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Hearing Health
in the Medical Home
Hearing Health in the medical home examines how
hearing screening and surveillance and early hearing detection
and intervention can be incorporated into routine primary
care visits.
Screening-
the use of a formal, objective, validated
instrument to determine specific diagnoses.1
Hearing screening within the context of the Medical Home has
become an important nationwide initiative. To work effectively,
links must be established between the birthing hospital, the
state agency overseeing hearing screening efforts, and the
primary care provider so that newborn hearing screening information
is communicated quickly and easily to the physician and the
family. This is closely followed by establishing collaborations
within the community that include: audiology, otolaryngology,
early intervention, genetics, parent-to-parent support groups,
and the deaf community2
Surveillance - a flexible, continuous
process in which knowledgeable professionals perform skilled
observations of children during child health care (in consultation
with families, specialists, child care providers, etc.)
3
Not all congenital hearing loss is present at birth and late
onset progressive hearing loss may be identified subsequently
in children with or without risk factors such as family history
or hyperbilirubinemia. Therefore, ongoing surveillance by
the medical home of speech and language milestones is important
to help identify children with possible hearing loss/impairment.
The Role of the Medical Home:
- Provide parents with information about hearing, speech,
and language milestones
- Identify and aggressively treat middle ear disease
- Provide hearing screening, monitor diagnostic audiological
testing and referral as needed
- Provide ongoing surveillance and referral to appropriate
resources
- Identify and refer for audiologic monitoring infants
who have risk indicators for late-onset hearing loss2
Guidelines for Pediatric Medical Homes
The most important step in universal hearing screening,
diagnosis and intervention is to identify a Medical Home
for every infant. Click
here to view a chart that outlines screenings, evaluations,
and services for each critical developmental milestone.
 A Medical Home for Infants Who are Deaf or Hard of Hearing
Volta Voices, April 2007 Word Document
In the early 1990s, a novel idea began sweeping the nation. The advent of a new generation of screening technologies made it possible to assess newborn babies’ hearing and identify those with congenital hearing loss in the first few months of life. Professionals familiar with early hearing screening technologies and the potential for markedly improved outcomes began advocating for universal newborn hearing screening. Initial results from states that adopted universal screening were encouraging, and the idea gained increasing acceptance. In little more than a decade, dramatic state-by-state adoption has made universal newborn hearing screening the rule rather than the exception.
Early Hearing Detection & Intervention
(EHDI) Programs
State EHDI programs promote universal newborn hearing screening,
develop effective tracking and follow-up as a part of the
public health system, promote appropriate and timely diagnosis
of hearing loss, prompt enrollment in appropriate Early
Intervention, ensure a medical home for all newborns and
strive to eliminate geographic and financial barriers to
service access. Early Intervention (Part C of IDEA) is a
federal grant program that assists states in operating a
comprehensive statewide program of early intervention services
for infants and toddlers with disabilities, ages birth through
age 2 years, and their families. To learn more about the
EHDI Program in your state click
here.
AAP "EHDI Chapter Champions Roster
Each AAP Chapter has identified at least one individual
to serve as the EHDI Chapter Champion. This individual
is responsible for leading and responding to health care
provider concerns regarding newborn hearing screening
in the state.
Web sites/ Organizations
American Academy of Pediatrics Child Health Topics:
www.aap.org/topics.html
Browse through health topics such as: Behavioral
and Mental Health, Community Health, Diseases and Conditions,
Family Health, Healthy Development, Navigating the Health
Care System, Populations with Unique Health Care Needs.
Direct link to Hearing information from the AAP: www.aap.org/healthtopics/visionhearing.cfm
Alexander Graham Bell Association for the Deaf
and Hard of Hearing: www.agbell.org
The Alexander Graham Bell Association for the Deaf and Hard
of Hearing is one of the world's largest membership organizations
and information centers on hearing loss and the auditory
approach.
American Academy of Otolaryngology-Head and Neck Surgery:
www.entnet.org
The Academy represents more than 10,000 otolaryngologist-head
and neck surgeons who diagnose and treat disorders of the
ears, nose, throat and related structures of the head and
neck.
American Online Instant Messenger Relay Service:
Click
here for more information.
AIM Relay Service will let hearing- and speech-disabled
users place relay telephone calls using their AOL Buddy
List or AIM Buddy List feature. The service can be accessed
from any PC or device running AOL services and will be free
for AOL members and Apple Computer's iChat users.
American Society for Deaf Children: www.deafchildren.org
ASDC's primary mission is to advocate for the highest quality
programs and services for parents in making sound and informed
choices to meet their children's educational, communication,
personal and social needs so that they may fully participate
in the global community of the 21st century.
American Speech-Language-Hearing Association: www.asha.org
ASHA's mission is to ensure that all people with speech,
language, and hearing disorders have access to quality services
to help them communicate more effectively.
Boys Town National Research Hospital "My Baby's
Hearing" Program: www.babyhearing.org
Babyhearing.org is brought to you by a team of professionals
at Boys Town National Research Hospital. This team includes
audiologists, speech-language pathologists, teachers of
the deaf, geneticists, doctors and parents of deaf and hard
of hearing children.
Captioned Media Program: www.cfv.org/
Free-loan media (no rental fees) open-captioned (no need
for a decoder). Funded by the US Department of Education
includes prepaid return labels. Deaf and hard of hearing
persons, teachers, parents, and others may borrow materials.
Other services include provision of free captioning information.
Early Hearing Detection and Intervention Program,
Centers for Disease Control and Prevention: www.cdc.gov/ncbddd/ehdi/default.htm
The Centers for Disease Control and Prevention (CDC) EHDI
program:
- Collaborates with federal, national, and state agencies
and organizations in assisting states and territories
to develop and implement EHDI programs.
