echos of ehdi: echos of ehdi: how periodic early childhood screening is growing william eiserman,...
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ECHOs of EHDI:ECHOs of EHDI:
How Periodic Early Childhood Screening is Growing
William Eiserman, PhD, Lenore Shisler, MS, Terry Foust, AuD - CCC-A, Randi Winston, AuD - FAAA, Karl White, PhD, Jan Buhrmann, PhD
Why is Periodic Hearing Why is Periodic Hearing Screening so Screening so
Important?Important?
Despite progress related to newborn hearing screening, approximately 10% of newborns in the US are not screened at birth, and 30-50% of infants who do not pass their newborn hearing screening are lost to follow-up.
Estimated incidence of sensorineural hearing loss in the US triples between birth and the school-age years, from 1 in 300 to 3 in 300
Hearing loss can occur at any time in a child’s life. Progressive and late-onset may occur at any time throughout early childhood
Approximately 35% of preschool children will have repeated ear infections before 3 years of age, nearly always resulting in fluctuating conductive hearing loss.
Without regular, physiologic screening, hearing loss is often impossible to detect.
Children with unidentified hearing loss are often identified with speech and language delays, described as having behavioral disorders or learning disabilities
Where is periodic Where is periodic screening happening?screening happening?
Head Start Programs Health care settings/Well-child visits Part C / Child find Community Outreach programs
In 2005, Head Start servedIn 2005, Head Start served
Approximately 968,000 children 152,000 were under 3 years In more than 20,000 centers
All children must receive a hearing screening within the first 45 days of enrollment
and annually thereafter.
Head Start has a standing
commitment to periodic early
hearing screening
Status of Head Start Hearing Status of Head Start Hearing Screening PracticesScreening Practices
Most Head Start programs are relying on outdated subjective, screening methods such as hand clapping, bell ringing, and parent questionnaires to screen children 0 – 3 years of age.
Most Head Start programs are unaware that Otoacoustic Emissions (OAE) technology, used with newborns, can also be used successfully in early childhood settings.
Purpose:
The Hearing Head Start ECHO Project
update hearing screening practices for children birth to three years served by Head Start programs nationwide through use of Otoacoustic Emissions (OAE) technology
ensure that all children with hearing health needs receive timely and appropriate intervention.
15 States15 States
Oregon Washington Utah North Carolina District of Columbia Nebraska Kansas
Colorado Alaska Michigan Arkansas Connecticut Illinois Hawai’i Missouri
OutcomesOutcomes
n=4518 children screened 257 (6%) were referred for medical/audiological follow-up
107 (42%) identified with a hearing loss or disorder requiring treatment or monitoring
* 7 Permanent hearing loss
* 83 Otitis media
* 2 Occluded PE Tubes
* Excessive earwave or congestion
52 (20%) normal/no treatment required
98 (38%) exited program before diagnosis/referral appointment completed
Early Identification of Hearing Loss
Conducting periodical Otoacoustic Emissions (OAE) hearing screening with infants and toddlers
during well child visits
Helping Children Hear and Now
Introducing…
a multimedia instructional package for health care providers
Instructional PackageInstructional Package
Three-part instructional DVD (22 min) Instructional Guide Protocol and Documentation Forms
ContentContent
Part 1 – Overview Part 2 - Equipment use and step-
by-step demonstration of OAE screening with infants and toddlers
Part 3 - Integrating OAE screening within a larger hearing health protocol
Next StepsNext Steps