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

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

3. 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

4. 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

5. 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

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

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

8. 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

9. 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

10. 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

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

12. 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

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

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

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

17. 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

18. 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

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

20. 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

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