Bridging the Gap from the Clinic to the Classroom Ellen Cobler, Au.D., CCC-A Senior Clinical Audiologist at University Hospitals Cleveland Medical Center

Prevalence of Hearing loss in Children according to the CDC and NIDCD 2 to 3 out of every 1,000 children in the United States are born with a detectable hearing loss in one or both ears. 90% of deaf children are born to hearing parents. 5 out of 6 children experience ear infections by the time they are 3 years old. 5 per every 1,000 children age 3-17 years of age parents have reported hearing loss when completing a National Health Interview Survey (NHIS) for children with developmental disabilities. 14.9% of children age 6-19 years of age have low or high frequency hearing loss of at least 16 decibel hearing level in one or both ears. About every 1.4 per 1,000 (1 in 714) children by 8 years of age have bilateral hearing loss of 40 dB or more. 1 in 8 people in the United States (13%) or 30 million aged 12 years or older has hearing loss in both ears, based on standard hearing examinations. Prevalence of Hearing loss in Children according to the CDC and NIDCD

Patient-Centered Care Patient-centered care is a quality of personal, professional, and organizational relationships that promotes excellent care with patient at its core. Helps empower the patient or family to be actively involved in their individual healthcare needs. This model of care has trained physicians and healthcare providers to be more mindful, informative, and empathic. Patient-centered care has transformed our roles that were once characterized by authority to that of goals of partnership and collaboration.

Patient-Centered Care – What does that mean to us? Child Family Educational Audiologist Teachers Counselors Clinical Audiologist SLPs

It seems so simple…so why is it so hard? Finding the child’s clinical audiologist. Getting the Release of Information signed by the family. Getting records or information for the clinic or audiologist. Lack of Time & Deadlines. Heavy Workloads. Limited Resources. Over extending our roles. Advancements in Technology.

Improving Communication & Collaboration with Best-Practices

Finding an clinical pediatric audiologist can be overwhelming Helpful Tips: Narrow your search down to the location the child is followed. Research the list of Clinical Pediatric Audiologists on the Ohio Department of Health’s website for contact information. www.odh.ohio.gov/odhprograms/cmh/infant%20Hearing/Diagnostic- Services.aspx. - Establish a contact at the clinic.

Obtaining and maintaining current releases of information. Helpful Tips: - Follow HIPPA guidelines and know your individual State laws (ORC – 3701.17) - Track and monitor requests. - Make sure your releases are dated, signed, and have not expired. - Always use a secure fax line, secure email address, or U.S. postal services when submitting healthcare data.

Lack of Time, Deadlines, Heavy Workloads, Limited Resources, Over-extending our roles “Doing more with less” the life of an audiologist. Helpful Tips: - Be proactive and keep consistent communication – not just when there are problems. - Work as a team, rely on others to help carry the workload together and to improve resource accessibility. - Use your specialty or role within the team to improve that child’s advantage.

Case Study #1 8 year old female referred from local ENT office for a sedated ABR due to questionable behavioral hearing test results Passed her newborn hearing screening at birth. History of middle ear infections and 2 sets of PE tubes since 3 years old. Failed recent hearing screening at school and at the pediatrician’s office. Concerns for academics at school due to attention. Advanced reader but struggles within the classroom. Socially and behaviorally different from her peers.

LEFT EAR

RIGHT EAR

Diagnosis & Monitoring

Case Study #2 8 year old male history of a mild to moderate sensorineural hearing loss in both ears. Parents wanted to upgrade his hearing aids and connectivity options. Family purchased binaural Phonak Sky V power behind-the-ear hearing aids and Roger 18 integrated receivers. School is using a Roger FM system with Touchscreen transmitter.

Case Study #3 4 year old male failed newborn hearing screening at birth. Follow up diagnostic ABR completed at age 1 month old and indicated a moderate sensorineural hearing loss in both ears. Fitted with binaural Oticon Sensei 13 behind-the-ear hearing aids at 3 months old. Mom struggled with his diagnosis from the beginning. During follow up hearing aid checks patient had poor consistent. Lost to follow up for over 2 years despite our efforts to bring the child back to the clinic (Mom would schedule then cancel or no show to appointments). Behavior concerns and struggling with communication.

Returned to clinic on April 13, 2017 due to lost hearing aids. Will be starting school in Fall 2017. His hearing aids were out of warranty as of January 2017. Prior authorization process with insurance for hearing aids. Release signed to talk and update his Educational Audiologist. Due to concerns a plan was created at school to ensure he is hearing.

Advancements in Technology https://www.phonak.com/us/en/hearing-aids/hearing-aids-for-children/hearing-aids-for-kids.html