10/1/2019 Nebraska Early Hearing Detection & Intervention - - PDF document

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Identifying Infants who are Deaf or Hard of Hearing Early Helps Children Reach Their Full Potential

Nebraska Early Hearing Detection & Intervention (NE-EHDI)

Recharge for Resilience Conference

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Objectives

• BRIEF Overview of NE-EHDI History & Purpose
• Why Newborn Hearing Screening is Important
• Collaboration with Home Visitors & Early Childhood Professionals

Nebraska Early Hearing Detection and Intervention Program

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Nebraska Infant Hearing Act was Passed in 2000

Nebraska Infant Hearing Act: Tasks

 Implement hearing screening as the standard of care for infants  Educate parents  Have birthing facilities and audiologists report data to DHHS  DHHS develop a system to track babies identified as deaf or hard of hearing  Establish and meet guidelines for early intervention referrals  Develop a mechanism for compliance review  Provide an annual report to the legislature  Apply for all available federal funding

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NE-EHDI Mission

The Nebraska Early Hearing Detection and Intervention Program develops, promotes, and supports systems to ensure all newborns in Nebraska receive hearing screenings, family-centered evaluations, and early intervention as appropriate.

NE-EHDI, also known as Newborn Hearing Screening is an unbiased program.

NE-EHDI informs parents of the resources available so they can utilize what is best for their family.

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Why is Newborn Hearing Screening Important?

The earlier, the better! Synaptogenesis – nerve cells (neurons) in the brain forming new connections.

• Research done by the Institute for Learning & Brain

Sciences-University of Washington suggests:

• babies begin to absorb language inside the womb

during the last 10 weeks of pregnancy

• the brain starts to map itself for language and

communication about 30 weeks gestational age

• Before babies are even born, they begin acquiring language.

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Why is Newborn Hearing Screening Important?

• The development of a child’s brain architecture

provides the foundation for all future learning, behavior, and health.

• The basic architecture of the brain is

constructed through an ongoing process that begins before birth and continues into adulthood.

• The early years are the most active period for

establishing neural connections, but new connections can form throughout life and unused connections continue to be pruned.

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Why is Newborn Hearing Screening Important?

Sensory pathways like those for basic vision and hearing are the first to develop, followed by early language skills and higher cognitive functions.

• InBrief: The Science of Early Childhood

Development, Harvard University

The timing is genetic, but early experiences determine whether the circuits are strong or weak. Source: C.A. Nelson (2000). Credit: Center on the Developing Child

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• When left undetected, a hearing loss can delay a child’s speech and

language development as well as his or her thinking, learning, and social skills.

• The earlier children are identified with hearing loss and start receiving

early intervention, the more likely they will stay on track with their hearing peers and reach their full potential.

The earlier, the better!

Why is Newborn Hearing Screening Important?

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EHDI System

• Hearing Screening
• Inpatient
• Outpatient
• Audiological Diagnostic Evaluation
• Early Intervention
• Family Support
• Data tracking and reporting

Joint Committee on Infant Hearing (JCIH) 1-3-6

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Partners in the EHDI Process

• Parents
• Home Visitors and Early Childhood Professionals
• Birthing Facilities
• Audiological Confirmatory Testing Facilities & Tele-audiology
• Primary Care Providers
• Medical Specialists (ENT, genetics, ophthalmology)
• Early Intervention (EDN-Part C, Regional Programs/Schools including Deaf Educators, Early

Head Start, Speech-Language Pathologists, Private Providers)

• Family-to-Family Support (Hands & Voices/Guide By Your Side, PTI-NE)
• Deaf and Hard of Hearing Community

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• Before newborn hearing screening, many times childhood hearing loss was not identified

until 2-1/2 to 3 years of age.

• 2016 CDC Data (most current national data) - 98% of U.S. born infants

have a hearing screening usually before hospital discharge.

• 2005-2018 NE-EHDI Data - Over 99% of Nebraska born infants have a

hearing screening before hospital discharge.

• ~3 children per 1,000 are identified as DHH shortly after birth each year.

Evidence Based Data - Importance of Universal Newborn Hearing Screening

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Comparison – National and Nebraska EHDI 1-3-6 Data

*Most current national data posted by CDC

*US – 2016 NE – 2016

% of babies screened by 1 month of age

94.8% 97.7%

% of babies diagnosed by 3 months of age

75.8% 58.7%

% of babies identified as D/HH - Enrolled in Early Intervention by 6 months of age

67.3% 78.0%

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NE-EHDI 1-3-6 Data for 2016-2018 Birth Years

*Percentages for 2018 “1-3-6” are preliminary data and most likely will change slightly before the final data is reported to CDC 12/16/19.

