Developing JCIH Recommendations on Quality Infant Audiology Services (Q*IAS) National EHDI Conference February 18-21, 2004 Pat Brookhouser, M.D. Brandt Culpepper, Ph.D., CCC-A Judith Gravel, Ph.D., CCC-A

The Joint Committee on Infant Hearing (JCIH) is recognized both nationally and internationally for its role in shaping public health policy with regard to early hearing detection and intervention (EHDI) programs.

First position statement in JCIH advocated for early detection of hearing loss. JCIH Year 2000 Position Statement - provided principles and guidelines for quality EHDI programs along with benchmarks and quality indicators for newborn hearing screening, assessment and intervention.

JCIH 2000 offered broad suggestions regarding the knowledge and skills needed by audiologists providing services to infants and young children.

However, there has been no specific direction offered by a nationally recognized professional group that would assist state EHDI coordinators or primary care physicians in identifying qualified providers of infant audiology services

Contract from Maternal and Child Health Bureau (MCHB/HRSA) –Administered through BTNRH Deliverable: –Develop and ultimately publish strong and comprehensive recommendations on Quality Infant Audiology Services (Q*IAS)

JCIH Q*IAS Recommendations Five project components: complete by August 31, Data collection; 2. Identification of existing models of service delivery;

1. Data Collection Survey of State EHDI system Web searches for additional resources Review of international and national policies, guidelines, and recommendations

Survey of State EHDI Systems One page survey sent to state EHDI coordinators ( and hardcopy) Follow-up (s) to those not responding Phones call to state directors to those not responding to previous efforts

Copies Requested Audiology services survey (when and results) List of infant audiology service providers Assessment protocols Amplification protocols Web site(s), related information

Responses N= 56/56 –50 states, DC, AS, MP, GU, PR, VI –43 - Returned by /fax (2 mailings via and snail mail) –13 responded to follow-up phone calls

U.S. Territories Responding

Has your state surveyed audiologists? N=56

State Survey of Infant Audiology Services Yes Pending No American Samoa Commonwealth N. Mariana Is. Guam Puerto Rico Virgin Islands

List of Infant Audiology Service Providers N=56

List of Infant Audiology Providers Yes Pending No American Samoa Commonwealth N. Mariana Is. Guam Puerto Rico Virgin Islands

Written Assessment Guidelines N=56

Infant Assessment Guidelines Recommended Pending None developed American Samoa Commonwealth N. Mariana Is. Guam Puerto Rico Virgin Islands Mandatory

Written Amplification Guidelines N=55

Infant Amplification Guidelines Existing Pending/Draft No known document American Samoa Commonwealth N. Mariana Is. Guam Puerto Rico Virgin Islands Mandatory

Credentials for Pediatric Audiology Yes Pending No American Samoa Commonwealth N. Mariana Is. Guam Puerto Rico Virgin Islands N=56

Summary YesNoPendingTotal Survey of Audiologists Provider List Assessment Guidelines Amplification Guidelines Credentials for Pediatric Auds 0560

Summary of State-Developed Infant Assessment Documents 38/42 state assessment documents available for inclusion 5 states report documents exist, but not included in the tally

Assessment Information Reviewed Objective Components –Click ABR, frequency-specific ABR, middle ear measures, EOAE, etc. Behavioral Components –BOA, VRA, COR, CPA, etc. Programmatic issues –Report to, minimal requirements Related components –Counseling, referrals, etc.

Summary of State-Developed Amplification Documents 18 * documents available for inclusion 4 states report documents developed 4 states said no, but have info to include 1 draft, but available *2 center-based approach

Amplification Information Reviewed Candidacy Preselection considerations Selection Objective and Behavioral measures Instrumentation

Also available... Examining approaches in other countries: Canada –Ontario Infant Hearing Program (IHP) UK –Newborn Hearing Screening Programme Workbook Australia

JCIH Q*IAS Recommendations Five project components: complete by August 31, Data collection; 2. Identification of existing models of service delivery; 3. Delineation of knowledge, skills, experience, and instrumentation needed to provide quality infant audiology services; 4. Development of models for continuing education; and 5. Recommendations.

Panel Meeting Development of JCIH Recommendations on Quality Infant Audiology Services (Q*IAS) December 12-14, 2003 Panel Meeting Development of JCIH Recommendations on Quality Infant Audiology Services (Q*IAS) December 12-14, 2003 ASHA National Office Supported by the Maternal & Child Health Bureau Contract #03-MCHB-057B-AB

Panel Invited Panel Michael Gorga Patricia Stelmachowicz Barbara Cone-Wesson Mary Pat Moeller Richard Seewald Brandt Culpepper –Judy Widen –Anne Marie Tharpe JCIH Panel Members Yvonne Sininger Christie Yoshinaga- Itano Jack Roush Linda Pippins Patrick Brookhouser Judy Gravel

JCIH Q*IAS Recommendations will address: availability and use of current assessment technologies; timely and appropriate selection, evaluation and monitoring of acoustic amplification and, in some cases, candidacy for cochlear implantation; competency in counseling; awareness of all communication options open to a family of an infant with hearing loss or who is deaf; and, knowledge regarding public health and education laws including eligibility, accessibility and covered services.

Overriding aim - to influence decisions/referrals made by Early Intervention programs at the state and local levels; thereby, leading states to recognize quality providers of infant audiologic services; supporting the development of service delivery models that ensure infants and families receive appropriate services; facilitating the possible development of specialty recognition by professional audiology associations; and, providing guidance to pediatricians who must seek quality audiologic services as they coordinate care of an infant with hearing loss through the medical home.

JCIH will seek approval from the professional organizations represented by the Committee to publish and disseminate the document American Academy of Audiology, American Academy of Pediatrics, American Speech-Language-Hearing Association, American Academy of Otolaryngology – Head and Neck Surgery, Council on the Education of the Deaf Directors of Speech and Hearing Programs in State Health and Welfare Agencies