1997 Finalist
State of Rhode Island
Innovations in American Government Awards
Innovations in American Government Awards
Rhode Island

Congenital hearing loss is the most common disability present at birth. Prior to the Rhode Island Hearing Assessment Program (RIHAP), screening methods were targeted at only a small group of infants and were too costly to be widely implemented. RIHAP represents the first statewide hearing screening program for newborns.

RIHAP has implemented an early detection and intervention process in all of the state's birthing hospitals. This system ensures that infants do not sustain some of the preventable disabilities associated with congenital hearing loss. Screening is incorporated into the nursery routine of each of Rhode Island's eight hospitals. A collaboration between professionals, parents and the deaf community enhances the diagnosis and intervention process.

Traditional screening methodologies, such as the "high risk register," targeted only those infants identified with a risk factor associated with hearing loss. These processes were soon found to be largely ineffective because 50 percent of hearing impaired infants have no risk factor. For instance, 90 percent of infants born with hearing loss are born to parents without any natural hearing loss.

RIHAP uses an information system that tracks infants from screening, through diagnosis by community providers (physicians and audiologists), to services such as the Rhode Island School for the Deaf. Twenty quality indicators track different dimensions of the child's development, three of which correspond to the most critical aspects of hearing development.

RIHAP has resulted in the successful screening of 13,800 newborns a year; over 65,000 infants since the program's inception. By screening 99 percent of Rhode Island's newborns, RIHAP has succeeded in reducing the age that infants receive treatment for congenital hearing loss to less than six months old. To aid replication, RIHAP maintains a protocol and information system. This system has already begun to influence other states, as Colorado, Hawaii, Utah, and Mississippi have deployed universal hearing laws and report screening levels as high as 80 percent.