Identifying Qualified Audiologists for Assessment of Babies National EHDI Conference Atlanta, Georgia Faye P. McCollister, EdD Consulting Audiologist, Professor Emeritus, University of Alabama Fmc901@earthlink.net

Need for Audiologists With Very Specific Skills Pediatric audiology Counseling Team management Intervention with very young children with hearing loss

Qualified Audiology Provider Appropriate state, national credentials Appropriate pediatric experience, with children less than 6 months of age Appropriate diagnostic equipment Interest in providing family-centered audiological management

Status of EHDI Programs : Audiological Diagnosis Equipment and techniques for diagnosis of hearing loss in infants continues to improve State coordinators estimate only 56.1% “receive diagnostic evaluations by 3 months of age

Changes in Population Characteristics Population Served Includes Very Young Children The Population Served has Increased Consumers of Early Intervention Services are Knowledgeable Regarding their Rights and Options Available

Changes in Population Characteristics Delayed Onset Hearing Loss Fluctuating Hearing Loss Progressive Hearing Loss Mild and Unilateral Hearing Loss Identified Early

Multiple Disabilities About 30% of children with hearing loss have multiple disabilities (CADS, Gallaudet) Will require interdisciplinary team management

Change in Use of Risk Indicators: Still Important JCIH risk indicators known to miss 50 % JCIH risk indicators not always evaluated (congenital infections, Conexin 26 gene) Parent report, medical record review can not give complete results However, knowledge of indicators gives opportunity to define etiology, provide better hearing loss management

Congenital CMV Infection Most frequently occurring congenital viral infection in man, herpes virus, 60–80 % adults infected 40,000 babies infected annually 90-95 % asymptomatic; 10 % symptomatic Symp 40.7% have HI = 1,628 Asymp. 7.4 % Have HI = 2,664 Total HI = 4,292 About 35 % of pediatric HI results from CMV

Connexin 26 Protein responsible for intracellular communication (transfer of ions between the hair cells in the cochlea and their support cells) Responsible for 20-30% of congenital hearing loss

Connexin 26 Several different mutations Usually recessive, occasionally dominant Almost always results in hearing loss that is: Congenital Severe-profound Non-progressive Non-syndromic

Vigilant Surveillance Required Estimated that about 16 % of Hearing Loss is Delayed in Onset Educate Parents Educate Primary Care Providers Provide Information on Normal Auditory Development Provide Information of Signs and Symptoms of Hearing Loss

Collaboration AAA ASHA State Licensure Boards State Audiology Associations State Speech and Hearing Organizations

Benefits of Identifying Qualified Audiologists Faster, more accurate diagnosis Decrease number of children lost to follow-up Decrease parental anxiety

Program Evaluation Instruments Audiology Survey Instruments Colorado Wisconsin Utah Arizona Generic Ohio Infanthearing.org

www.infanthearing.org

Survey Development Demographic Information Interest Equipment Individual or facility, confidentiality Interest Want to be included Do not have skills, need training Equipment Sufficient to perform rec. protocols Experience Numbers, ages, sedation, hearing aids ….. Protocols Documented

Survey Development Efficiency/Timeliness Intervals between diagnosis/hearing aid fitting Referral to intervention Tracking/Reporting Referrals made Statistical information Team Management Medical Intervention Parental Support Materials provided

National EHDI Technical Assistance System EHDI Network members located in each of the MCHB regions Information dissemination and training Web site (www.infanthearing.org) Collaboration with other groups and agencies

NCHAM Network Activities Workshops on Pediatric Diagnostic Audiology 6 weeks of on-line preparation 2 day face-to-face workshop 3 month follow-up practicum

Efficient Hearing Screening and Diagnostic Audiological Services…. Brings Better Opportunities To Babies and Young Children With Hearing Loss