1. Primary Goal I - Identification/Screening1 month D - Diagnosis/Evaluation3 months E - Early Intervention6 months A - Additional Assessment(s) L - Linking to (2 days) A - Appropriate S - Services A – And45 days P – Programs

6. Percent of Neonates Screened - 1998 >90% 75-89% 60-74% 40-59% 25-39% 10-24% 5-9% < 5%

9. Early Hearing Detection and Intervention Progression of States towards Universal Newborn Hearing Screening 1993199519961997199819992000 Year 0 10 20 30 40 50 Number of States <5%6-9%10-24%15-39% 40-59%60-74%75-89%>90%

12. Pediatric Evaluations Use a combination of behavioral and objective tests to obtain frequency-specific, ear-specific, and family/child-specific information Ensure that referral sources have audiologists and associated professionals with appropriate knowledge and skills to perform pediatric evaluations and that the facility has the necessary instrumentation for the audiologists to obtain the necessary information

13. Basic Pediatric Auditory Evaluation Case History and Parental Report Related Screenings / Referral Information Age-appropriate Behavioral Assessment Protocols Objective Assessment Protocols Integration and Interpretation of Results Counseling with Family and Professionals Recommendations Referrals

14. Ensuring Appropriate and Timely Diagnosis of Hearing Loss Develop collaborative efforts of hospitals and community referral sources Monitor data management, tracking and follow-up procedures Collect accurate contact information with a back- up (family member, friend, email address, cell phone number, etc.) Establish a brief time-frame between screening and follow-up measures

15. Timely Diagnosis (cont.) Clearly communicate follow-up procedures and schedule appointments with families –if possible, before they leave the facility Enlist support from medical community (pediatricians, medical home, etc.) Ensure proper training for all personnel in the EHDI program Address cultural and diversity issues as applicable for each phase of the EHDI program

16. Benchmarks (JCIH, 2000) Newborns screened by 1 month Infants with hearing loss identified by 3 months Infants enrolled in family-centered EI by 6 months Professionals are knowledgeable Amplification use begins within 1 month of diagnosis Ongoing audiological management - not to exceed 3 month intervals

17. Timeframe for Communication PL 105-17: IDEA –Referral for evaluation must be made to a public agency within 2 working days of identification –IFSP must be developed by a multidisciplinary team within 45 days of receiving the referral State and local policies and procedures

18. Using the Team Approach Developing and identifying professional interactions to ensure that families receive sensitive, timely, seamless service between screening, evaluation and early intervention services. Communication ACCESS is viewed as the key element for developing successful communication skills.

20. What do Parents Want? Early identification of hearing loss Timely receipt of test results Professional service and interactions Information (verbal and written) Emotional support Summary - Uzcategui & Yoshinaga-Itano & SKI*HI

21. Parents Advice for Professionals Listen to us! Be knowledgeable Be honest Be professional Tell us everything Mertens, D. M., Sass-Lehrer, M., & Scott-Olson, K. (2000) Sensitivity in the family-professional relationship: Developmental implications for young deaf and hard of hearing children. In P. Spencer, C. Erting, & M. Marschark (Eds.). The deaf child in the family and at school.

22. Parents Views of Professionals Professionals have information that parents do not have Professionals may have biases Professionals wait until parents are ready Professionals wait until parents ask Professionals are uncomfortable sharing bad news Professionals may underestimate parents Mertens, D. M., Sass-Lehrer, M. & Scott-Olsen, K. (2000)

23. Communication w/ Stakeholders Who? –Families, medical home, involved professionals, state systems What? –Information! –available/not available, recommendations, referrals, requests When? –As its available, follow-up letters as appropriate, w/in outlined timelines How? –Person to person, written, as requested

24. Use Acronyms with Care Auditory Brainstem Response –ABR –BAER –BSER –BSERA –EAP –BEAP –BERA –AABR –SABR –ABAER Otoacoustic Emissions –OAE –EOAE –SFOAE –TEOAE –DPOAE –COAE –TOAE –DPE –ADP

25. Acronyms (cont.) EHDI UNHS IFSP WBN NICU IDEA JCAHO PCP HMO DRG CPT AAA AAP ASHA CDC HRSA JCIH MCHB MDNC NCCC NCHAM OSERS RIHAP

26. Emerging Trends Minority populations are increasing By the year 2020, it is estimated that the minority populations will exceed the white population in the US The diversity of professionals serving those with hearing loss is limited

27. General Population vs Audiologists