Hearing and Vision Screening Who, When, and Why

1. Hearing and Vision ScreeningWho, When, and Why

2. Hearing & Vision • For the newborn, hearing his/her parents voices started as a fetus in the uterus. After birth, the newborn now gets to put a face on those familiar voices. • This is where the communication initiates. • It all starts at the top.

3. Hearing & Vision • Who receives Hearing & Vision Screening? • When do children receive Hearing & Vision Screenings? • Why do children receive Hearing & Vision Screenings?

4. WHO • NEWBORNS • On January 1, 2003 the universal newborn screening for hearing loss program began in Illinois. The goals of the program include detection of hearing loss in infants before 3 months of age and the initiation of appropriate intervention no later than 6 months of age.

5. State Programs • States have taken a variety of approaches to address this issue: some mandate that all hospitals or birthing centers screen infants for hearing loss before they are discharged; some mandate that insurance policies cover the cost of the screening; others use state dollars to fund screening programs. 

6. THE ILLINOIS NEWBORN HEARING PROGRAM • IDPH is charged with maintaining a registry of infants in need of follow-up. In addition, IDPH is required to refer children with confirmed hearing losses for services to minimize problems caused by the impairment. • For further information about the Illinois Newborn Hearing Program, contact the IDPH Newborn Hearing Program team at (voice) 217-782-4733 or (TTY) 800-547-0466.

7. THE ILLINOIS NEWBORN HEARING PROGRAM • The Illinois Newborn Hearing Screening Program maintains the registry of infants in need of follow-up testing through three stages: • Screening; • Audiologicevaluation of those with an abnormal result (confirmation); and • Early intervention for those with confirmed hearing impairment

8. Who • In addition to newborn screenings routine screenings are also required.

9. Who • According to the IDPH Vision and Hearing Screening Codes (77 Ill. Adm. Code 675 and 685), vision and hearing screening services "shall be provided annually for all preschool children three years of age or older in any public or private educational program or licensed child care facility."

10. WHO • Department of Children Services also require routine hearing and vision screenings. • Part 407.310, Health Requirements for Children:  "D). The center shall ensure that hearing and vision screening services are provided annually in accordance with Illinois Department of Public Health’s Hearing and Vision Screening Codes (77 Ill. Adm. Code 675 and 685) and the Illinois Child Vision and Hearing Test Act (410 ILCS 205)."

11. Who • Can perform hearing and vision screenings: • Certification by the State of Illinois as a licensed Vision Screening Technician and Hearing Screening Technician is required for individuals performing hearing and vision screenings.

12. When • According to both DCFS and Illinois Department of Public health, screenings are to be obtained annually.

13. Hearing & Vision • As the infant grows his/her body systems grow and develop. • Hearing and vision interventions are required for the infants and children to reach developmental milestones. • It is of utmost importance that with hearing and vision screenings infants and children can successfully grow and develop.

14. WHY • The first three years of life are the most important for language and speech development. • Consequently, for many infants and young children with unidentified hearing impairment, much of the crucial period for language and speech development may be lost. • This in turn leads to lower reading abilities, poorer academic achievement and fewer career opportunities (Task Force on Newborn and Infant Hearing).

15. State ProgramsWith early intervention in mind, states have taken action to ensure children are screened and treated early for hearing loss.  Screening programs are typically cost-effective.

16. WHY • According to the American Academy of Pediatrics, hearing loss is one of the most frequently occurring birth defects; approximately 3 infants per 1,000 are born with moderate, profound or severe hearing loss.  Hearing loss is even more common in infants admitted to intensive care units at birth. 

17. Why • According to the Centers for Disease Control and Prevention, of the nearly 4 million infants born in the United States in 2005, 91.5 percent were screened for hearing loss.  States have taken a variety of approaches to this issue: some mandate that all hospitals or birthing centers screen infants for hearing loss before they are discharged; some mandate that insurance policies cover the cost of the screening; others use state dollars to fund screening programs.  Still other states require that information on hearing screening be available to parents before they leave the hospital.  Fourteen states allow newborns to be exempt from universal hearing screening programs if a parent objects to the testing.

18. Why • If hearing loss is not detected and treated early, it can impede speech, language and cognitive development.  Over time, such a delay can lead to significant educational costs and learning difficulties. 

19. Why • With early intervention in mind, states have taken action to ensure children are screened and treated early for hearing loss.  • Screening programs are typically cost-effective and amount to about $10-$50 per baby, according to NCHAM. National Center for Hearing Assessment and Management

20. Why • The National Center for Hearing Assessment and Management (NCHAM) reports that detecting and treating hearing loss at birth for one child saves $400,000 in special education costs by the time that child graduates from high school.

21. State Programs • The hospital are required to maintain written documentation in the infant’s clinical record. • Such documentation shall include: • Procedures used for hearing screening • Time and location for the screening • Individual administering the screening test • Screening results per ear, for each and every screening or screening attempt and recommendations for further testing.