NE-EHDI Comparison Data for 2016 – 2018 Birth Years NE-EHDI 2016 NE-EHDI 2017 NE-EHDI 2018*

% of babies screened by 1 month of age

98% 98% 97%

% of babies diagnosed by 3 months of age

59% 63% 73%

% of babies identified as D/HH & Enrolled in Early Intervention by 6 months of age

78% 78% 86%

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NE-EHDI Data for 2016-2018 Birth Years

*Percentages for 2018 are preliminary data and most likely will change slightly before the final data is reported to CDC 12/16/19.

NE-EHDI Comparison Data for 2016 – 2018 Birth Years NE-EHDI 2016 NE-EHDI 2017 NE-EHDI 2018*

# of Births

27,116 26,266 25,918

# Identified as D/HH

62 54 58

# Unresponsive after communication with EHDI

23 24 27

# Lost to follow-up (No response to calls/letters from EHDI)

2 2 1

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Collaboration with Home Visitors and Early Childhood Professionals Important part of the EHDI Team to Help EDUCATE

• Share with Pregnant Clients
• Nebraska Newborn Hearing Screening Video – Did you know?

https://www.youtube.com/watch?v=qnWjPJgOLjc#action=share

• FREE NE-EHDI brochure “Can Your Baby Hear”

http://dhhs.ne.gov/Pages/EHDI-Order-Literature.aspx

• CMV information (online video and FREE handouts)

http://dhhs.ne.gov/Pages/EHDI-Order-Literature.aspx

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Collaboration with Home Visitors and Early Childhood Professionals Important part of the EHDI Team to Help EDUCATE

• Share with Clients with children up to age 3 who are identified as DHH
• NE-EHDI Parent Resource Guide

http://dhhs.ne.gov/Pages/EHDI-Parent-Resource-Guide.aspx

• Nebraska Hands & Voices/Guide By Your Side Program
• HearU Nebraska (Children’s Hearing Aid Loaner Bank)
• Parent Training Information – PTI Nebraska

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More Possibilities for Collaboration

• Invite NE-EHDI to present and/or exhibit at conferences, meetings, health fairs
• NEW HRSA EHDI Funding for 4/1/2020 – 3/31/2024 Requirements:
• Expand our capacity to support hearing screening, diagnosis, and enrollment into EI for those

infants who pass a newborn hearing screen but later develop hearing loss up to 3 years of age Required to develop a plan by 3/31/2022 Starting conversations to partner with Early Head Start Other ideas for partners who may be conducting hearing screens during early childhood? Other ideas for collaborations?

E-mail ideas to brenda.coufal@nebraska.gov

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Questions?

brenda.coufal@nebraska.gov http://dhhs.ne.gov/EHDI

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References

Nebraska State Law and State Statutes https://nebraskalegislature.gov/laws/search_range_statute.php?begin_section=71-4734&end_section=71-4744 Joint Committee on Infant Hearing, 2007 Position Statement http://www.jcih.org/posstatemts.htm Ask I-LABS Outreach: How Early Does Learning Begin? – Institute for Learning & Brain Sciences-University of Washington http://ilabs.uw.edu/i-labs-news/ask-i-labs-outreach-how-early-does-learning-begin https://www.washington.edu/news/2013/01/02/while-in-womb-babies-begin-learning-language-from-their-mothers/ First Five Nebraska http://www.firstfivenebraska.org/the-early-years-are-important/infants-toddlers http://www.firstfivenebraska.org/uploads/FFN_Science_of_Success_One-Sheeter_1.3.18.pdf Center on Developing Child, Harvard University https://developingchild.harvard.edu/resources/inbrief-science-of-ecd/ ASHA Newborn Hearing Screening Overview: http://www.asha.org/Practice-Portal/Professional-Issues/Newborn-Hearing-Screening/

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References

National Center for Hearing Assessment and Management (NCHAM) https://infanthearing.org/ehdi-ebook/2019_ebook/12%20Chapter12Audiologists2019.pdf http://www.infanthearing.org/ehdi-ebook/2019_ebook/5%20Chapter5Audiology101%202019.pdf https://www.infanthearing.org/hrsa-webinar/newborn-screening.html National Institutes of Health (NIH) – Newborn Hearing Screening https://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=104 2016 US EHDI Data obtained from CDC EHDI Dashboard https://ehdidash.cdc.gov/IAS/ Sound Beginnings – Facts about Pediatric Hearing Loss http://www.soundbeginnings.org/download/Facts_about_Pediatric_Hearing_Loss.pdf CDC’s Progress in Detecting Infant Hearing Loss https://www.cdc.gov/ncbddd/hearingloss/documents/hearing-factsheet-508.pdf Photos Courtesy of: http://www.jordansochorphotography.com/ http://www.angiemariephotography.net/