[Congressional Record Volume 145, Number 63 (Tuesday, May 4, 1999)]
[Senate]
[Pages S4677-S4678]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. SNOWE (for herself, Mr. Harkin, and Mr. Frist):
  S. 956. A bill to establish programs regarding early detection, 
diagnosis, and interventions for newborns and infants with hearing 
loss; to the Committee on Health, Education, Labor, and Pensions.


   newborn and infant hearing screening and intervention act of 1999

 Ms. SNOWE. Mr. President, I rise today to introduce the 
Newborn and Infant Hearing Screening and Intervention Act of 1999. This 
bill is a companion bill to H.R. 1193, introduced in the House by 
Representative Jim Walsh. I am pleased to be joined again this year by 
my colleague from Iowa, Senator Harkin, who has long been a champion of 
the hearing impaired, and my colleague from Tennessee, Senator Frist.
  We usually associate hearing problems with the aging process, and it 
is true that the largest group of Americans suffering from hearing 
impairment are those in the 65 to 75 year age range. But at the same 
time, approximately 1.5 to 3 out of every 1000 children--or as many as 
33 children per day--are born with significant hearing problems. 
According to the National Institute on Deafness and Other Communication 
Disorders, as many as 12,000 infants are born each year in the United 
States with some form of hearing impairment.
  In recent years, scientists have stressed that the first years of a 
child's life are crucial to their future development. This makes early 
detection and intervention of hearing loss a necessity if we are to 
ensure that all our children get the strong start they deserve. 
Specialists in speech and language development believe that the crucial 
period of speech and communication in a child's life can begin as early 
as six months of age. Unfortunately, though the average age of 
diagnosis of hearing loss is close to three years of age.
  The ability to hear is a major element of one's ability to read and 
communicate. To the extent that we can help infants and young children 
overcome disabilities detected early in life, we will improve their 
ability to function in society, receive an education, obtain meaningful 
employment, and enjoy a better quality of life. Without early diagnosis 
and intervention, these children are behind the learning curve--
literally--before they have even started. They should not be denied a 
strong start in life simply for the lack of a simple screening test.
  There are many causes of hearing loss, and in many states a newborn 
child is screened only if the physician is aware of some factor that 
puts that baby in a risk category. The good news is that over 550 
hospitals in 46 states operate universal newborn hearing screening 
programs. Nine states--Hawaii, Rhode Island, Mississippi, Connecticut, 
Colorado, Utah, Virginia, West Virginia, and Massachusetts--have passed 
legislation requiring universal newborn hearing screening. Hawaii, 
Mississippi, Rhode Island, Utah, and Wyoming have statewide early 
hearing detection and intervention programs. And scientists across the 
country are developing and implementing model rural-based infant 
hearing, screening, follow-up, and intervention programs for children 
at risk for hearing and language disabilities.
  The bad news is that, unfortunately, only about 20 percent of the 
babies in this country are born in hospitals with universal newborn 
hearing screening programs, and more than 85 percent of all hospitals 
do not do a hearing screening before sending the baby home.
  Universal screening is not a new idea. As early as 1965, the Advisory 
Committee on Education of the Deaf, in a report of the Secretary of 
Health, Education and Welfare, recommended the development and 
nationwide implementation of ``universally applied procedures for early 
identification.'' In 1989, former Surgeon General C. Everett Koop used 
the year 2000 as a goal for identifying 90 percent of children with 
significant hearing loss before they are one year old.
  In 1997, an expert panel at the National Institute of Deafness and 
Other Communication Disorders recommended that the first hearing 
screening be carried out before an infant is three months old in order 
to ensure that treatment can begin before six months of age. The Panel 
also recommended that the most comprehensive and effective way of 
ensuring screening before an infant is six months old is to have 
newborns screened before they sent home from the hospital. But a 1998 
report by the Commission on Education of the Deaf estimated that the 
average age at which a child with congenital hearing loss was 
identified in the United States was a 2\1/2\ to 3 years old, with many 
children not being identified until five or six years old.
  It is time to move beyond the recommendations and achieve the goal of 
universal screening. In addition to the nine states that require 
screening, the Bureau of Maternal and Child Health, in conjunction with 
the Centers for Disease Control, is helping 17 states commit to 
achieving universal hearing screening by the year 2000. This plan will 
lead to the screening of more than one million newborns a year, but it 
still leaves more than half the states without universal screening 
programs.
  The purpose of the bill I am introducing today is to provide the 
additional assistance necessary to help all the states in implementing 
programs to ensure that all our newborns are tested and to ensure that 
those identified with a hearing impairment get help. Specifically, the 
bill:
  (1) Authorizes $5 million in FY 2000 and $8 million in FY 2001 for 
the Secretary of Health and Human Services to work with the states to 
develop early detection, diagnosis and intervention networks for the 
purpose of developing models to ensure testing and to collect data;
  (2) Authorizes $5 million in FY 2000 and $7 million in FY 2001 for 
the Centers for Disease Control to provide technical assistance to 
State agencies and to conduct applied research related to infant 
hearing detection, diagnosis and treatment/intervention; and
  (3) Authorizes the National Institutes of Health to carry out 
research on the efficacy of new screening techniques and technology.
  A baby born today will be part of this country's future in the 21st 
century. Surely we owe it to that child to give them a strong start on 
that future by ensuring that if they do have a hearing impairment it is 
diagnosed and treatment started well before their first year of life is 
completed. I urge my colleagues to join me, Senator Harkin, and Senator 
Frist in supporting the Newborn and Infant Hearing Screening and 
Intervention Act of 1999.
 Mr. HARKIN. Mr. President, I am pleased to introduce, along 
with my colleagues, Senator Snowe and Senator Frist, the Newborn and 
Infant Hearing Screening and Intervention Act of 1999.
  Tne Newborn and Infant Hearing Screening and Intervention Act would 
help States establish programs to detect and diagnose hearing loss in 
every

