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Early Hearing Detection: Collaboration and Outcomes
 

Early Hearing Detection: Collaboration and Outcomes

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T. Carroll presentation given at the 2012 South Carolina Home Visiting Summit

T. Carroll presentation given at the 2012 South Carolina Home Visiting Summit

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    Early Hearing Detection: Collaboration and Outcomes Early Hearing Detection: Collaboration and Outcomes Presentation Transcript

    • Early Hearing Detection and Intervention: Opportunities for Collaboration to Impact Outcomes
    • Why Do Newborn HearingScreening…… Hearing loss is the most frequent occurring birth defect Incidence Per 10,000 Births 30 25 20 15 10 5 0
    • Why Do Newborn HearingScreening…… Hearing loss is the most frequent occurring birth defect Undetected hearing loss in children has serious negative consequences  Poorer academic achievement  Reduced educational and social opportunities  Increased cost in special education  Miss the “critical window” for language acquisition  Birth – 2 y.o.
    • Why Do Newborn Hearing Screening……Boys Town National Research Hospital Study of Earlier vs. Later 6 5 Identified <6 mos (n = 25) Language Age (yrs) Identified >6 mos (n = 104) 4 3 2 1 0 0.8 1.2 1.8 2.2 2.8 3.2 3.8 4.2 4.8 Age (yrs) Moeller, M.P. (1997).Personal communication moeller@boystown.org ,
    • Why Do Newborn Hearing Screening…… Vocabulary Size for Hearing Impaired Children Identified Before and After 6 Months of Age 300 Identified BEFORE 6 Months 250Vocabulary Size Identified AFTER 6 Months 200 150 100 50 0 13-18 mos 19-24 mos 25-30 mos 31-36 mos (n = 15/8) (n = 12/16) (n = 11/20) (n = 8/19) Chronological Age in Months
    • SC Legislation – 1976 Code Section 44-37-40"Universal Newborn Hearing Screening and Intervention Act"  Effective June 30, 2001  All hospitals required to screen newborns during birth admission for hearing loss  Exception: Hospitals with less than average of 100 births annually  All hospitals required to give parents educational information regarding the importance of hearing screening regardless of number of births (April 1, 2001)
    • SC Legislation – 1976 Code Section 44-37-40"Universal Newborn Hearing Screening and Intervention Act"  Follow Up  Reporting &  All babies referred by hospital screening are to receive: Monitoring  Audiologic Evaluation by  NBHS reporting Audiologist, or procedures must be  Medical Evaluation by Physician or followed by: Otolaryngologist, or  Hospitals  Both if indicated  Audiologists  Confirmed HL:  Medical Intervention  Early Interventionists  Audiologic Habilitation  Early Intervention services  Augmentative Hearing Devices
    • SC Legislation – 1976 Code Section 44-37-40"Universal Newborn Hearing Screening and Intervention Act"  Miscellaneous  Establish Advisory Council to include reps from:  Agencies  Professional Disciplines  Hospitals  Consumers  DHHS shall provide reimbursement  DHEC shall provide reimbursement
    • First Sound Process Refer to BabyNetHospital Referred to Audiology Hearing Fail Audiologist for Fail Diagnostic CHL HabilitationScreening Re-Screen Evaluation Recs Pass Hearing Pass Normal Aids CI SignLiterature Lang Literature Literature Parent Support
    • DATA COLLECTION HOSPITALS  AUDIOLOGISTS  Started with paper data  Started with paper data collection collection  ~ 2003 began electronic  ~ 2003 began electronic data collection data collection  April 1, 2008 data  Report results of any collection process newborn referred by integrated with Vital hospital for follow up Records  Report screening results on every baby
    • How Do We Test Babies? ?????
    • How Do We Test Babies?
    • How Do We Test Babies?Two types of tests can be done on newborns: Auditory Brainstem Response (ABR)  Tests the infant’s ability to hear soft sound through miniature earphones  Sensors measure baby’s brainwaves to determine if the sounds are heard normally Otoacoustic Emissions (OAE)  Measured directly with a miniature microphone  Measures response coming from inner hair cells
    • Goals of EHDI 1–3-6  Screen by 1 month old  Confirmed diagnosis by 3 months old  In Early Intervention by 6 months old
    • How Are We Doing? Screening Rate100% 99% 98%98% 97% 97% 97% 97% 97% 96% 96%96% 95%94% 93%92%90% AAP 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
    • How Are We Doing? Confirmed HL120 106100 85 82 74 77 7580 68 62 5860 404020 0 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
    • How Are We Doing? EI by 6 mos old120% 100%100% 88%80% 63% 60% 58%60% 51% 49% 53% 43% 38%40% 20% 0% AAP 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
    • How Are We Doing? Lost to Follow-Up/Documentation50% 43%40% 38% 37% 32% 33% 29%30% 21% 23% 23%20%10% 0% 2003 2004 2005 2006 2007 2008 2009 2010 2011
    • Things to Celebrate 100% labor and delivery hospitals conduct screenings More than 55,000 babies are screened each year prior to discharge Data reporting system linked to vital records
    • Things to Improve Follow up rates for failed screen Data reporting Parent support
    • Collaboration Opportunities Home Visitation & ECHO Programs Report Screening Results Verification of Screening Report Results Diagnostic Results Report Need Audiology for Further Resource Follow Up
    • FIRST SOUND Questions? Tara Carroll, MCD, CCC/A First Sound Program Manager/Audiologist 803-898-0708 carroltp@dhec.sc.gov