(0214) Early Intervention Disparities in Hearing-Impaired Children: Socioeconomic Influence on Access to Services and Long-Term Outcomes

Introduction: The Early Hearing Detection and Intervention (EHDI) program recommends screening for hearing impairment or deafness within the first month of age, with confirmed cases requiring intervention and special services, including speech, occupational, or behavioral therapy, no later than 6 months of age to prevent adverse effects on speech, language, and social skills. This study aims to use National Survey of Children’s Health (NSCH) data to identify social factors linked to children not receiving such services before 6 months of age.

Methods: This retrospective study used 2020-2021 NSCH data to assess if children with hearing impairment received early services. Logistic regression was used to compare those who did or did not receive special services before 6 months of age with the household insurance status, income level, Women, Infants, and Children (WIC) services utilization, and food stamp usage.

Results: Out of 1,078 children with hearing impairments, 21.6% (n = 228) received developmental services within 6 months. Children who did not receive services were more likely to be from households below the federal poverty level (OR = 0.41, 95% CI: 0.24-0.71, p = 0.0001) and less likely to come from families receiving benefits from the WIC program (OR = 2.72, 95% CI: 1.77-4.23, p < 0.0001). In the early intervention group, insurance adequacy and parental job stability rates were increased but not statistically significant (p = 0.131 and p = 0.261, respectively).

Conclusions: Delayed access to early intervention services for children with hearing impairment is significantly associated with lower income levels and decreased likelihood of family members receiving WIC benefits, indicating potential barriers such as limited awareness and utilization of resources and support programs. These findings suggest that delayed access to early intervention services may be influenced by socioeconomic status and future research is needed to address specific family factors influencing delayed intervention as well as the role of parental education in timely screening and follow-up.