Download Campaign for Healthy Hearing in Kids: A Collaborative Partnership

The Campaign for Healthy
Hearing in Kids:
a collaborative partnership
Jennifer Rossi, MS
Jenna Voss, MA, CED
theOmaha Hearing School
Omaha, Nebraska
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.
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
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.
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)
Nebraska Newborn Hearing Screening
2004 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.
Connecting with Collaborative Partners
Connecting with Our Collaborative Partners
Connecting with Our Collaborative Partners
Our Protocol
adapted from Hearing Head Start Early
Childhood Hearing Outreach (ECHO)
Project
 National Center for Hearing
Assessment and Management,
Utah State University
1 – Step Protocol
Verify Parental Consent
Visual Inspection
PASS
Pass Visual Inspection
Refer upon Visual Inspection
Perform OAE Screening
Give/Send Results to Parent
REFER
Give/Send Results to Parent
2 – Step Protocol
Verify Parental Consent
Visual Inspection
Pass Visual Inspection
Refer Upon Visual Inspection
Perform OAE Screening
Give/Send Results to Parent
PASS
REFER
Rescreen (2 Weeks Later)
PASS
REFER
Give/Send Results to Parent
Our Equipment
Maico ERO-SCAN Screening Test System
DPOAE
4 Frequencies (3 required for a PASS)
Remote Probe
Current Status Report (1.18.06)
1800
1600
1400
1200
1000
800
600
400
200
0
1689
1-Step Protocol
911
2-Step Protocol
778
Total
200
200
0
# Screened
# Re-screened
77
106
183
# Referred
Our Challenges
Conveying the importance of timely
follow-up!
Funding for equipment and
administrative cost
Staffing
Scheduling
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!
Is this working?
Participant Comments
“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
“This is a great
service that you provide
for children!”
~director of large daycare
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
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
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.
Contact us
Jennifer Rossi
[email protected]
Jenna Voss
[email protected]
theOmaha
Hearing School
1110 North 66th St.
Omaha, NE 68132
402.558.1546
http://www.oraldeafed.org/schools/omaha/index.html
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.