Identifying Qualified Audiologists for Assessment of Babies
National EHDI ConferenceAtlanta, Georgia
Faye P. McCollister, EdDConsulting Audiologist, Professor Emeritus, University of Alabama
Need for Audiologists With Very Specific Skills
Pediatric audiology
Counseling
Team management
Intervention with very young children with hearing loss
Qualified Audiology Provider
Appropriate state, national credentials Appropriate pediatric experience, with
children less than 6 months of age Appropriate diagnostic equipment Interest in providing family-centered
audiological management
Status of EHDI Programs :Audiological Diagnosis
Equipment and techniques for diagnosis of hearing loss in infants continues to improve
State coordinators estimate only 56.1% “receive diagnostic evaluations by 3 months of age
Changes in Population Characteristics
Population Served Includes Very Young Children
The Population Served has Increased
Consumers of Early Intervention Services are Knowledgeable Regarding their Rights and Options Available
Changes in Population Characteristics
Delayed Onset Hearing Loss
Fluctuating Hearing Loss
Progressive Hearing Loss
Mild and Unilateral Hearing Loss Identified Early
Multiple Disabilities
About 30% of children with hearing loss have multiple disabilities (CADS, Gallaudet)
Will require interdisciplinary team management
Change in Use of Risk Indicators: Still Important
JCIH risk indicators known to miss 50 %
JCIH risk indicators not always evaluated (congenital infections, Conexin 26 gene)
Parent report, medical record review can not give complete results
However, knowledge of indicators gives opportunity to define etiology, provide better hearing loss management
Congenital CMV Infection
Most frequently occurring congenital viral infection in man, herpes virus, 60–80 % adults infected
40,000 babies infected annually
90-95 % asymptomatic; 10 % symptomatic
Symp 40.7% have HI = 1,628» Asymp. 7.4 % Have HI = 2,664» Total HI = 4,292
About 35 % of pediatric HI results from CMV
Connexin 26
Protein responsible for intracellular communication (transfer of ions between the hair cells in the cochlea and their support cells)
Responsible for 20-30% of congenital hearing loss
Connexin 26
Several different mutations
Usually recessive, occasionally dominant
Almost always results in hearing loss that is:
Congenital
Severe-profound
Non-progressive
Non-syndromic
Vigilant Surveillance Required
Estimated that about 16 % of Hearing Loss is Delayed in Onset» Educate Parents» Educate Primary Care Providers» Provide Information on Normal Auditory
Development» Provide Information of Signs and Symptoms of
Hearing Loss
Collaboration
AAA ASHA State Licensure Boards State Audiology Associations State Speech and Hearing
Organizations
Benefits of Identifying Qualified Audiologists
Faster, more accurate diagnosis Decrease number of children lost
to follow-up Decrease parental anxiety
Program Evaluation Instruments
Audiology Survey Instruments» Colorado» Wisconsin» Utah» Arizona» Generic» Ohio
Infanthearing.org
www.infanthearing.org
Survey Development
Demographic Information» Individual or facility, confidentiality
Interest» Want to be included
» Do not have skills, need training Equipment
» Sufficient to perform rec. protocols Experience
» Numbers, ages, sedation, hearing aids ….. Protocols Documented
Survey Development
Efficiency/Timeliness» Intervals between diagnosis/hearing aid fitting» Referral to intervention
Tracking/Reporting» Referrals made» Statistical information
Team Management» Medical» Intervention
Parental Support» Materials provided
National EHDI Technical Assistance System
EHDI Network members located in each of the MCHB regions
Information dissemination and training
Web site (www.infanthearing.org)
Collaboration with other groups and agencies
NCHAM Network Activities
Workshops on Pediatric Diagnostic Audiology
» 6 weeks of on-line preparation
» 2 day face-to-face workshop
» 3 month follow-up practicum
Efficient Hearing Screening and
Diagnostic Audiological Services….
Brings Better Opportunities To Babies and Young Children With Hearing Loss