The Campaign for Healthy Hearing in Kids:

1. The Campaign for Healthy Hearing in Kids:a collaborative partnership Jennifer Rossi, MS Jenna Voss, MA, CED theOmaha Hearing School Omaha, Nebraska

2. Faculty Disclosure Information In the past 12 months, we have not had a significant financial interest or other relationship with the manufacturers of the products or providers of the service that will be discussed in our presentation. This presentation will not include discussion of pharmaceuticals or devices that have not been approved by the FDA or unapproved or “off-label” uses of pharmaceuticals or devices.

3. Campaign for Healthy Hearing in Kids: What is it? • Our Purpose • to identify children with hearing health needs and refer them for medical follow-up • Our Method • conduct DPOAE screenings • Our Target Population • children in the greater Omaha area • birth to age five • “at-risk” elementary aged children

4. Why do it? • Hearing loss is the most common birth defect.1 • 1/300 children born in the US is born with hearing loss. • Chronic middle ear infection is one of the most common childhood health issues.2 • 50% of children will have at least one middle ear infection by one year of age. • Between 1 and 3 years of age, 35% will have had repeated episodes. • Children develop late onset and progressive losses after passing newborn hearing screenings.3 • Monitor biannually until age three and annually thereafter.

5. Early Identification/Early Intervention “If hearing impaired children are not identified early, it is difficult, if not impossible, for many of them to acquire the fundamental language, social, and cognitive skills that provide the foundation for later schooling and success in society. When early identification and intervention occurs, hearing impaired children make dramatic progress, are more successful in school, and become more productive members of society. The earlier intervention and habilitation begin, the more dramatic the benefits.” United States Department of Health and Human Services4 (1990)

6. Nebraska Newborn Hearing Screening2004 Annual Report5 • 26,485 births • 25,966 newborns screened at birth • 918 newborns did not pass • 158 newborns discharged prior to screening • 793 newborns recommended for monitoring, intervention, and follow-up • 506 infants were rescreened; 110 received diagnostic evaluation *These statistics are based on the aggregate reports from birthing facilities. There are certainly discrepancies between aggregate and individually-identifiable data.

7. Connecting with Collaborative Partners

8. Connecting with Our Collaborative Partners

9. Connecting with Our Collaborative Partners

10. Our Protocol • adapted from Hearing Head Start Early Childhood Hearing Outreach (ECHO) Project • National Center for Hearing Assessment and Management, Utah State University

11. 1 – Step Protocol

12. 2 – Step Protocol

13. Our Equipment • Maico ERO-SCAN Screening Test System • DPOAE • 4 Frequencies (3 required for a PASS) • Remote Probe

14. Current Status Report (1.18.06)

15. Our Challenges • Conveying the importance of timely follow-up! • Funding for equipment and administrative cost • Staffing • Scheduling

16. Is this working?Follow-up evaluations • Program evaluation developed after one year • 1-5 Rating Scale; Comments • 3 Categories: overall experience, site visit, parent feedback • Initial Distribution of 25 evaluation forms • 11 were returned • “Excellent” and “Agree” Responses: professionalism, correspondence, and cost! • “Average” and “Neutral” Responses: explanation of technology, parent interest • “Poor” and “Disagree” Responses: none!

17. “Wonderful service! It is difficult to obtain accurate assessment on 3 and 4 year old students-this eliminates guesswork… I would highly recommend this service and truly feel this is the way all hearing screenings throughout a child’s school years should be conducted!” ~public school nurse “This gives a home daycare an opportunity to give children a service usually provided by a big daycare.” ~owner of a home daycare Is this working?Participant Comments “This is a great service that you provide for children!” ~director of large daycare

18. Is this working?Brian’s Story • 4 years old • University Childcare Center • REFER, parents notified • Parents took child to Dr.; fluid noted • Received diagnostic testing from school audiologist; bilateral, conductive 50dB loss • Received PE tubes

19. Is this working?Matt’s Story • 4.5 years old • Head Start program • REFER, parents notified • Mom called to schedule another screening (prior to Dr. visit); encouraged to contact Dr. and/or school audiologist • Rescreened (per mom’s request), REFER, school nurse notified • Received diagnostic testing from school audiologist; bilateral conductive loss was noted • Visited Dr.; wax removed

20. Is this working?Katie’s Story • 4 years old • Head Start program • Red Flag: Mom noted, on permission slip, that child referred newborn hearing screening • REFER, parents notified; classroom teacher noted concerns about child’s speech and hearing (child is “a little bit deaf”) • School nurse, District Health Service Coordinator, Family Support Worker acquired consent for “exchange of information” • Reports from NE Newborn Hearing Screening Program and audiology clinic indicate: • REFER newborn hearing screening • 2 weeks – DPOAEs not present; ABR findings suggest mild to moderate loss bilaterally • 1 y 3 mo – VRA sound field findings indicate moderate loss • 1 y 9 mo - Ear mold impressions and hearing aid fitting • Child lost to further audiologic management/early intervention.

21. Contact us Jennifer Rossi jrossi@hearingschool.org Jenna Voss jvoss@hearingschool.org theOmaha Hearing School 1110 North 66th St. Omaha, NE 68132 402.558.1546 http://www.oraldeafed.org/schools/omaha/index.html

22. References • 1. White, K. R. (October, 1997). The scientific basis for newborn hearing screening: Issues and evidence. Invited keynote address to the Early Hearing Detection and Intervention (EHDI) Workshop sponsored by the Centers for Disease Control and Prevention, Atlanta, Georgia. • 2. National Institute on Deafness and Other Communication Disorders. (2002). Otitis media (ear infection) (NIH Publication No. 974216). Bethesda, MD: Author. • 3. Joint Committee on Infant Hearing (2000). Principles and guidelines for early hearing detection and intervention programs. Audiology Today, Special Issue, 1-23. • 4. U.S. Department of Health and Human Services (HHS). (1990). Healthy People 2000: National Health Promotion and Disease Prevention Objectives. Washington, DC: Public Health Service. • 5. Nebraska Health and Human Services System (2004). Nebraska Newborn Screening Annual Report: dried blood spot screening for metabolic & inherited disorders and newborn hearing screening programs. Lincoln, NE.