First Advisor

Meinke, Deanna K.

Second Advisor

Weber, Jennifer E.

Degree Name

Doctor of Audiology

Document Type


Date Created



One of the current national early hearing detection and intervention goals is to ensure that infants who do not pass their newborn hearing screening process will have a diagnostic evaluation completed before three months of age. However, data collected by the Centers for Disease Control and Prevention (2013b) in 2011 indicated states could not document that diagnostic evaluations were completed within this time frame for 43.1% of infants who needed them. The purpose of this study was to identify factors that affected the ability of parents in Colorado to obtain a rescreening after their infant’s initial newborn hearing screening was not passed. Further, this study sought to identify specific factors that affected the ability of parents to obtain an audiologic diagnostic evaluation after a subsequent hearing rescreening was not passed in Colorado. A survey was developed as a factor analysis instrument for parents in Colorado whose infant did not pass the initial newborn hearing screening and/or rescreening in 2014. The surveys consisted of demographic questions as well as a series of questions prompting parents to respond regarding their experience with their infant's newborn hearing screening and follow-up. After a trial administration was completed, the survey was mailed by the Colorado Department of Public Health and Environment to 445 parents. Fifteen percent (n = 67) of the surveys were returned as undeliverable. Of the 23 completed and returned surveys, 43% (n = 10) represented families who had already obtained an appropriate follow-up. Therefore, only 57% (n = 13) of the returned surveys were included in the data analysis. Since approximately 50% of responding parents had already obtained appropriate follow-up services, it was assumed follow-up rates in Colorado might be underestimated. Therefore, simple improvements in accurate record keeping were described, which might also improve the rate of follow-up represented by data at the Colorado Department of Public Health and Environment (2004). The planned factor analysis could not be implemented due to the poor response rate and small number of actual respondents. A summary of survey responses and parent comments highlighting case examples were provided. No one factor was determined to affect parental follow-up for all families. However, five factors did affect follow-up for each family: scheduling, communication, financial, personal and emotional, and cooccurring medical barriers. Of the five factors explored through this study, scheduling barriers were the most frequently reported, influencing follow-up for parents. The second most common barrier related to communication. Given these results, simple improvements in scheduling and parent communication were recommended to improve the follow-up rate after newborn hearing screenings.


Audiology, Hearing assessment, Infants


103 pages

Local Identifiers


Rights Statement

Copyright is held by the author.