Early Hearing Detection: Collaboration and Outcomes

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

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Early Hearing Detection: Collaboration and Outcomes

  1. 1. Early Hearing Detection and Intervention: Opportunities for Collaboration to Impact Outcomes
  2. 2. 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
  3. 3. 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.
  4. 4. 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 ,
  5. 5. 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
  6. 6. 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)
  7. 7. 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
  8. 8. 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
  9. 9. 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
  10. 10. 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
  11. 11. How Do We Test Babies? ?????
  12. 12. How Do We Test Babies?
  13. 13. 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
  14. 14. Goals of EHDI 1–3-6  Screen by 1 month old  Confirmed diagnosis by 3 months old  In Early Intervention by 6 months old
  15. 15. 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
  16. 16. 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
  17. 17. 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
  18. 18. 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
  19. 19. 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
  20. 20. Things to Improve Follow up rates for failed screen Data reporting Parent support
  21. 21. Collaboration Opportunities Home Visitation & ECHO Programs Report Screening Results Verification of Screening Report Results Diagnostic Results Report Need Audiology for Further Resource Follow Up
  22. 22. FIRST SOUND Questions? Tara Carroll, MCD, CCC/A First Sound Program Manager/Audiologist 803-898-0708 carroltp@dhec.sc.gov

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