1. I HEAR Manitoba (Infant Hearing Early Assessment & Referral) Leanne Gardiner, Au.D. Coordinator- Infant Hearing Screening Program

2. Canadian Statistics In 1999, CASLPA (Canadian Association of Speech-Language Pathologists and Audiologists) made the statement that the prevalence of newborn and infant hearing loss is estimated to range from 1.5 to 6/1000 births. Because 20-30% of hearing-impaired infants will acquire their hearing loss during childhood, a complete screening program needs to be complemented by a system of ongoing surveillance throughout infancy and early childhood (NIH, 1993, Joint Committee on Infant Hearing, 2000) –This will ensure that progressive, late onset and acquired hearing losses are also identified as early as possible.

3. Current status in Canada Canada lags behind Europe and the U.S. where hearing screening for all newborns has been legislated in 38 States (2007). At present provincially mandated Universal Hearing Screening Programs are being implemented in Ontario, New Brunswick, Nova Scotia, P.E.I, and BC.

4. Regional Participation I HEAR Manitoba has been implemented in the Brandon, Assiniboine, and Burntwood RHAs.

5. Brandon/Assiniboine 2006 Totals and Percentages Total Births 1357 Total Tested 1197(88.2%) Passed 1009(84.0%) Referred 188(15.7%) Returned for Rescreen 134(71.3%) Passed 133(99.3%) Referred 1(.007%) Not Tested 160(11.8%) Returned for test 79 (49%) Refused Test 14(1.03%)

6. Victories!!! I HEAR Manitoba has identified 3 babies in the last year and a half with the help of the Winnipeg RHA and the Health Science Centre. One baby presents with multiple disabilities related to a syndrome, the second baby presents with a malformation of the ear which will require surgical rehabilitation. The third baby was officially diagnosed at 5 weeks of age and fit with 2 hearing aids before 6 months of age. He is currently receiving rehabilitation from our Teacher of the Deaf and Hard of Hearing and he is doing extremely well. Note* All 3 babies were identified in the well baby nursery and not in the NICU. If we had only NICU screening, all 3 babies would have been missed.

7. Burntwood RHA 2006 Totals and Percentages Total Births667 Total Tested635(95.2%) Passed510(80.2%) Referred125(19.9%) Returned for Rescreen 74(59%) Passed 69(93%) Referred 5(6.7%) Not Tested 32(4.7%) Returned for test 0(0.00%) Refused Test 4(.006%)

8. Collaboration In 2006, the Manitoba Advisory Committee for Infant Hearing Screening was developed. –The goals of the committee are: Appropriate audiological tests and procedures for screening & Diagnostics Uniform reporting procedures Centralize coordination, tracking, and follow-up provincially Appropriate management of hearing loss and amplification in identified newborns Appropriate counselling support for families Coordination of medical, social, educational, Audiological, and habilitational services Public & Professional educational programs

9. Implications of not having a program………. Not testing babies for hearing loss has enormous costs, both for children, families, and taxpayers. The American Academy of Audiology has tagged the cost of not testing babies for hearing loss at $1,000,000 over a child’s lifetime.

10. Challenges Funding Data Management Resources Getting families to follow through

11. Funding In 2005, the CTI signed an agreement to provide $128,000 in funding to operate the newborn hearing screening program. Equipment funding of $250,000 has been donated by the Lion’s Club 5M hearing committee. Currently, we are relying on each Region to provide staffing resources and equipment supplement funding.

12. Data Management Tracking system limitations –Currently, there is no data base system which will allow us to track infants within each Region or from Region to Region. –A system that tracks with hospitals, Regional Audiology Departments, and intervention programs is essential to cross- check.

13. Resources Continuing ongoing vacancies of Audiologists, Teachers of the Deaf, and Early Interventionists. There is an inadequate number of Audiologists with infant expertise. –More educational opportunities are needed. Physician Support.

14. Lack of Follow-up Getting Families to follow through –Screening Phase- babies born at the hospital with a hearing screening program, but do not return for the recommended outpatient screening. –Diagnostic Phase- Children who refer from the screening process but do not receive diagnostic confirmation. –Intervention Phase- Children diagnosed with a hearing loss, but do not receive intervention.

15. How do we measure up to other provinces? Ontario- $4.7 million start-up, 7$ million annually. British Columbia- $6.3 million annually. Nova Scotia- $1 million annually Alberta- $1 million grant and then it was discontinued. PEI- ? Saskatchewan- Denied Based on recent extensive data from the U.S., direct costs are approximately $35 per baby for the entire program

16. Future Direction We are currently working in conjunction with the Lion’s club to raise more funding for equipment in order to begin implementation in the Central RHA. The ultimate goal would be to follow the lead of the other Provinces and rally for Province wide funding.

17. Questions????