1. Reaching Out to Professionals: Workshop Development
Amy Mirizzi, MPH
Donna C. Maselli, RN, MPH
Connecticut Department of Public Health
Hartford, CT

2. Faculty Disclosure Information
In the past 12 months, I have not had a significant financial interest or other relationship with the manufacturer(s) of the product(s) or provider(s) of the service(s) that will be discussed in my presentation.
This presentation will not include discussion of pharmaceuticals or devices that have not been approved by the FDA.

3. Connecticut EHDI Program Components
Department of Public Health
Lead agency for universal newborn hearing screening program
Program development
Tracking & follow-up
Education
Diagnostic Testing Centers
Performs diagnostic test battery
Refers infants to E.I.
Reports to DPH
CT Birth-to-Three System
Lead agency for IDEA, Part C

4. Newborn Hearing Screening Task Force
Meets monthly to discuss issues surrounding EHDI
Interdisciplinary members representative of:
Diagnostic Testing Centers (Audiologists), ENT, Family, Deaf Counselor, Deaf Educator, Hospital Staff, DPH and others from state political and government agencies
Role
Developed ‘Best Practice Standards for Infant Diagnostic Testing’
Assists with the development of educational materials
Participates in trainings of health care providers
Provides technical expertise as needed
Assists in planning and quality improvement

5. Identified Need for Trainings
Target Audiences
Audiologists (Diagnostic Testing Centers)
Birth Hospital staff
Needs assessment
MCHB UNHS new grant initiatives
Task Force members experience in the field
DPH tracking & lost to follow-up rates
Communication with 16 diagnostic testing centers

6. Newborn Hearing Screening Symposium October 26, 2005
Audiology Training
Newborn Hearing Screening Symposium
October 26, 2005

7. Newborn Hearing Screening Symposium
Target Audience
Audiologists working with infants and children
16 diagnostic testing centers
Co-sponsored with University of Connecticut’s Department of Communication Sciences
Approved ASHA CE Provider
0.6 CEUs (Advanced Level: Professional Area)
Full day conference

8. Newborn Hearing Screening Symposium
Objectives:
To increase awareness of appropriate diagnostic procedures and early intervention services.
To enhance knowledge of current topics and initiatives related to childhood hearing loss.
To increase knowledge of medical issues related to congenital, early onset, and progressive hearing loss
To facilitate prompt and accurate diagnosis of hearing loss and referral to EI

9. Speakers & Agenda Topics
Pediatric Audiologist
The Diagnostic Evaluation
Various dx tests and equipment
Task Force recommended battery of tests
Tips on how to improve technique
Pediatric Audiologists
Case Studies in the Diagnostic Process
Learn from shared experiences
Otolaryngologist
The ENT Evaluation

10. Agenda Continued… Geneticist CT AAP Chapter Champion
Benefits of Genetic Testing/When Referrals to Other Specialists are Indicated
Statistics related to genetics and hearing loss
Genetic testing
Syndromic versus non-syndromic hearing loss
Inheritance patterns
Case Studies
Referrals to other Specialists
CT AAP Chapter Champion
Connecting with the Primary Care Provider
Resources for PCP’s
Role of the AAP & PCP in EHDI

11. Agenda… DPH EHDI Staff Past, Present, and Future Initiatives
Program overview
Statistics
Results of PCP survey
Reporting to DPH
Study results “The Lack of EI on Infants with Hearing Loss”

12. Agenda… NE Regional MCHB EHDI Audiologist
Risk Factors for Hearing Loss
JCIH Risk indicators
Importance of timely and appropriate diagnosis of hearing loss
Principles and issues of early intervention and follow-up
State Department of Education Representative
Services for Children with Hearing Loss in the School System
State education statistics related to children with special health care needs
Education-related mandates and policies
IEP vs. IFSP
Section 504 of the Rehabilitation Act

13. Evaluations Feedback on whether participants felt… Objectives were met
Information presented was educational
Presenters were effective
Materials were relevant
Location and meeting space were convenient and functional

14. Evaluation Comments Excellent Symposium
Very informative and worthwhile
Excellent!
Very comprehensive & useful information
Very informative day with excellent speakers
Excellent range of topics within the larger ‘Hearing Impairment’ theme
AAP Web slides difficult to read in handout
Nice job!