- Assists states in building EHDI data and surveillance
systems to improve their capacity to ensure that all infants
are screened for hearing loss and receive appropriate
follow-up services.
- Supports research efforts to:
- Identify causes of hearing loss
- Determine developmental outcomes and family issues
- Collect Information on referral rates from EHDI
programs
- Assess the effectiveness and cost of EHDI programs
- Uses information gained through the EHDI surveillance
systems to find new, preventable causes of hearing loss.
- Maintains an information clearinghouse on issues related
to EHDI that will be available through the CDC EHDI web
site and bi-monthly teleconferences.
The Hearing Exchange: www.hearingexchange.com/
If you or your child is hard of hearing or deaf, or you
are a professional who works with children or adults with
hearing loss. The "Hearing Exchange is an online community
for the exchange of ideas and information on hearing loss.
No matter what method of communication you have chosen,
you'll find interesting and supportive information.
International Hearing Society: ihsinfo.org/
IHS advocates and supports the highest standard of professional
competency, business integrity and excellence in serving
the hearing impaired.
Marion Downs National Center for Infant Hearing: www.colorado.edu/slhs/mdnc/
The Marion Downs National Center for Infant Hearing is a
center for the coordination of statewide systems for screening,
diagnosis, and intervention for newborns and infants with
hearing loss.
National Deaf Education Network and Clearinghouse:
www.clerccenter.gallaudet.edu
Info to Go, from the Laurent Clerc National Deaf Education
Center's office of Publications and Information Dissemination
(formerly the National Deaf Education Network and Clearinghouse),
is a centralized source of information on topics dealing
with deafness and hearing loss in children and young people
under 21 years of age. Info to Go responds to a wide range
of questions from the general public, deaf and hard of hearing
people, their families, and professionals who work with
them.
National Association of the Deaf: www.nad.org
The National Association of the Deaf (NAD), established
in 1880, is the oldest and largest constituency organization
safeguarding the accessibility and civil rights of 28 million
deaf and hard of hearing Americans in education, employment,
health care, and telecommunications.
National Center for Hearing Assessment and Management:
www.infanthearing.org
The goal of NCHAM is to ensure that all infants and toddlers
with hearing loss are identified as early as possible and
provided with timely and appropriate audiological, educational,
and medical intervention. NCHAM activities to reach their
goal include:
- Enhancing web site features and expanding their toll-free
telephone technical assistance hours and expertise
- Establishing a National EHDI Assistance Network of
12 expert audiologists to help states in the MCHB regions
where they live implement and refine EHDI programs
- Sponsoring an annual conference to allow states and
programs to share information on all components of effective
EHDI systems
- Reintroducing the Sound Ideas newsletter and producing
three additional EHDI monographs similar to the well-received
UNHS Implementation Guide
National Institute on Deafness and Other Communication
Disorders: www.nidcd.nih.gov
The National Institute on Deafness and Other Communication
Disorders (NIDCD) is one of the Institutes that comprise
the National Institutes of Health (NIH). NIH is the Federal
government's focal point for the support of biomedical research.
NIDCD is mandated to conduct and support biomedical and
behavioral research and research training in the normal
and disordered processes of hearing, balance, smell, taste,
voice, speech, and language. The Institute also conducts
and supports research and research training related to disease
prevention and health promotion; addresses special biomedical
and behavioral problems associated with people who have
communication impairments or disorders; and supports efforts
to create devices which substitute for lost and impaired
sensory and communication function.
National Family Association for Deaf-Blind (NFADB)
http://www.nfadb.org/home.htm
The National Family Association for Deaf-Blind is a non-profit, volunteer-based family association. The organization’s philosophy is that individuals who are deaf-blind are valued members of society and are entitled to the same opportunities and choices as other members of the community. NFADB is the largest national network of families focusing on issues surrounding deaf blindness. Children are considered to be deaf-blind when the combination of their hearing and vision loss causes such severe communication and other developmental and educational needs that they require significant and unique adaptations in their educational programs.
Ski Hi Institute: www.coe.usu.edu/skihi/
The SKI-HI Institute is a group of dedicated individuals
whose goal is to enhance the lives of young children with
special needs and their families. Many programs have been
developed at the SKI-HI Institute for children who are deaf/
hard of hearing, blind/visually impaired, deaf-blind, multi-disabled,
or who have any special needs
Strategies For Teaching Children:
www.as.wvu.edu/~scidis/hearing.html
This site presents accommodation and inclusive strategies
for students with disabilities. Topics include teaching
strategies, learning environments, and assistive/adaptive
technologies. All of the strategies have been found to assist
students with disabilities in their academic pursuits. The
strategies herein have been collected over the last 40 years
primarily from science teachers, special educators, and
by teachers in schools for the deaf and blind.
References
1. Meisels SJ, Provence S. Screening and
Assessment. Guidelines for Identifying Young Disabled and
Developmentally Vulnerable Children and Their Families.
Washington, DC: National Center for Clinical Infant Programs;
1989
2. Childhood
Hearing: A sound foundation in the Medical Home. An
online CME module available through Pedialink. This project
was funded through a cooperative agreement with the National
Center on Birth Defects and Developmental Disabilities at
the Centers for Disease Control and Prevention.
3. Dworkin SM, Shannon A, Dworkin
P. ChildServ Curriculum. Hartford, CT: Center for Children's
Health and Development, St Francis Hospital and Medical
Center;1999
Last Updated
August 13, 2008
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