[[Page S4678]]

newborn child and to promote appropriate treatment and intervention for 
newborns with hearing loss. The Act would fund research by the National 
Institutes of Health to determine the best detection, diagnostic, 
treatment and intervention techniques and technologies.
  Every year, approximately 12,000 children in the United States are 
born with a hearing impairment. Most of them will not be diagnosed as 
hearing-impaired until after their second birthday. The consequences of 
not detecting early hearing impairment are significant, but easily 
avoidable.
  Late detection means that crucial years of stimulating the brain's 
hearing centers are lost. It may delay speech and language development. 
Delayed language development can retard a child's educational progress, 
minimize his or her socialization skills, and as a result, destroy his 
or her self-esteem and confidence. On top of all that, many children 
are diagnosed incorrectly as having behavioral or cognitive problems, 
simply because of their undetected hearing loss.
  In 1988, the Commission on Education of the Deaf reported to Congress 
that early detection, diagnosis and treatment were essential to 
improving the status of education for people who are deaf in the United 
States. Based on that report and others, in 1991, when I was chair of 
the Labor-HHS Subcommittee on Appropriations, we urged the National 
Institute on Deafness and Other Communication Deisorders--NIDCD--to 
determine the most effective means of identifying hearing impairments 
in newborn infants. In 1993, the Labor-HHS Subcommittee supported 
NIDCD's efforts to sponsor a consensus development conference on early 
identification of hearing impairment in infants and children. And in 
1998, the Subcommittee encouraged NIDCD to pursue research on 
intervention strategies for infants with hearing impairments, and 
encouraged HRSA to provide states with the results of the NIH study on 
the most effective forms of screening infants for hearing loss.
  Mr. President, the Act we are introducing today builds on these 
earlier efforts. The Act would help states develop programs that many 
of them already are working on; it would not impose a single federal 
mandate. At least eight states already have mandatory testing programs; 
many others have legislation pending to establish such programs. Other 
states have achieved universal newborn testing voluntarily. These 
programs can work; they deserve federal help.
  One of the highlights of my Congressional career, indeed, of my life, 
has been working on policies and laws to ensure that people with 
disabilities have an equal opportunity to succeed in our society. This 
is especially meaningful to me, because my brother Frank became deaf as 
a child.
  I watched Frank grow up, and I saw how few options and support 
services were available for people who were deaf. I remember the 
frustrations and challenges Frank faced, and I told myself early on 
that I would do all I could to break down the barriers in our society 
that prevented people who were deaf from reaching their potential. By 
supporting early screening, diagnosis, and treatment programs, this act 
would go a long way toward accomplishing that goal.
  I would like to thank Senators Snowe and Frist for their hard work 
and support of this act, and I hope our colleagues will join us in this 
worthy effort.
                                 ______