SO U N D
MAT T E R S
2015 • ISSUE 2
Audiology Newsletter of the Minnesota Early Hearing Detection & Intervention Program
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Hearing Screening to Diagnosis
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Minnesota’s EHDI System - Progress & Needs
Minnesota continues to make progress toward providing all
babies with access to newborn hearing screening and timely
follow-up. As of December 31, 2014, a snapshot of our
Minnesota EHDI system looks like this:
INITIAL HEARING SCREENING
• REFER rate at hospital discharge = 4.2% [Goal <4%]
• Total infants screened = 98.9% [Goal = 100%]
• Missed / undocumented screens = 0.9% [Goal = 0%]
»» Often due to NICU transfer (49%) and Out-ofHospital births (27%)
OUTPATIENT RESCREENING by 1 month
• Only 61.1% of those (>1800 grams) who receive
outpatient rescreen accomplish that by 1 month
[Goal = 100%]
DIAGNOSIS by 3 months
• Only 58% of those (>1800 grams) with reported
diagnosis complete the process by 3 months [Goal = 100%]
• Minnesota data indicates a 30-50% chance of some
type/degree of confirmed hearing loss in infants
if they do not pass the first outpatient rescreen.
Therefore, 50-80+ infants who were lost to follow-up
in 2014 may have undiagnosed hearing loss.
MDH quality improvement efforts to target areas of
greatest need in 2015 include:
• Work to close the gap on undocumented hearing
screens following NICU transfers
• Improve hospital scheduling of initial follow-up visit
(ideally 1-2 weeks post discharge) after REFER result
at birth
• Increase prompt scheduling of diagnostic ABR after
first outpatient REFER
• Ongoing collaboration/data sharing with midwifery,
primary care, audiology, and otolaryngology communities
regarding EHDI best practices and local needs
LOST TO FOLLOW-UP/DOCUMENTATION
• 37% (175/474) of those who continue to REFER
after discharge [Goal = 0%]
Audiologists can continue to support these efforts
locally by: 1) Ensuring that schedules can accommodate
outpatient rescreen within 1-2 weeks after hospital
discharge, 2) Immediately schedule diagnostic ABR if baby
does not pass the first outpatient rescreen.
did you know?
ECHO Early Childhood Hearing Outreach
The Early Childhood Hearing Outreach (ECHO) initiative is an extension of the National Center for Hearing
Assessment and Management (NCHAM). This national project focuses on extending periodic hearing screening of
young children through age 3, using OAE technology primarily in Early Head Start Programs. Trained regional staff is
available to support local school districts and Early Head Start programs plan and implement appropriate OAE hearing
screening practices and follow-up for this age group. For more information, please contact [email protected]
Tune IN!
Trends in Audiology
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2015 Parent Hearing Aid Management Survey Results
When it comes to hearing aids, parents want your help!
NCHAM surveyed Minnesota parents and identified
information, skills, and training they would like their
audiologist to provide for them at orientation and on an
ongoing basis. View NCHAM’s entire report here! Here
are a few of their most pressing questions.
1. What can my child hear with and without the hearing
aids, and what does my child NOT hear?
2. When should hearing aid settings be checked?
3. How can I help my child hear in background noise?
4. How can I get loaner hearing aids?
5. How can I do a Ling 6 sound check?
6. How do I perform hearing aid maintenance?
7. How can I keep hearing aids on when my child resists?
Parents’ three greatest challenges to hearing aid use
included activities (riding in car, playing outside), child
not wanting to wear aids, and fear of losing or damaging
hearing aids.
Q&A
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Q
A
What services do Local Public Health nurses
provide for children in Minnesota with suspected
or confirmed hearing loss?
LPH nurses make calls to families, medical
providers, and audiologists, helping connect
families with follow-up appointments. Sometimes
they ask providers for reports. They connect
families with local resources and transportation,
and identify eligibility for medical assistance.
By the Numbers
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In 2014, Local Public Health (LPH) Staff in Minnesota:
Assisted 17 children who were considered “lost”
complete diagnosis of their hearing loss
• Made initial referrals to Early Intervention for
42 children who had not been referred by their
audiologist
• Provided 66 families with needed referrals or
information on insurance and financial resources
LPH staff receives yearly updates and training regarding
EHDI best practices. Audiologists are encouraged to
contact Local Public Health staff in their counties for
added support in removing barriers for their patients.
LPH staff can assist families in scheduling follow-up
appointments, address transportation needs, and answer
questions related to available financial resources. Find
your county’s LPH EHDI contact here: http://www.
improveehdi.org/mn/library/files/countykeycontacts.pdf
STAT
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In 2014, MDH notified Local Public Health (LPH)
agencies of 442 children lost to follow-up after newborn
hearing screening and of 243 children with confirmed
hearing loss. Since 2009, MDH partnership with LPH
has contributed to significant improvements in loss to
follow-up (20% in 2009 to 6% in 2014) and to large
increases in knowledge of Part C Early Intervention
enrollment (22% in 2009 to 76% in 2013) once
permanent hearing loss is confirmed.
Have You Heard?
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Ongoing EHDI Collaboration with ENT
Otolaryngologists’ role in delivering a consistent message
to families regarding newborn hearing follow-up is
very important. MDH Newborn Screening Program
recognizes this, and has continued to promote EHDI to
ENT providers throughout the state. With support of
the Newborn Hearing Screening Advisory Committee
representatives (otolaryngologists Dr. Tina Huang,
M.D., Dr. Geoffrey Service, M.D., and ad hoc member
Dr. Abby Meyer, M.D.), EHDI collaboration with ENT
over the last two years has included:
• Development and distribution of EHDI Guidelines
for Otolaryngologists
• Development of a quick reference flow chart, ENT
Guide to the Newborn Hearing Diagnostic Process
• EHDI exhibit table at the annual Minnesota
Academy of Otolaryngology (MAO) meeting and
inclusion of above ENT Guide in attendee packets
• Distribution of MAO member newsletter
highlighting key EHDI priorities
Audiologists can help promote these documents in their
local communities to reach providers who may not be
involved with MAO.
Last Words from the
Advisory Committee
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Meeting highlights...
• Specialized psychological evaluations for deaf, hard of
hearing, or deaf-blind children are available
• Discussion of cCMV (congenital cytomegalovirus)
and emerging screening practices in the U.S.
• New advances in genetic testing for hearing loss
• Updated Guidelines for Universal Newborn Hearing
Screening Programs in the NICU were approved
Next meeting: May 27, 2015
1:00 – 4:00 p.m.
Wilder Foundation
451 Lexington Parkway North
St. Paul, MN 55104
Contact Us:
Newborn Screening Program
601 Robert St N, St Paul, MN 55155
Phone: (800) 664-7772 or (651) 201-5466
Fax: (651) 215-6285
Email: [email protected]
Web: www.health.state.mn.us/newbornscreening
EHDI Website: www.improveehdi.org/mn