Title: 'Audiologic services for children with orofacial clefts in Massachusetts'
Track: 5 - Medical Home
Keyword(s): Orofacial clefts, hearing loss
Learning Objectives:
  1. Evaluate access to and timeliness of audiologic diagnostic services (ADS) for children with orofacial clefts (OC) in Massachusetts.


Almost 100 infants are born with OC in Massachusetts annually. It is estimated that as many as 80% of these children have hearing loss (HL). Prevalence estimates for HL vary widely, underscoring the need to ensure early hearing detection and intervention among children with OC. We used statewide births from the Massachusetts Childhood Hearing Data System and the Birth Defects Surveillance System to evaluate HL prevalence and ADS timeliness among all children with OC, born in 2004-2008. Orofacial and otic procedural data were obtained from the Pregnancy to Early Life Longitudinal database. Of the 441 children with OC, only 118 (26.8%) received ADS; 93 (78.8%) were diagnosed with HL. Children with OC were 5.0 times more likely to have HL than children without OC (95% confidence interval: 4.6-5.6). Over 80% of the children with OC and HL had bilateral, mild/moderate HL of conductive or unknown etiology. There were 274 children with cleft lips; 88 (32.1%) had record of cleft lip repair surgery at the median age of 4.7 months. Of the 334 children with cleft palates, 86 (25.7%) had record of cleft palate repair at the median age of 9.5 months. 75 (17.0%) of all children with OC had record of myringotomy at the median age of 9.6 months. However the final hearing status of majority of the children who received orofacial or otic surgery is unknown; only 9 children (less than 15.0%) received follow-up ADS after a cleft palate repair or a myringotomy. Chronic conductive HL can delay critical speech and language acquisition among children with OC, inhibiting communication, intellectual development and socialization. The findings from this analysis can be used to inform medical home policies related to regular and timely ADS for children with OC.
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Rashmi Dayalu - POC,Primary Presenter
Massachusetts Department of Public Health
     Credentials: MPH
      Rashmi Dayalu, MPH, BS is the Epidemiologist for the Massachusetts Universal Newborn Hearing Screening Program. She is responsible for data collection, quality assurance, analysis, interpretation and dissemination to federal and state partners. Rashmi received her MPH in Epidemiology in 2007 with a concentration in Global Health from the University of Michigan, Ann Arbor. She received her undergraduate degree in Cell and Molecular Biology from the University of Washington, Seattle.

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.