2021 Type and Severity Summary of Identified Cases of Hearing Loss

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November 2023

Data Source: 2021 CDC Early Hearing Detection and Intervention (EHDI) Hearing Screening & Follow-up Survey (HSFS)

Background: CDC’s National Center on Birth Defects and Developmental Disabilities promotes the health of babies, children, and adults, with a focus on preventing birth defects and developmental disabilities and optimizing the health outcomes of people with disabilities. As part of these efforts, the center is actively involved in addressing the early identification of permanent hearing loss among newborns and infants.

Hearing loss affects between 1 and 2 per 1,000 infants in the United States and, when left undetected or untreated, can delay a child’s speech and language, social, and emotional development.¹ To ensure children with permanent hearing loss are identified and receive services as soon after birth as possible, states and territories have implemented Early Hearing Detection and Intervention (EHDI) programs. These EHDI programs work to ensure all infants

Are screened for hearing loss, by 1 month of age
Receive diagnostic, audiologic evaluation (for those not passing the screening), by 3 months of age
Are enrolled in early intervention (for those identified with permanent hearing loss), by 6 months of age²

The Hearing Screening & Follow-up Survey (HSFS) is a voluntary survey sent out annually by CDC to each jurisdictional EHDI program. It requests aggregated hearing information on infants born in a specified calendar year (e.g., 2021). The survey helps to assess the progress of EHDI efforts to identify infants with permanent hearing loss across the United States.

This summary highlights type, severity, and laterality of permanent hearing loss for babies born between January 1, 2021 and December 31, 2021. Categories of severity are based on the American Speech-Language-Hearing Association (ASHA) classification system for hearing loss. The ASHA categories are as follows:

ASHA Categories
Degree of Hearing Loss	Hearing loss range (dB HL)
Normal	-10 to 15
Slight	16 to 25
Mild	26 to 40
Moderate	41 to 55
Moderately severe	56 to 70
Severe	71 to 90
Profound	91+

Number of Survey Respondents Who Provided Type and Severity Data: 52^α (48 states, 3 territories, 1 district) AK, AZ, AR, CA, CO, Commonwealth of the Northern Mariana Islands, CT, DE, District of Columbia, FL, GA, Guam, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, Puerto Rico, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY

2020 Type and Severity Summary of Identified Cases of Hearing Loss (By Ear):ASHA Classification
			BILATERAL (by Ear)					UNILATERAL (by Ear)			LATERALITY UNKNOWN (i.e., Unknown if case is a unilateral or bilateral loss)
			Total Number of Reported Infants with Hearing Loss, 2021 CDC EHDI HSFS								6,520 Children
			RIGHT EAR	LEFT EAR		UNKNOWN EAR (degree of loss for each ear)		RIGHT EAR	LEFT EAR	UNKNOWN EAR
			RIGHT EAR	LEFT EAR		UNKNOWN EAR (degree of loss for each ear)		RIGHT EAR	LEFT EAR	UNKNOWN EAR		Sensorineural	Slight	33	31	0	0	13	11	0	1
Mild		595	592		0	0	98	106	0	0
Moderate		697	681		0	0	90	114	0	2
Moderately Severe		279	294		0	0	56	68	0	2
Severe		242	240		0	0	85	80	0	2
Profound		526	537		0	0	166	162	0	1
Unknown Severity		62	69		0	0	23	20	0	70
Conductive	Slight		76	6		0	0	4	1	0	0
	Mild		70	62		0	0	33	33	0	0
	Moderate		92	90		0	0	100	68	0	1
	Moderately Severe		85	85		0	0	187	88	0	0
	Severe		34	30		0	0	47	41	0	1
	Unknown Severity		48	50		0	0	90	44	0	16
Mixed	Slight		1	4		0	0	1	0	0	0
	Mild		43	41		0	0	6	8	0	0
	Moderate		76	85		0	0	14	27	0	1
	Moderately Severe		81	85		0	0	27	25	0	1
	Severe		58	49		0	0	23	21	0	0
	Profound		24	33		0	0	11	7	0	0
	Unknown Severity		20	20		0	0	8	3	0	11
Type Unknown	Slight		13	16		0	0	5	11	0	0
	Mild		66	76		0	0	31	23	0	16
	Moderate		58	64		0	0	9	23	1	18
	Moderately Severe		27	36		0	0	16	18	0	3
	Severe		29	15		0	0	7	8	0	0
	Profound		31	31		0	0	6	7	0	6
	Unknown Severity		96	79		2	2	37	30	1	257
Auditory Neuropathy	Slight		1	0		0	0	0	0	0	0
	Mild		4	3		0	0	0	0	0	0
	Moderate		1	1		0	0	4	7	0	0
	Moderately Severe		4	2		0	0	0	2	0	0
	Severe		11	9		0	0	2	8	0	0
	Profound		20	21		0	0	17	19	0	0
	Unknown Severity		125	126		0	0	42	50	0	1
Totals by Ear			3,559	3,563		2	2	1,258	1,133	2	410
Totals by Child			3,561			2		1,258	1,133	2	410
Laterality Totals (by Child)			3,563 Bilateral Cases					*2,393 Unilateral Cases*
Total all Types and Severity (by Child)											6,366
Cases Resolved (i.e., hearing loss to no hearing loss)											154
Overall Total (by Child)											*6,520*

Summary of Type and Severity of Identified Cases of Hearing Loss in 2021

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References

¹American Speech-Language-Hearing Association (ASHA). Effects of hearing loss on development. Available at: https://www.asha.org/public/hearing/effects-of-hearing-loss-on-development.
Accessed April 8, 2021

²Year 2019 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs (2019). Journal of Early Hearing Detection and Intervention, 4(2), 1-44. https://digitalcommons.usu.edu/jehdi/vol4/iss2/1/

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2021 Type and Severity Summary of Identified Cases of Hearing Loss

Summary of Type and Severity of Identified Cases of Hearing Loss in 2021

References

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