No abstract

No abstract

If all infants were screened for hearing loss using the 2-stage OAE/A-ABR newborn hearing screening protocol currently used in many hospitals, then approximately 23% of those with PHL at approximately 9 months of age would have passed the A-ABR. This happens in part because much of the A-ABR screening equipment in current use was designed to identify infants with moderate or greater hearing loss. Thus, program administrators should be certain that the screening program, equipment, and protocols are designed to identify the type of hearing loss targeted by their program. The results also show the need for continued surveillance of hearing status during childhood.

During the last 20 years, the number of infants evaluated for permanent hearing loss at birth has increased dramatically with universal newborn hearing screening and intervention (UNHSI) programs operating in all US states and many territories. One of the most urgent challenges of UNHSI programs involves loss to follow-up among families whose infants screen positive for hearing loss. We surveyed 55 state and territorial UNHSI programs and conducted site visits with 8 state programs to evaluate progress in reaching program goals and to identify barriers to successful follow-up. We conclude that programs have made great strides in screening infants for hearing loss, but barriers to linking families of infants who do not pass the screening to further follow-up remain. We identified 4 areas in which there were barriers to follow-up (lack of service-system capacity, lack of provider knowledge, challenges to families in obtaining services, and information gaps), as well as successful strategies used by some states to address barriers within each of these areas. We also identified 5 key areas for future program improvements: (1) improving data systems to support surveillance and follow-up activities; (2) ensuring that all infants have a medical home; (3) building capacity beyond identified providers; (4) developing family support services; and (5) promoting the importance of early detection. Pediatrics 2010;126:S19-S27

Pediatricians and other primary care providers recognize the benefits of early detection and intervention for permanent hearing loss in infants. The current system of newborn hearing screening can be enhanced by strengthening the medical community's involvement in the process from screening to follow-up. Physician roles will be supported through the provision of action-oriented resources that educate parents about the importance of follow-up and that prepare professionals to incorporate appropriate surveillance procedures in daily practice.

The importance of identifying congenital hearing loss during the first few months of life has been recognized for almost 60 years. Unfortunately, until more effective newborn hearing screening equipment and procedures were developed in the late 1980s, it was not practical to implement programs for identifying hearing loss during the first few months of life. This paper reviews the activities implemented by the federal government in the last 15 years to promote more effective Early Hearing Detection and Intervention (EHDI) programs, and summarizes legislation passed by states related to universal newborn hearing screening. In surveys conducted in 1998 and 2001, State EHDI Coordinators were asked to rate the degree to which various issues were obstacles to implementing effective EHDI programs. The most serious obstacles are the shortage of qualified pediatric audiologists, inadequate reimbursement for screening and diagnosis, and lack of knowledge among primary health care providers about EHDI issues. Opposition to EHDI programs by hospital administrators was rated substantially lower in 2001 than in 1998. State EHDI Coordinators were also surveyed about how well their EHDI program is addressing issues related to screening, diagnosis, early intervention, linkages to medical home providers, tracking and data management, and family support programs. Although substantial progress has been made, many gaps remain with current EHDI programs.

No abstract

This study sought to determine the effectiveness of telepractice as a method of delivering early intervention services to families of infants and toddlers who are deaf or hard of hearing. A comparison group design was applied to ascertain the child, family, and provider outcomes via telepractice compared with traditional in-person home visits. A total of 48 children and their families, along with 15 providers from 5 early intervention programs, across the country participated. Children in the telepractice group received more intervention, although the number of prescribed sessions was equal across groups. Analyses of covariance demonstrated that children in the telepractice group scored statistically significantly higher than children in the in-person group on the PLS-5 Receptive Language subscale and PLS-5 Total Language standard scores, and the groups scored similarly on other language measures. There were no statistically significant differences between groups in regard to family outcomes of support, knowledge, and community involvement. Analysis of video recordings of telepractice versus in-person home visits resulted in higher scores for provider responsiveness and parent engagement. This study supports the effectiveness of telepractice in delivering early intervention services to families of children who are deaf or hard of hearing. Further research involving randomized trials with larger, more diverse populations is warranted.