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Primary Goal

Primary Goal. I - I dentification/Screening 1 month D - D iagnosis/Evaluation 3 months E - E arly Intervention 6 months A - A dditional Assessment(s) L - L inking to (2 days) A - A ppropriate S - S ervices A – A nd 45 days P – P rograms .

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Primary Goal

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  1. Primary Goal • I - Identification/Screening 1 month • D - Diagnosis/Evaluation 3 months • E - Early Intervention 6 months • A - Additional Assessment(s) • L - Linking to (2 days) • A - Appropriate • S - Services • A – And 45 days • P – Programs

  2. Percent of Neonates Screened - 1998 >90% 75-89% 60-74% 40-59% 25-39% 10-24% 5-9% < 5%

  3. Early Hearing Detection and Intervention Progression of States towards Universal Newborn Hearing Screening 50 <5% 6-9% 10-24% 15-39% 40-59% 60-74% 75-89% >90% 40 30 Number of States 20 10 0 1993 1995 1996 1997 1998 1999 2000 Year

  4. Pediatric Evaluations • Use a combination of behavioral and objective tests to obtain frequency-specific, ear-specific, and family/child-specific information • Ensure that referral sources have audiologists and associated professionals with appropriate knowledge and skills to perform pediatric evaluations and that the facility has the necessary instrumentation for the audiologists to obtain the necessary information

  5. Basic Pediatric Auditory Evaluation • Case History and Parental Report • Related Screenings / Referral Information • Age-appropriate Behavioral Assessment Protocols • Objective Assessment Protocols • Integration and Interpretation of Results • Counseling with Family and Professionals • Recommendations • Referrals

  6. Ensuring Appropriate and Timely Diagnosis of Hearing Loss • Develop collaborative efforts of hospitals and community referral sources • Monitor data management, tracking and follow-up procedures • Collect accurate contact information with a back-up (family member, friend, email address, cell phone number, etc.) • Establish a brief time-frame between screening and follow-up measures

  7. Timely Diagnosis (cont.) • Clearly communicate follow-up procedures and schedule appointments with families –if possible, before they leave the facility • Enlist support from medical community (pediatricians, medical home, etc.) • Ensure proper training for all personnel in the EHDI program • Address cultural and diversity issues as applicable for each phase of the EHDI program

  8. Benchmarks (JCIH, 2000) • Newborns screened by 1 month • Infants with hearing loss identified by 3 months • Infants enrolled in family-centered EI by 6 months • Professionals are knowledgeable • Amplification use begins within 1 month of diagnosis • Ongoing audiological management - not to exceed 3 month intervals

  9. Timeframe for Communication • PL 105-17: IDEA • Referral for evaluation must be made to a public agency within 2 working days of identification • IFSP must be developed by a multidisciplinary team within 45 days of receiving the referral • State and local policies and procedures

  10. Using the Team Approach • Developing and identifying professional interactions to ensure that families receive sensitive, timely, seamless service between screening, evaluation and early intervention services. • Communication ACCESS is viewed as the key element for developing successful communication skills.

  11. What do Parents Want? • Early identification of hearing loss • Timely receipt of test results • Professional service and interactions • Information (verbal and written) • Emotional support Summary - Uzcategui & Yoshinaga-Itano & SKI*HI

  12. Parents’ Advice for Professionals • Listen to us! • Be knowledgeable • Be honest • Be professional • Tell us everything Mertens, D. M., Sass-Lehrer, M., & Scott-Olson, K. (2000) Sensitivity in the family-professional relationship: Developmental implications for young deaf and hard of hearing children. In P. Spencer, C. Erting, & M. Marschark (Eds.). The deaf child in the family and at school.

  13. Parents’ Views of Professionals • Professionals have information that parents do not have • Professionals may have biases • Professionals wait until parents are “ready” • Professionals wait until parents ask • Professionals are uncomfortable sharing “bad news” • Professionals may underestimate parents Mertens, D. M., Sass-Lehrer, M. & Scott-Olsen, K. (2000)

  14. Communication w/ Stakeholders • Who? • Families, medical home, involved professionals, state systems • What? • Information! –available/not available, recommendations, referrals, requests • When? • As it’s available, follow-up letters as appropriate, w/in outlined timelines • How? • Person to person, written, as requested

  15. Auditory Brainstem Response ABR BAER BSER BSERA EAP BEAP BERA AABR SABR ABAER Otoacoustic Emissions OAE EOAE SFOAE TEOAE DPOAE COAE TOAE DPE ADP Use Acronyms with Care

  16. EHDI UNHS IFSP WBN NICU IDEA JCAHO PCP HMO DRG CPT AAA AAP ASHA CDC HRSA JCIH MCHB MDNC NCCC NCHAM OSERS RIHAP Acronyms (cont.)

  17. Emerging Trends • Minority populations are increasing • By the year 2020, it is estimated that the minority populations will exceed the white population in the US • The diversity of professionals serving those with hearing loss is limited

  18. General Population vs Audiologists

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