15. Are there any topics that you would like to see additional training on?
Would like more training on actual testing procedures: problems, pitfalls, how to overcome these. In talking to a number of the persons in the diagnostic centers, some do not see high volumes of children and do not feel comfortable with diagnosing. More training might reduce the diagnosis time (increase age at diagnosis).
ASSR vs. ABR

16. Outcomes from Hearing Symposium
Recommendations for future trainings shared with University of CT for 2006 upcoming audiology training
DPH staff conducting presentation on EHDI program to audiology students

17. Public Health Initiatives for Newborns November 2, 2005
Hospital Training
Public Health Initiatives for Newborns
November 2, 2005

18. Public Health Initiatives for Newborns
Target Audience
Hospital staff
Well baby nursery and NICU Nurse Managers and nurses
Hospital hearing screening staff
Objectives:
To enhance knowledge of current public health initiatives for newborns.
To reinforce newborn screening purposes, techniques, and reporting practices and requirements, including the importance of monitoring and follow-up of at risk infants.

19. Speakers & Agenda Topics
DPH Breastfeeding Coordinator (WIC)
DPH Breastfeeding Initiatives
Program’s past, present, and future initiatives
Data reporting and collection
Breastfeeding rates by hospital
Medical Director of Cystic Fibrosis Screening Program
Newborn Screening for Cystic Fibrosis
Disease description, including signs and symptoms
Screening rationale and statistics
Benefits of universal screening and early identification

20. Agenda continued…
DPH
The Connecticut Immunization Registry & Tracking System
History of immunizations in CT
Parental consent to be in the registry
Overview and benefits for pediatric practices, parents, and public health
Compliance & incentives to increase reporting

21. Agenda… Newborn Hearing Screening Program
Data Reporting
Enhancements to the internet based reporting system
Newborn Screening: Past, Present, & Future Initiatives
Review of screening, diagnostic, and early intervention process
Genetic components
Laboratory NBS and Birth Defects Registry
PCP & family survey results
Screening methods for NICU babies
Early Intervention Specialty Center Audiologist
Risk Indicators and the Importance of Follow-Up Monitoring
Congenital, early onset, and progressive hearing loss
Validate parental concern

22. Evaluation Comments
Very good review and chance to ask questions, clarify expectations, and enhance practice at hospital level
Very interesting, informative conference – relevant to our practice. Provided combination of new information and reinforcement of current process for NBS – will bring information back to staff
Too much for afternoon session
Enjoyed questions, interactive component
“Risk indicators” basically review of earlier speaker
Appreciated the positive feedback about our efforts in screening
Vents were loud and made it difficult to hear questions/comments from audience
Positive feedback regarding sharing information through case studies
Looking forward to next year’s conference

23. Suggestions Offer nursing CEUs for future conferences
Open conference to other providers, such as:
Pediatricians
Pediatric nurse practitioners
PAs in pediatric offices

24. Are there any topics that you would like to see additional training on?
Hearing Screening:
More info/education about Birth-to-Three (EI), so we can better refer and describe service to our parents
Is there information about hearing and speech in the rainbow packet? (i.e. milestones for parents to watch for?)

25. Are there any topics that you would like to see additional training on?
Lab Screening:
How to talk to parents about uncertain diagnoses (already aware of fact sheets)
PKU “rules” – a map or flow diagram (i.e. if transfused – do this in “x” time period)
Information on blood specimen collection
A talk offering guidance as to expected follow up (as far as repeating NBS heelstick specimens, immediate repeat vs. before discharge, etc.)
Immunization Registry:
More information about entering data into the Immunization Registry in the case of infants hospitalized for 9-12 months after birth (and thus receiving their immunizations as an inpatient)

26. Are there any topics that you would like to see additional training on?
Other:
Follow up on HIV initiatives since implementation of mandatory testing
Continued updates are great (keep current without repeating old information)
Orientation session for new people in hospitals to reporting system and Electronic Vital records System (EVRS) – who will be responsible for data entry
Car seat safety laws

27. Outcomes from Public Health Initiatives Conference
Evidence of collaboration between various MCH programs within DPH
Recommendations for future training needs identified and shared

28. Summary Trainings provided positive benefits for Participants DPH
Networking opportunity
Opportunities to learn from others, develop ideas, ask questions
DPH
Show appreciation for participants dedication to newborns
Share protocol changes and new incentives
Highlight DPH initiatives
Identify topics for future trainings