Transcript ECHO`s of EHDI: How periodic early childhood screening is growing

ECHOs of EHDI:
How Periodic Early Childhood
Screening is Growing
William Eiserman, PhD, Lenore Shisler, MS, Terry Foust, AuD - CCC-A,
Randi Winston, AuD - FAAA, Karl White, PhD, Jan Buhrmann, PhD
Why is Periodic Hearing
Screening so Important?
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Despite progress related to newborn hearing screening,
approximately 10% of newborns in the US are not screened at birth, and 30-50% of infants
who do not pass their newborn hearing screening are lost to follow-up.
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Estimated incidence of sensorineural hearing loss in the US triples between birth and the
school-age years, from 1 in 300 to 3 in 300
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Hearing loss can occur at any time in a child’s life. Progressive and late-onset may occur
at any time throughout early childhood
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Approximately 35% of preschool children will have repeated ear infections before 3 years
of age, nearly always resulting in fluctuating conductive hearing loss.
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Without regular, physiologic screening, hearing loss is often impossible to detect.
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Children with unidentified hearing loss are often identified with speech and language
delays, described as having behavioral disorders or learning disabilities
Where is periodic
screening happening?
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Head Start Programs
Health care settings/Well-child visits
Part C / Child find
Community Outreach programs
In 2005, Head Start served
Approximately 968,000 children
 152,000 were under 3 years
 In more than 20,000 centers
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Head Start has
a standing
commitment to
periodic early
hearing screening
All children must receive a hearing screening
within the first 45 days of enrollment
and annually thereafter.
Status of Head Start Hearing
Screening Practices
Most Head Start programs
are relying on outdated
subjective, screening
methods such as hand
clapping, bell ringing, and
parent questionnaires to
screen children 0 – 3 years
of age.
Most Head Start
programs are
unaware that
Otoacoustic
Emissions (OAE)
technology, used with
newborns, can also
be used successfully
in early childhood
settings.
The Hearing Head Start ECHO Project
Purpose:
 update hearing screening
practices for children birth to
three years served by Head Start
programs nationwide through
use of Otoacoustic Emissions
(OAE) technology
 ensure that all children with
hearing health needs receive
timely and appropriate
intervention.
15 States
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Oregon
Washington
Utah
North Carolina
District of Columbia
Nebraska
Kansas
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Colorado
Alaska
Michigan
Arkansas
Connecticut
Illinois
Hawai’i
Missouri
Outcomes
n=4518 children screened
257 (6%) were referred for medical/audiological follow-up
 107 (42%) identified with a hearing loss or disorder requiring
treatment or monitoring
* 7 Permanent hearing loss
* 83 Otitis media
* 2 Occluded PE Tubes
* Excessive earwave or congestion
 52 (20%) normal/no treatment required
 98 (38%) exited program before diagnosis/referral
appointment completed
Early Identification
of Hearing Loss
Introducing…
a multimedia
instructional
package for
health care
providers
Conducting periodical Otoacoustic Emissions
(OAE) hearing screening with infants and
toddlers during well child visits
Helping
Children
Hear
and
Now
Instructional Package
Three-part instructional DVD (22 min)
 Instructional Guide
 Protocol and Documentation Forms
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Content
1 – Overview
 Part 2 - Equipment use and stepby-step demonstration of OAE
screening with infants and toddlers
 Part 3 - Integrating OAE screening
within a larger hearing health
protocol
 Part
Next Steps