Failed Screenings and Delayed Diagnoses: Identifying Discrepancies in Newborn Hearing Screening Programs

Monday, October 19, 2026

8:48 AM - 8:54 AM PT

Location: 406A

Presenting Author(s)

Ashley M. Nassiri, MD

Assistant Professor of Otolaryngology and Head and Neck Surgery (Otology/Neurotology)
University of Colorado School of Medicine
Aurora, Colorado, United States

Senior Author(s)

Ashley M. Nassiri, MD

Assistant Professor of Otolaryngology and Head and Neck Surgery (Otology/Neurotology)
University of Colorado School of Medicine
Aurora, Colorado, United States

Co-Author(s)

KU

Kristin Uhler, PhD

Associate Professor, Department of Physical Medicine and Rehabilitation
University of Colorado, United States

Senior Author(s)

LC

Liza Creel, PhD

Associate Professor, Division of Health Care Policy and Research
University of Colorado, United States

Co-Author(s)

SS

Stacy Stiell, AuD

Lead Pediatric Clinical Audiologist
University of Colorado, United States
BM

Bridget Mosley, MPH

Data Analyst and Epidemiologist, Adult and Child Center for Outcomes Research & Delivery Science
University of Colorado, United States

Introduction: Despite universal adoption of newborn hearing screening, the CDC reports high rates of loss to follow-up for those who failed screening and frequent delayed treatment for hearing loss. Limited information exists about the details of hearing screening programs.

Methods: The Colorado State Newborn Hearing Screening Database and the All-Payers Claims Database were utilized to identify rates of failed screenings, age at time of screening and diagnostic testing, and incidence of congenital hearing loss.

Results: 181,428 newborns had accessible hearing screening results in the database in 2020-2022. 18,382 (10.1%) failed at least one screening, with 3,338 (1.8%) patients having failed the most recent screening. The median age at screening was 1 day (IQR 1-2). A statistically significantly greater number of males failed their most recent screening (57% males vs 43% females, p< 0.0001). The median age at time of diagnostic testing was 84 days (IQR 29-238), which was similar between sexes. Patients living in rural areas had significantly later diagnostic testing compared to those in metropolitan or micropolitan areas (110 days vs 82 vs 84, respectively, p< 0.005). The incidence of congenital hearing loss of any type was calculated as 0.4717 between 2015 to 2022, with no significant rate changes over time (p>0.05).

Conclusions: These data represent a more granular view of the hearing screening and diagnosis program in Colorado. A large portion (10%) of newborns fail at least one screen, creating significant burden for follow-up for families and health systems. Patients living in rural areas experience delayed diagnostic testing. A better understanding of the underlying causes of these findings may offer solutions to barriers to access to pediatric hearing health care.