22. State Programs • Vision and hearing screening services shall be administered to all children as early as possible, but no later than their first year in any public or private education program, licensed day care center or residential facility for handicapped children; and periodically thereafter, to identify those children with vision or hearing impairments or both so that such conditions can be managed or treated. 410 ILCS 205/3)

23. How the Ear Works • A baby's hearing, is fully mature by the end of his first month outside the womb. • Hearing system is based solely on physical movement. • Your ears are one of the most incredible parts of your body!

24. Hearing • To hear sound, your ear has to do three basic things: • Direct the sound waves into the hearing part of the ear • Sense the fluctuations in air pressure • Translate these fluctuations into an electrical signal that your brain can understand

25. The Ear

26. The Ear Pinna/Outer Ear Sound Waves • The outer structure of the ear. • Funnel and focus sound waves on their way to the middle ear and auditory canal.

27. The Ear Middle Ear • The middle ear contains the auditory canal/ ear drum

28. The Ear Inner Ear • The inner ear functions for purposes of equilibrium

29. Infections of The Ear • An ear infection, or otitis media, is the most common cause of earaches. • Can affect children and adults.

30. Infections of The Ear • It very often accompanies a common cold, the flu, or other types of respiratory infections. This is because the middle ear is connected to the upper respiratory tract by a tiny channel known as the eustachian tube. • Germs that are growing in the nose or sinus cavities can climb up the eustachian tube and enter the middle ear to start growing.

31. Infections of The Ear • In children and infants, the eustachian tube is often too soft or immature and has a harder time staying open. • Allergies, post nasal drainage, sinus infections, and adenoid problems can all interfere with the eustachian tube’s ability to let air pass into the middle ear. 

32. Infections of The Ear • When the doctor looks at the ear drum, he or she will see that it is red, often bulging, and be able to make the diagnosis of an ear infection. 

33. Infections of The Ear • Ear infections occur in various patterns. A single, isolated case is called an acute ear infection (acute otitis media). • If the condition clears up but comes back as many as three times in a six-month period (or four times in a single year), the person is said to have recurrent ear infections (recurrent acute otitis media).

34. Infections of The Ear • Recurrent acute otitis media usually indicates the eustachian tube isn't working well. • A fluid buildup in the middle ear without infection is a condition where fluid stays in the ear because it is not well ventilated, but germs have not started to grow.

35. Infections of The Ear In recent years, scientists have identified the characteristics of people most likely to suffer recurrent middle ear infections:  • Males • Individuals with a family history of ear infections • Babies who are bottle-fed (breastfed babies get fewer ear infections) • Children in day care centers • People living in households with tobacco smokers • People with abnormalities of the palate, such as a cleft palate • People with poor or damaged immune systems or chronic respiratory diseases such as cystic fibrosis and asthma

36. Complications of Ear infections • Chronic or recurrent middle ear infections can have long-term complications. These include scarring of the eardrum with hearing loss, speech and language developmental problems, and meningitis.

37. Complications of Ear infections • A hearing test may be needed if you child suffers from chronic or frequent ear infections.

38. Ear Tubes • If your child has recurrent ear infections or fluid that just won’t go away, hearing loss and a delay in speech may be a real concern. One solution is for your doctor to insert small tubes through the eardrum.

39. Ear Tubes • Ear tubes let fluid drain out of the middle ear and prevent fluid from building back up. This can decrease pressure and pain, while restoring hearing. The tubes are usually left in for 8 to 18 months and most often fall out on their own.

40. Preventing Ear Infections • The biggest cause of ear infections is the common cold, so one strategy for prevention is to keep cold viruses at bay. The most effective way to do this is frequent and meticulous hand washing.

41. Preventing Ear Infections • Other lines of defense against ear infections include avoiding secondhand smoke, vaccinating your children, and breastfeeding your baby for at least six months.

42. Allergies and Ear Infections • Like colds, allergies can irritate the Eustachian tubes and contribute to middle ear infections. Getting allergies under control can help reduce the risk of ear infections.

43. Eyes • Communication Starts at The Top

44. Eyes • As any mom will tell you, a newborn baby always looks at the face of the person holding them. • The baby will stare and not make a sound as if he or she is studying the object in front of them.

45. Eyes • Newborns have all the eye structures necessary to see when they are born, still a newborn has to learn how to utilize his/her eyes. • Development of vision begin at birth.

46. Eyes • While your newborn's eyes are physically capable of seeing just fine at birth, his brain isn't ready to process all that visual information, so things are not clear, they are fuzzy for a while.

47. Eyes • As the newborn’s brain develops, so does his/her ability to see clearly, giving him/her the tools he/she needs to understand and manage his/her environment.

48. Eyes • Babies spend much of their early weeks and months of life developing skills such as focusing, teaming their eye movements, recognizing depth, developing eye-hand coordination, and making spatial judgments.

49. Eyes • As the child grows, more complex skills are developed, such as visual perception and visual motor integration. • These skills are needed to meet the child’s growing need to understand and interpret their world.  

50. Eye Anatomy