Identifying Qualified Audiologists for Assessment of Babies

National EHDI ConferenceAtlanta, Georgia

Faye P. McCollister, EdDConsulting Audiologist, Professor Emeritus, University of Alabama

Fmc901@earthlink.net

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