Objective: Provide recommendations to audiologists for the management of children with unilateral hearing loss (UHL) and for needed research that can lend further insight into important unanswered questions. Design: An international panel of experts on children with UHL was convened following a day and a half of presentations on the same. The evidence reviewed for this parameter was gathered through webbased literature searches specifically designed for academic and health care resources, recent systematic reviews of literature, and new research presented at the conference that underwent peer review for publication by the time of this writing. Study sample: Expert opinions and electronic databases including Cumulative Index to Nursing and
As universal newborn hearing systems (screening, diagnosis, intervention) are being established around the world, the success of children who are identified to be deaf and hard of hearing is critically impacted by parent's reactions, acceptance, and advocacy for their child. It is imperative for professionals who are creating systems for Early Hearing, Detection, and Intervention to understand and learn from families' experiences in order to improve this process. This manuscript will identify the areas in which parents have spoken out about the professionals they have encountered through the system: what parents wish for in a healthy, productive relationship with professionals; and how parents can play a part in advocating for a system in which families needs are met so that infants identified to be deaf or hard of hearing can reach their full potential.
Although ϳ95% of US newborns are now screened for hearing loss at birth, more than half of those who do not pass the screen lack a documented diagnosis. In an effort to improve the quality of the follow-up process, teams from 8 states participated in a breakthroughseries learning collaborative. Teams were trained in the Model for Improvement, a quality-improvement approach that entails setting clear aims, tracking results, identifying proven or promising change strategies, and the use of small-scale, rapid-cycle plan-do-study-act tests of these changes. Parents acted as equal partners with professionals in guiding system improvement. Teams identified promising change strategies including ensuring the correct identification of the primary care provider before discharge from the birthing hospital; obtaining a second contact number for each family before discharge; "scripting" the message given to families when an infant does not pass the initial screening test; and using a "roadmap for families" as a joint communication tool between parents and professionals to demonstrate each family's location on the "diagnostic journey." A learningcollaborative approach to quality improvement can be applied at a state-system level. Participants reported that the collaborative experience allowed them to move beyond a focus on improving their own service to improving connections between services and viewing themselves as part of a larger system of care. Ongoing quality-improvement efforts will require refinement of measures used to assess improvement, development of valid indicators of system performance, and an active role for families at all levels of system improvement. Pediatrics
Significant progress has been made over the past 2 decades in reducing the age of hearing loss identification. However, many parents in this study experienced challenges that resulted in delays that exceeded Joint Committee on Infant Hearing (2007) recommendations of diagnosis by 3 months of age. The parent-reported experiences provide valuable information about areas that need further investigation to improve the early hearing detection and intervention process for children with hearing loss.
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