Canadian audiologists are urging federal decision-makers to prioritize child hearing health following a report card from the Canadian Infant Hearing Task Force showing the country has once again received an overall ‘insufficient’ grade.
Little has changed since the task force’s initial 2014 Early Hearing Detection and Intervention Report Card, said Marlene Bagatto, Western Communication Sciences and Disorders professor and task force chairperson.
The latest report card demonstrates the slow rate of progress at the provincial and territorial level and exposes an alarming disparity in the hearing health services available to infants and children in Canada.
“Babies who are born in different parts of this country do not have the same access to hearing health care. That’s just wrong,” Bagatto said. “Whether you are born in Ontario, British Columbia, Nova Scotia or the Yukon, if that baby has hearing loss you should feel good they will get the appropriate hearing health care. It should not matter where you were born in Canada; every baby should have access to early and appropriate hearing health care.”
It’s time, she stressed, for the federal government to take a policy leadership role and provide guidance to provinces and territories.
“Too little progress has been made since Canada’s failing grade in 2014. Five years later, Canada’s overall grade remains insufficient,” she said.
The 2019 report card gave a ‘sufficient’ grade to Alberta, British Columbia, Northwest Territories, Nova Scotia, Ontario and the Yukon. ‘Insufficient’ grades were handed out to Manitoba, Nunavut, Prince Edward Island, New Brunswick, Newfoundland and Labrador, Quebec and Saskatchewan.
Alberta, Northwest Territories and the Yukon improved from the first report card; New Brunswick and Prince Edward Island both received failing grades after passing in 2014.
“I like to be positive. It’s not my style to give a negative message. But we have to shine a light on something that’s not going well in order to make that positive change,” Bagatto said. “When you put more of a magnifying glass on the report card, there was some positive change for some groups, so Alberta. Other places, like Saskatchewan and Manitoba, have since received funding for the screening component, but that alone is not sufficient for a full program.
“And there have been a couple places, like New Brunswick and Prince Edward Island, who had a good rating last time, but this time do not, and that speaks to the sustainability.”
The grades in the 2019 report card were based on whether all five components of an Early Hearing Detection and Intervention program are available province or territory-wide. These components include universal hearing screening of all newborns; identification of babies with permanent hearing loss; intervention services which include support for technology and communication development; family support; and monitoring and evaluation of the program.
“It is important to remember that universal newborn hearing screening is only one component of a comprehensive early hearing detection and intervention program,” Bagatto said. “While high-quality pediatric audiology services are available in Canada, access to these services, and their coordination within the broader health-care system, remains a problem in many regions.”
Each province and territory were lacking in different ways, she added, noting while universal screening is happening for most, the next steps in the process are often what’s lacking, such as access to a collaborative set of services to test the hearing of babies two to three months of age.
“An audiologist experienced with other (age) populations will not have the equipment or expertise to test a baby’s hearing properly and accurately enough to fit a hearing aid. That’s the next part to address,” Bagatto said. “The protocol written for fitting babies early in life need to be done properly; that’s the whole point of identifying them as soon as possible so we can intervene.”
Bagatto added healthy hearing and communication development have important implications for brain development, learning, behaviour development, personal and social relationships and overall well-being. The most critical time for learning language is from birth to 2 years.
“The earlier a baby’s hearing loss is detected, the sooner language development supports can be put in place to help a child learn language – whether it’s spoken, signed or both – and communicate with the world around them,” she said. “If you’re beyond that age, that window, and the ability to learn language with ease, closes.”
Bagatto added we have technology, expertise and protocols that can be shared between provinces and territories, noting “we don’t need to reinvent the wheel.”
“We can share things that were developed in one province with another. But we need a guiding framework, a road map from the federal government to support this initiative,” she said. “We will continue to advocate for improved early hearing detection and intervention programs until all children in Canada have equal access to comprehensive early hearing health services.”