Christine Yoshinaga-Itano, PhD, University of Colorado (Funded 2019) The theoretical basis for the establishment of Early Hearing Detection and Intervention (EHDI) programs throughout the United States has been based upon the premise that EHDI can result in significantly improved language/developmental outcomes which should result in decreased need for special education services over time, better employment and decreased need for lifelong public support. Universal newborn hearing screening programs began to be established in Colorado in 1992-3 and legislation was passed in 1998 with the EHDI system fully implemented by 2000. Colorado has collected placement data (since 1992) and outcomes data (since the 1970s) on our state population. In 1978, statewide outcomes data were collected on the Test of Auditory Comprehension (TACL) , Test of Syntactic Ability, Woodcock- Johnson Psychoeducational Tests of Achievement, the Clarke Speech Intelligibility Test and assessments of written language. Data on the TACL is also available on a statewide population of children who received early intervention services after identification, as a result of the Colorado EHDI system, through 7 years of age. Collection of statewide educational placement data began to be collected in the early 1990s and was collected continuously from 1999-2005. Longitudinal data from the largest school district in the state from 2017 with comprehensive educational placement data is also available. Also available are data on 600+ children provides current educational outcomes on a large sample of children. Additionally, statewide outcome data on the Colorado State Assessment Project (CSAP) was collected on the Colorado population of children who are deaf/hard of hearing in 2004-2005. Although educational placement options have changed since the late 1970s, there should be sufficient data to calculate educational placement changes over time, as well as the change in costs since establishing EHDI (early hearing detection and intervention) programs in 2000. The costs of educational placement in Colorado were calculated based on 1993 costs and published in 1998 and the changes in costs over time as well as current costs are available. The data should be sufficient to calculate economic benefit of EHDI.

Impact of Early Hearing Detection and Intervention (EHDI) on the Educational Costs and Placements of Hearing Impaired Children

Currently, there are no studies with longitudinal data of placement and outcomes of children before and after the development of EHDI systems. The broad long term goal of this research project is to investigate the cost benefit for children with educationally significant hearing loss as a result of universal newborn hearing screening/early hearing detection and intervention (UNHS/EHDI). A hypothesis of significant cost benefit is based upon a theoretical foundation that UNHS/EHDI has had a positive impact on early access to language and communication, providing children with an opportunity to develop language and reading skills comparable to hearing peers. Improved language and reading skills should decrease the need for intensive special education services, thereby reducing the economic cost, due to educational placement needs for children with educationally significant hearing loss. The cost benefits should be evidenced by a significant decrease in the number of children with educationally significant hearing loss who receive special education services (have an Individual Educational Plan (IEP)), the percent of children who have 504 Plans (accommodation but no direct special education services) and a decrease in the intensity of services for children who have Individual Educational Plans. This study should provide actual rather than estimated changes in educational placement and the economic benefit of establishing EHDI in the state of Colorado.