the campaign for healthy hearing in kids: a collaborative partnership jennifer rossi, ms jenna voss,...

The Campaign for Healthy Hearing in Kids:a collaborative

partnershipJennifer Rossi, MS

Jenna Voss, MA, CEDtheOmaha 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 Screening2004 Annual Report5 26,485 births25,966 newborns screened at birth918 newborns did not pass158 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

PASS REFER

Give/Send Results to Parent

Perform OAE Screening

Pass Visual Inspection

Give/Send Results to Parent

Refer upon Visual Inspection

Visual Inspection

2 – Step Protocol

PASS

PASS

Give/Send Results to Parent

REFER

Rescreen (2 Weeks Later)

REFER

Perform OAE Screening

Pass Visual Inspection

Give/Send Results to Parent

Refer Upon Visual Inspection

Visual Inspection

Verify Parental Consent

Our Equipment

Maico ERO-SCAN Screening Test System DPOAE 4 Frequencies (3 required for a PASS) Remote Probe

Current Status Report (1.18.06)

0

778

77

200

911

106183200

1689

020040060080010001200140016001800

# Screened # Re-screened # Referred

1-Step Protocol

2-Step Protocol

Total

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 jrossi@hearingschool.org

Jenna Voss jvoss@hearingschool.org

theOmaha Hearing School1110 North 66th St.Omaha, NE 68132

402.558.1546http://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.