August, 2016      

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ECHO Initiative 
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August 30, 2016 
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ECHO Initiative
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 Probes and Tips 

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Tip of the Month
Share Hearing Health Goals and Responsibilities with Health Care Providers

Hearing health is both a medical and an educational issue and children are well served when all providers are able to work together to achieve the best outcomes. With the mutual goal of the earliest possible identification of children who are Deaf or Hard of Hearing, Early Care and Education Providers and Health Care Providers (HCPs) each carry responsibility for navigating the shared intersections of hearing screening and follow-up.  Although there are multiple ways that providers can coordinate activities and responsibilities, the strategies outlined below have proven to work well for many providers across the country. 
Follow-up after newborn hearing screening. Results of the newborn hearing screen, usually recorded by the birth hospital, should be part of a child's health r ecord. Making sure that a child either passed the newborn screen or that  follow-up testing has been done is a responsibility shared by all participants in the child's medical home.  

When children are lost to follow-up from the newborn screen and a
re later enroll ed in Early Head Start (EHS) programs, EHS providers are uniquely positioned to join with the child's HCP, and the State Early Hearing Detection and Intervention (EHDI) Coordinator, to help families overcome barriers and complete the needed rescreen or evaluation.

Families often know and trust EHS program personnel. When EHS staff reinforce the importance of taking the follow-up steps outlined by the EHDI program, parents are likely to respond in a positive way.  In some cases, EHS staff can conduct the recommended follow-up screening.  In other cases, EHS providers can work closely with the HCP to assist families in making, and keeping, an appointment with a pediatric audiologist. When the rescreen or evaluation has
been completed, EHS staff can report outcomes back to the EHDI Program Coordinator and, if needed, can help to connect the family with Early Intervention services.    
Hearing screening in early childhood. Most HCPs do not currently have the equipment needed to screen the hearing of children under 4 years of age. Time constraints during well-child visits also mean that HCPs are pressed to assess many aspects of a child's well being and a hearing screen may not be a priority.

The hearing screening
Young boy being screened recommended in Head Start, and generally carried out by trained EHS staff, thus becomes an important contribution to a young child's medical home profile. Because this is an intersection of shared responsibility with HCPs,
it is important for EHS providers to take the time to
explain to partner HCPs that evidence-based Otoacoustic Emissions (OAE) screening will be conducted by screeners who have been trained to use the equipment following a carefully tested, multi-step protocol. When HCPs understand and support the larger EHS hearing screening program goals and activities, they are better prepared to respond appropriately when individual children are referred for medical evaluation.  
When children do not pass the OAE screening and are referred to an HCP for a medical evaluation, EHS providers should be sure to provide specific information about the child's OAE results , along with a reminder that the purpose of the referral is to evaluate the status of the child's outer and middle ear. In addition to making a referral, EHS staff will also need to obtain the referral results. Again, using a standardized form to record referral outcomes is often helpful. The consultation provided by the HCP then informs EHS about the timing of the the next step in the screening process. 
Finally, if the child still does not pass the OAE Rescreen after medical clearance, the EHS provider and the HCP will again work together to refer the child to a pediatric audiologist for a more comprehensive evaluation and any additional services that may be required to minimize the impact of a hearing loss by maximizing access to language. 
Probe of the Month
How have you successfully navigated shared hearing screening responsibilities with Health Care Providers?

Let us know at:    
And, as always, share with anyone you think would benefit from our resources.     

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Probes and Tips is a newsletter from the ECHO Initiative that provides monthly TIPS

to enhance early childhood hearing screening and follow-up practices and PROBES

 about current activities so we can learn from one another's successes and challenges.