February 26-28, 2017 • Atlanta, GA


  |  EHDI Loss to Follow-Up: Barriers That Prevent Families from Seeking Follow-Up Care

EHDI Loss to Follow-Up: Barriers That Prevent Families from Seeking Follow-Up Care

National statistical data states that nearly 36% of children who did not pass the Universal Newborn Hearing Screening are lost to follow-up. That means approximately 20,000 babies could have permanent hearing loss and may not receive proper intervention before they reach school age. Children who are identified as having hearing loss and receive intervention by six months of age have better speech, language and educational outcomes. We examine several of the key factors that interfere with timely follow-up leading to a diagnosis of permanent hearing loss. The most significant barriers include health insurance issues (uninsured, underinsured, highly restrictive coverage, excessive co-insurance), maternal education and limited understanding of the need for follow-up, socio-economic status, and health care access limitation due to ethnicity, race or cultural background. In some cases, the families that are lost to follow-up seem to be overwhelmed with life itself or cannot afford the loss of hourly wages by taking time off from work. The problems are multi-faceted, and for that reason the solutions must be like-wise. Possible techniques to reduce lost to follow-up include: Provide ongoing education to screeners on how to convey information to mothers; Providing family navigators to assist the family in accessing community and regional services. Facilitating access to a national directory of facilities capable of providing diagnostic testing; Ensure effective communication via the home language of the family. Flexible hours for evenings and weekends, especially for families who travel great distances or live in large metropolitan areas; Coordinate collaborative care with physicians and audiology colleagues who have capability and capacity to provide key, complementary elements of diagnostic service. These and other potential remedies will be discussed as part of this poster.

  • Identify the key factors that interfere with timely follow-up leading to a diagnosis of permanent hearing loss.
  • Implement tactics to aid families in overcoming the factors that keep them from seeking timely and appropriate care.
  • Identify specific techniques that all clinicians can incorporate into everyday practice to facilitate follow-up with audiologists and other medical professionals.


Handout is not Available

CART transcripts are NOT YET available, but will be posted shortly after the conference


Robert Fifer (), University of Miami, rfifer@med.miami.edu;
Robert C. Fifer, is the Director of Audiology and Speech-Language Pathology at the Mailman Center for Child Development, University of Miami School of Medicine. He received his B.S. from the University of Nebraska at Omaha in Speech-Language Pathology with a minor in Deaf Education. His M.A. is from Central Michigan University in Audiology, and his Ph.D. is from Baylor College of Medicine in Audiology and Bioacoustics. Dr. Fifer’s clinical and research interests focus on the areas of auditory evoked potentials, central auditory processing, early detection of hearing loss in children, and auditory anatomy and physiology. He is a Past-President of the Florida Association of Speech-Language Pathologists and Audiologists, a member of ASHA’s Health Care Economics Committee, and the ASHA representative to the American Medical Association’s Health Care Professions Advisory Committee for the Relative Value Utilization Committee in addition to being ASHA’s representative to the AMA’s Practice Expense Advisory Committee.


Financial - Receives Consulting fee for Consulting from Duke University.   Receives Speaker for Teaching and speaking from Mississippi Speech and Hearing Association.  

Nonfinancial - No relevant nonfinancial relationship exist.

Rachel Mehringer (), University of Miami Mailman Center for Child Development, rxm1092@med.miami.edu;
Rachel Mehringer Au.D. Candidate is in the accelerated three year program at Indiana University in Bloomington, IN. She completed her undergraduate studies at Indiana University, where she received a Bachelor of Arts in speech and hearing sciences. During graduate school, Rachel has obtained a variety of clinical experiences in locations including educational, private practice, and Otolaryngology offices. It was in the Indianapolis Public Schools where she realized her love for pediatric audiology. She is thrilled to be completing her final year at a location as diverse the Mailman Center


Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.