PREFACEThis document is a supplement to the recommendations in the year 2007 position statement of the Joint Committee on Infant Hearing (JCIH) 1 and provides comprehensive guidelines for early hearing detection and intervention (EHDI) programs on establishing strong early intervention (EI) systems with appropriate expertise to meet the needs of children who are deaf or hard of hearing (D/HH).EI services represent the purpose and goal of the entire EHDI process. Screening and confirmation that a child is D/HH are largely meaningless without appropriate, individualized, targeted and high-quality intervention. For the infant or young child who is D/HH to reach his or her full potential, carefully designed individualized intervention must be implemented promptly, utilizing service providers with optimal knowledge and skill levels and providing services on the basis of research, best practices, and proven models.The delivery of EI services is complex and requires individualization to meet the identified needs of the child and family. Because of the diverse needs of the population of children who are D/HH and their families, well-controlled intervention studies are challenging. At this time, few comparative effectiveness studies have been conducted. Randomized controlled trials are particularly difficult for ethical reasons, making it challenging to establish causal links between interventions and outcomes. EI systems must partner with colleagues in research to document what works for children and families and to strengthen the evidence base supporting practices.Despite limitations and gaps in the evidence, the literature does contain research studies in which all children who were D/HH had access to the same well-defined EI service. These studies indicate that positive outcomes are possible, and they provide guidance about key program components that appear to promote these outcomes. This EI services document, drafted by teams of professionals with extensive expertise in EI programs for children who are D/HH and their families, relied on literature searches, existing systematic reviews, and recent professional consensus statements in developing this set of guidelines (eg, refs 2 and 3;
Despite considerable differences in the HUI3 and the QWB scale, we found agreement between the two instruments at the mean, but clinically important differences across a number of measures. The two instruments are likely to yield different estimates of cost-effectiveness ratios, especially for interventions involving mild to moderate hearing loss.
Benefit of the Baha in providing audibility of the speech spectrum for infants and children with bilateral congenital conductive hearing loss has been demonstrated, offering important and timely data supporting third-party reimbursement.
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