Knowledge, Attitudes, and Practices of Physicians about EHDI Systems

Part 13 – Early Intervention for Children with Hearing Loss

In 2012-2013, the Oklahoma Newborn Hearing Screening Program (NHSP)/Early Hearing Detection and Intervention (EHDI) system partnered with the National Center for Hearing Assessment and Management (NCHAM) at Utah State University, Boys Town National Research Hospital, and the University of Oklahoma Health Sciences Center – Department of Communication Sciences and Disorders to conduct a nationwide survey with state specific information to understand what physicians think, know, and feel about newborn hearing screening and follow up. Results from the survey have been analyzed to develop resources for physicians and their patients related to newborn hearing screening/follow up.

According to the American Academy of Pediatrics “Children who are deaf or hard of hearing face a potential developmental emergency and should be identified as quickly as possible so that appropriate intervention services can be started.” National standards set forth by the Center for Disease Control and Prevention (CDC) indicate that all infants should have a “1-3-6” Process: screening by 1 month of age, diagnosis of hearing loss by 3 months of age (if applicable), and entry into early intervention (EI) services by 6 months of age. However, during the survey, only 6.8% of Oklahoma physicians indicated they routinely referred a family of a child with confirmed permanent hearing loss to a child development specialist or early interventionist. A slightly higher portion of physicians, 31.4%, indicated they referred those children to a Speech Language Pathologist. Finally, less than a percent of providers, 0.8%, sent children to an occupational therapist. To assist Oklahoma providers in state and national best practices in the area of early intervention, resources have been provided below.

ASK THE EXPERTS:
Lori Watson & Petra Teel, Deaf Educators/Early Interventionists

Why should children identified with permanent hearing loss be referred to early intervention services?
Early Intervention for children with hearing loss is vitally important for their future success as adults.  As experts in this field, we see firsthand the optimal outcomes when a family starts early in receiving services for their baby with hearing loss.  With early intervention we are now seeing children who are deaf or hard of hearing entering into schools without language delays!  That is amazing and is what we desire for all children; that they have every opportunity to develop their brain and language as early as possible – when the brain is primed for learning language.  Early intervention services can start immediately after a baby is diagnosed with hearing loss.   Oklahoma experts feel strongly about meeting with these families soon after a diagnosis to counsel, support, and educate them in decisions that are ahead.  It is not only national best practice, but necessary that families receive this information from a professional trained in working with families and infants and toddlers with hearing loss who share this information in an unbiased manor.

Who can refer a child for early intervention services? Does the medical home play a role in this process?
Anyone can refer to early intervention services.  SoonerStart, Oklahoma’s early intervention program, is available for families of infants and toddlers with hearing loss throughout the state.  The easiest way to refer a family is to call in the referral to your local SoonerStart office.  (A list of offices and numbers is provided below).  This phone referral takes less than 5 minutes – but the name, DOB, parents name and contact numbers with address will be needed. It is best to refer a family as soon as they receive a diagnosis of hearing loss.  Thankfully, here in Oklahoma, the EHDI process has been very efficient in screening our Oklahoma babies, following-up, and getting a diagnosis within a very small time-frame (faster than most states) making optimal use of these first months of brain development.

In SoonerStart, families have the opportunity to receive all the information on hearing loss and communication and language as well as resources and supports throughout the state.  The earlier we start the better the outcomes for children with hearing loss!

The PCP has an important role in connecting families with essential early intervention services.

To receive a copy of the previous articles in this series, please send an email to NewBornScreen@health.ok.gov

Lori Watson, MS, CED, is the Deaf and Hard of Hearing Regional Consultant serving central and western Oklahoma.  Certified as an early childhood teacher and a teacher of the deaf, Lori has been working for SoonerStart for over eleven years counseling families and providing early intervention services to families with hearing loss in rural and urban Oklahoma.

Petra Teel, MA, CED, LSLS Cert. AVT is the Deaf and Hard of Hearing Regional Consultant serving Tulsa Metro and eastern Oklahoma. Certified as an Educator of the Deaf and as a Listening and Spoken Language Specialist, Petra has been serving families with children who have hearing loss for ten years in early intervention, has been a classroom teacher of the deaf for nine years, and is an adjunct instructor at The University of Tulsa in their Deaf Education Program and Gallaudet University in their Infant, Toddlers, and Families program.