthew is curious and active. It would not be immediately obvious to anyone watching him interact with everyone in the office that he is also deaf.

Matthew's hearing impairment was first diagnosed when he was 13 months old. Although he received hearing aids and intensive speech therapy right away, and now goes to a special school, Matthew remains more than a year behind in his language development. His mother says, "I wish he had been tested at birth. It's hard to watch him struggle to communicate, and know that we lost that important first year."

Every day in this country, 60 babies are born with some degree of hearing loss -- the most common congenital disorder found in newborns. And although most hearing problems are diagnosed by the time a child turns 3, by then it's often too late. Speech and language development are delayed, affecting social and emotional growth as well as academic achievement. Most children never catch up.

This is why experts from the National Institutes of Health, the American Academy of Pediatrics, the National Association of the Deaf, and the American Speech-Language-Hearing Association recommend screening all newborns for hearing loss before they are discharged from the hospital.

In addition to the developmental and academic problems that occur when diagnosis is delayed, there are several other reasons to screen infants. The earlier impairment is detected, the earlier a child will receive critical support services, such as hearing aids, exposure to sign language or speech therapy.

We were surprised a few years ago to learn that reading and talking to babies -- even those too young to respond -- lay the groundwork for vocabulary and later reading success, and actually enhance the capacity of the growing brain. Imagine the disadvantage for the child who can neither hear the stories we read nor enjoy the songs we sing.

It should come as no surprise, though, to learn that when these children receive appropriate intervention before 6 months of age, they develop significantly better language skills, minimizing the need for rehabilitation when they start school.

According to research done at the University of Colorado, the age when a child's hearing loss is first identified and intervention begins is the single best predictor of educational success. Furthermore, early intervention can save taxpayers nearly $100,000 in education, medical and therapy expenses over the course of the child's life.

Screening is accurate, quick, inexpensive -- ranging from $18 to $40 -- and simple to perform, even on newborns. And hard as it is to believe, infants as young as 3 months can be fitted with hearing aids.

Last month, a new law mandating universal newborn hearing screening took effect in Maryland. Before then, as in so many other jurisdictions, the only newborns tested were those identified as being at "high risk" for hearing loss. Risk factors included low birth weight, admission to the newborn intensive care unit, jaundice, birth defects of the head and neck, meningitis and a family history of hearing problems.

Unfortunately, only about half of the babies eventually diagnosed as hearing-impaired fell into the high-risk category and were tested before they left the hospital. Now, every child born in Maryland -- as well as more than 30 other states -- will be screened before they go home.

For the last two years, the President's budget has included funding to expand and develop universal newborn hearing, screening and intervention programs. Earlier this year, the Department of Health and Human Services distributed the first $3 million to states in the form of grants. It's time to take the next step.

Hearing loss in children is an especially severe handicap because it affects the ability to learn basic language skills, without which they are often misdiagnosed as mentally retarded, autistic, brain-damaged or schizophrenic.

Matthew was lucky that his parents and his doctors picked up his hearing loss as early as they did. But a simple test, shortly after he was born, most likely would have identified his hearing impairment even earlier, improving his chances of developing normal language skills, and helping him to keep up with his buddies academically.

We know that hearing loss is the most common congenital disorder afflicting children in this country. But thanks to remarkable new technologies, we also know how, for many children, to mitigate its worst consequences. The key is early detection -- and now is the time to act. Now is the time to screen all newborns for hearing loss before they leave the hospital.

To find out more about Hillary Rodham Clinton and read her past columns, visit the Creators Syndicate web page at


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