Seven out of 13 Canadian provinces and territories do not provide sufficient infant hearing health care, according to a new report card led by Western University audiologist and faculty member Marlene Bagatto. As a result, Bagatto and her collaborators at the Canadian Infant Hearing Task Force (CIHTF) find more than one third of Canadian infants experience a health care inequity which impacts their development and education.
The 2024 national report card, developed on behalf of the CIHTF reveals little has changed since the Task Force's 2019 Early Hearing Detection and Intervention (EHDI) Report Card. Overall, the report card gave Canada a grade of "insufficient," as it did in 2019, when it comes to providing infant hearing health services.
Marlene Bagatto
"Every child in Canada deserves access to timely and high-quality hearing health services. Your postal code must not determine whether you and your child have access to early hearing health care within a comprehensive EHDI program," said Bagatto, a professor at Western's School of Communication Sciences and Disorders and the National Centre for Audiology.
Bagatto joins members of the CIHTF in Ottawa today (May 28) to meet with federal government officials, where they shared their latest findings and requested new national hearing health care guidelines for children. These guidelines would serve as a policy roadmap for provinces and territories, drawing on best practices in areas that currently provide successful and sustainable EHDI programs.
Some positive results
The provinces and territories with "sufficient" EHDI programs in 2019, namely Alberta, British Columbia, Northwest Territories, Nova Scotia, Ontario and Yukon Territories, have sustained this grade for the past five years. Provinces and territories graded as "insufficient" are working to improve and advance.
For instance, a third-party external consultant reviewed New Brunswick's provincial infant hearing health care services and provided actionable recommendations. In Prince Edward Island, clinical protocols are being developed with a goal for implementation. And several insufficient regions such as New Brunswick, Nunavut and Saskatchewan have implemented newborn screening for congenital cytomegalovirus (cCMV), the leading cause of non-genetic hearing loss in newborns.
The grades in the 2024 EHDI Report Card were based on availability of all five components in an EHDI program province or territory-wide. The five components are:
- Universal newborn hearing screening
- Identification of babies with permanent hearing loss
- Intervention services, including support for technology and communication development
- Family support
- Monitoring and evaluation of the program
"It is important to remember that universal newborn hearing screening (UNHS) is only one component of a comprehensive EHDI program," said Bagatto. "Along with screening all babies at birth, a comprehensive and effective EHDI program must include a hearing assessment to confirm the presence or absence of permanent hearing loss, support services that involve technology (if the family chooses) and language development, family support as well as monitoring and evaluation of the program," said Bagatto.
Knowing the status of a child's hearing is critical to support families in making communication and educational decisions for their child. Healthy hearing and communication development have important implications for brain development, learning, behaviour, relationships and overall well-being.
"While high-quality pediatric audiology services are available in Canada, access to and availability of these services and their coordination within the broader health care system remains absent in many regions," said Bagatto.
Research shows the most critical time for learning language is from birth to two years of age. The earlier a baby's hearing loss is detected, the sooner language development support can be put in place to help a child learn language - whether it's spoken, signed or both - and communicate with the world around them.
"We will continue to advocate for the availability of comprehensive infant hearing health services across Canada so that all Canadian children and their families have equal access to comprehensive early hearing health care," said Bagatto.
