Download Sound Matters Newsletter - 2015 Issue 4 (PDF)

SO U N D
MAT T E R S
2015 • ISSUE 4
Audiology Newsletter of the Minnesota Early Hearing Detection & Intervention Program
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Unilateral hearing loss
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New research on language outcomes
A multi-state research project is providing new
information about Language Outcomes of Children with
Unilateral Hearing Loss. With the support of fourteen
participating state EHDI programs, the National Early
Childhood Assessment Project (Sedey et.al) summarized
characteristics of 132 children with unilateral hearing
loss, reviewed language outcome data, and hoped to
identify characteristics of children with more successful
language outcomes.
Characteristics of the total study population included:
• 79% of children were identified by 3 months
• Just over half were utilizing amplification
Assessment was completed on one to five occasions,
and assessment tools included the Minnesota Child
Development Inventory, and the MacArther-Bates
Communicative Development Inventory. Data showed:
• 25% to 35% of participants demonstrated delayed
language
• Language delays were evident as early as 2 years of age
• No identifiable factors associated with language delays
(including degree of loss or use of amplification)
Current data (study is ongoing) suggests that children
with unilateral hearing loss should have language reevaluated again just after age 2, so that evidence based
decisions can be made regarding care delivery and early
intervention.
Another recent publication in Pediatrics, “Asymmetric
Hearing During Development: The Aural Preference
Syndrome and Treatment Options,” highlights that
single sided deafness in early childhood reorganizes the
auditory pathway toward the hearing ear, weakening
central representation of the deaf ear. Providing early
and effective stimulation with hearing aid or cochlear
implant plays a large role in securing the auditory
system’s potential for binaural/spatial hearing.
did you know?
Unilateral hearing loss and amplification
During 2014, reports from audiologists for newly diagnosed children in Minnesota with unilateral hearing loss showed:
• 42% were fit with amplification
• 8% declined amplification at the time of diagnosis
• 23% did not have amplification recommended at the time of diagnosis
• 27% had unknown plan regarding amplification (e.g. status not reported, testing in process, family undecided)
Tune IN!
Trends in Audiology
STAT
Timeliness of amplification following diagnosis
About 2/3 of Minnesota children are enrolled in Part
C within 2 months of diagnosis. This number has
remained relatively stable over time. Audiologists have
helped by making consistent and direct referrals to
Help Me Grow, Minnesota’s Part C program, soon after
diagnosis. Per federal law (Department of Education, 34
CFR Part 303), referrals should be made within 7 days.
• • • • •
• • • • •
Timeliness to early intervention (Part C)
Minnesota’s EHDI goal is to fit children with
amplification by one month following diagnosis. Data
reported by audiologists for 2014 show one-third of
Minnesota children were fit with amplification by one
month following diagnosis, and another 39% were fit by
2 months after diagnosis. Thank you for your continuing
efforts to streamline your processes in order to help
Minnesota children access devices earlier!
Timeliness of Amplification Fitting
*includes children with bilateral hearing loss who did not decline
For children with permanent hearing loss, MDH
contacts each child’s primary care provider to provide
just-in-time information about childhood hearing loss
and recommend referrals to medical specialties. Data
from 2014 suggest that most children see ENT (87%),
but a significant number are still not being referred
to genetics (36% evaluated) and ophthalmology
(41% evaluated). Audiologists can help by counseling
parents about the importance of specialty evaluations,
recommending specialty evaluations in reports to
primary care, and facilitate scheduling when possible.
34%
15%
5%
≤1
2
3
2%
3%
2%
5
6
>6
4
Months from diagnosis to fitting
Q&A
• • • • •
Q
A
• • • • •
Referrals to medical specialties
39%
% of
children
By the Numbers
Percent referred,
Medical Specialty
Percent Evaluated
unknown if
Percent declined
Percent not referred
1%
2%
evaluated
ENT
87%
10%
Referrals to Medical Specialties
Genetic
36%
11%
10%
43%
Ophthalmology
41%
9%
6%
44%
2%
10%
How soon are infants contacted for parent-toparent support?
Minnesota Hands and Voices is able to contact
about 90% of families referred to them. In 2014,
46% of families were contacted within one month
of diagnosis; up from 21% contacted within one
month of diagnosis 2012. This was a significant
increase from 2012 made through collaborative
efforts. Audiologists are key to connecting families
with parent support and can improve these timely
connections even more by increasing the number
of direct referrals.
1%
100%
87%
0%
Not referred
Evaluated
ENT
Declined
43%
44%
10%
11%
6%
9%
36%
41%
Genetics
Ophth.
Referred, unknown if evaluated
Have You Heard?
• • • • •
Improving outcomes for children with mild bilateral
hearing loss
Children with mild hearing loss may seem to hear
sounds and conversation. They may have passed a
hearing screening or have no audible delay in speech
articulation. When audiologists recommend hearing
aids, parents may question the fitting if they do not
observe a big difference.
A new article in JSLHR by Walker, et al, “The Influence
of Hearing Aid Use on Outcomes of Children with
Mild Hearing Loss” gives audiologists more evidence
to show parents why consistent hearing aid use is
important. Authors studied 5-7 year-olds, separated
into groups based on hearing aid use ranging from
full-time to non-use. They investigated effects of
cumulative auditory experience (audibility, hearing aid
use, and input over time) and found that consistent
hearing aid use was a significant predictor of expressive
morphosyntax(grammar), receptive vocabulary, and
phonological awareness – high level cognitive tasks not
routinely measured by audiologists. Children with mild
hearing loss who were non-users of hearing aids were at
risk for delays in these areas.
Typical validation tools like speech perception in noise
or speech articulation improvements may not show large
improvements for children with mild hearing loss. This
new evidence may help parents persevere with device use
knowing they are supporting their child’s higher level
cognitive and language outcomes.
Last Words from the
Advisory Committee
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Meeting highlights...
• Update on the MN Deaf Mentor Program
• Minnesota Department of Education 2015 legislative
report on outcomes for “Students who are Deaf or
Hard of Hearing in Minnesota” is now available
• Minnesota EHDI 2014 Annual Report review
Next meeting: Contact Us:
Newborn Screening Program
601 Robert St N, St Paul, MN 55155
Phone: (800) 664-7772 or (651) 201-5466
Fax: (651) 215-6285
Email: [email protected]
Web: www.health.state.mn.us/newbornscreening
EHDI Website: www.improveehdi.org/mn
November 4, 2015
1:00 – 4:00 p.m.
Wilder Foundation
451 Lexington Parkway North
St. Paul, MN 55104