Referral/Notification and Reporting Learning Objectives

ARIZONA T3 HOW TO TRAIN HEARING SCREENERS RENEWAL CURRICULUM: REFERRAL/NOTIFICATION AND REPORTING T3 Referral, Notification & Reporting

Referral/Notification and Reporting Learning Objectives • Understand the results of hearing screening methods. • Know appropriate responses to screening outcomes. • Demonstrate principles of effectively communicating with parents. • Understand documentation and tracking procedures. • Know how to report screening results to ADHS. • Understand the role of community resources. T3 Referral, Notification & Reporting

Pure Tone Screening To pass a pure tone screening,a child must respond to each of these four frequencies at the screening level in both ears: 25 dB HL 500 Hz 20 dB HL 1000 Hz 20 dB HL 2000 Hz 20 dB HL 4000 Hz T3 Referral, Notification & Reporting

Tympanometry To pass a three-frequency, pure tone hearing screening with tympanometry, the child: • Responds to the pure tone screen at 1000 Hz, 2000 Hz and 4000 Hz at 20 dB in each ear, and • Reaches a point of maximum immittance in each ear within the range of +100 mm H2O to -200 mm H2O in each ear. T3 Referral, Notification & Reporting

Otoacoustic Emissions (OAE) To pass the otoacoustic emissions screening: • Reproducibility must be greater than 50% in each ear; and • The response must present no less than 3 dB above the noise floor at a minimum of three frequencies. T3 Referral, Notification & Reporting

Documentation Requirements The Arizona DHS Hearing Screening Rules contain requirements for: • referringchildren who do not pass the second hearing screening test, • notifyingparents, and • makingreports to the agency. T3 Referral, Notification & Reporting

Referrals All referrals are made to the parent/guardian for follow-up with one or more of the following: • Audiologist • Physician • Primary care practitioner T3 Referral, Notification & Reporting

Referral Conditions • If a child fails 2nd pure tone and school has an audiologist, screener may consult with the audiologist. • If one of “Four Reasons NOT to Screen” is present, refer to primary care practitioner or physician. • If a child fails 2nd pure tone and school has no audiologist and parents have insurance, refer to parent who will refer to physician and/or an audiologist for further evaluation. • If a child fails the 2nd pure tone and no school audiologist and no insurance, parents may need assistance in finding care; discussed further in Resources section. • If a child passes pure tone and fails tympanometry, refer to primary care physician/may be middle ear problem. • If a child passes tympanometry and fails pure tone, refer to an audiologist/may be hearing loss. • If only pure tone or OAE are used without tympanometry, refer to either an audiologist or health care provider. T3 Referral, Notification & Reporting

Good Listening Skills • Assure privacy. • Show interest in their concerns. • Be attentive. • Minimize distractions. • Welcome their questions. • Try to imagine what the parent is feeling. • Resist the temptation to quickly give advice or make judgments beyond your expertise. • Allow parents to clarify the meaning of the screening results, and facilitate their efforts in taking the next steps required to evaluate the child’s hearing. T3 Referral, Notification & Reporting

“How Do You Say It?”Activity • Parents want you to appreciate their concern for their child’s health. • Parents want clear and accurate information. • Parents want you to recognize that they want the best for their child. T3 Referral, Notification & Reporting

Notifications • Each of the child’s teachers • Person responsible for school’s special education services T3 Referral, Notification & Reporting

Specific Program Documentation • Class Screening Results • Hearing Re-screening List • Individual Hearing Screening Results T3 Referral, Notification & Reporting

Diagnostic and Support Services • Private health insurance plan or HMO • Local health department • School nurse • Audiologist contracted with school district • Audiologist in private practice or on staff of hospital or clinic • AHCCCS • KidsCare • ASDB Regional Cooperative Programs • CCRS T3 Referral, Notification & Reporting

Early Childhood Resources • Parent Outreach Program • Arizona Early Intervention Program • Arizona Council for the Hearing Impaired • ADHS Sensory Program T3 Referral, Notification & Reporting

Hearing Screening Program Report • Enrolled at the time of the first screening • Did not have a first screening • Had a first screening • Did not pass a first screening • Had a second screening • Did not pass the second screening • Were evaluated by an audiologist • Were evaluated by a physician or primary care practitioner • Were first diagnosed as deaf or hard of hearing during the current school year • Were diagnosed as deaf or hard of hearing during a prior school year T3 Referral, Notification & Reporting

ADHS Sensory Program Reported results help the Sensory Program evaluate how successful our state is in identifying children with hearing loss and in providing timely and appropriate educational and medical follow-up and management. T3 Referral, Notification & Reporting

Referral/Notification and Reporting Learning Objectives