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Audiological Services Committee
Contact:
Sherry Weber-Mouton,
Director of Audiological Services
1.
Co-sponsors Needed for Early Hearing Detection and Intervention
Ensure that Young Children with Hearing Loss Have Access to Early Intervention
Services
Please contact your U.S. Senators and urge them to co-sponsor the Early Hearing
Detection and Intervention (EHDI) Act of 2007, S. 1069. This important
legislation would reauthorize EHDI grants to states, which fund state-wide
programs that screen newborns for hearing loss before they leave the hospital.
Additionally, the legislation would expand states' ability to enroll identified
babies in early intervention programs.
http://takeaction.asha.org/asha2/issues/alert/alertid=11249571&PROCESS=Take+Action
2.
Co-Sponsors Needed for Direct Access to Audiologists Legislation
Allow Medicare Beneficiaries to Go Directly to an Audiologist
The "Medicare Hearing Health Care Enhancement Act of 2007" would allow Medicare
beneficiaries the option of going directly to a qualified audiologist for
hearing and balance diagnostic tests without first having to seek a physician
referral.
http://takeaction.asha.org/asha2/issues/alert/?alertid=10549306
3.
Co-Sponsors Needed for the Hearing Aid Assistance Tax Credit
Urge Your Legislators to Co-Sponsor H.R. 2329 and S. 1410
Please ask your Representative and Senators to co-sponsor the Hearing Aid
Assistance Tax Credit Act, H.R. 2329 and S. 1410, respectively. This legislation
would provide a tax credit of up to $500 per hearing aid, once every five years,
for parents purchasing a hearing aid for a dependent child or for persons over
55.
http://takeaction.asha.org/asha2/issues/alert/?alertid=9909731
Year 2007
Position Statement: Principles and Guidelines for Early Hearing Detection and
Intervention Programs
The following
are highlights of updates made since the 2000 JCIH statement:
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Definition of
targeted hearing loss
-
The
definition has been expanded from congenital permanent
bilateral, unilateral sensory, or permanent conductive hearing
loss to include neural hearing loss (eg, "auditory neuropathy/dyssynchrony")
in infants admitted to the NICU.
-
Hearing-screening and -rescreening protocols
-
Separate protocols are recommended for NICU and well-infant
nurseries. NICU infants admitted for more than 5 days are to
have auditory brainstem response (ABR) included as part of their
screening so that neural hearing loss will not be missed.
-
For
infants who do not pass automated ABR testing in the NICU,
referral should be made directly to an audiologist for
rescreening and, when indicated, comprehensive evaluation
including ABR.
-
For
rescreening, a complete screening on both ears is recommended,
even if only 1 ear failed the initial screening.
-
For
readmissions in the first month of life for all infants (NICU or
well infant), when there are conditions associated with
potential hearing loss (eg, hyperbilirubinemia that requires
exchange transfusion or culture-positive sepsis), a repeat
hearing screening is recommended before discharge.
-
Diagnostic
audiology evaluation
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Audiologists with skills and expertise in evaluating newborn and
young infants with hearing loss should provide audiology
diagnostic and auditory habilitation services (selection and
fitting of amplification device).
-
At
least 1 ABR test is recommended as part of a complete audiology
diagnostic evaluation for children younger than 3 years for
confirmation of permanent hearing loss.
-
The
timing and number of hearing reevaluations for children with
risk factors should be customized and individualized depending
on the relative likelihood of a subsequent delayed-onset hearing
loss. Infants who pass the neonatal screening but have a risk
factor should have at least 1 diagnostic audiology assessment by
24 to 30 months of age. Early and more frequent assessment may
be indicated for children with cytomegalovirus (CMV) infection,
syndromes associated with progressive hearing loss,
neurodegenerative disorders, trauma, or culture-positive
postnatal infections associated with sensorineural hearing loss;
for children who have received extracorporeal membrane
oxygenation (ECMO) or chemotherapy; and when there is caregiver
concern or a family history of hearing loss.
-
For
families who elect amplification, infants in whom permanent
hearing loss is diagnosed should be fitted with an amplification
device within 1 month of diagnosis.
-
Medical
evaluation
-
For
infants with confirmed hearing loss, a genetics consultation
should be offered to their families.
-
Every
infant with confirmed hearing loss should be evaluated by an
otolaryngologist who has knowledge of pediatric hearing loss and
have at least 1 examination to assess visual acuity by an
ophthalmologist who is experienced in evaluating infants.
-
The
risk factors for congenital and acquired hearing loss have been
combined in a single list rather than grouped by time of onset.
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Early
intervention
-
All
families of infants with any degree of bilateral or unilateral
permanent hearing loss should be considered eligible for early
intervention services.
-
There
should be recognized central referral points of entry that
ensure specialty services for infants with confirmed hearing
loss.
-
Early
intervention services for infants with confirmed hearing loss
should be provided by professionals who have expertise in
hearing loss, including educators of the deaf, speech-language
pathologists, and audiologists.
-
In
response to a previous emphasis on "natural environments," the
JCIH recommends that both home-based and center-based
intervention options be offered.
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Surveillance
and screening in the medical home
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For
all infants, regular surveillance of developmental milestones,
auditory skills, parental concerns, and middle-ear status should
be performed in the medical home, consistent with the American
Academy of Pediatrics (AAP) pediatric periodicity schedule. All
infants should have an objective standardized screening of
global development with a validated assessment tool at 9, 18,
and 24 to 30 months of age or at any time if the health care
professional or family has concern.
-
Infants who do not pass the speech-language portion of a medical
home global screening or for whom there is a concern regarding
hearing or language should be referred for speech-language
evaluation and audiology assessment.
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Communication
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The
birth hospital, in collaboration with the state EHDI
coordinator, should ensure that the hearing-screening results
are conveyed to the parents and the medical home.
-
Parents should be provided with appropriate follow-up and
resource information, and hospitals should ensure that each
infant is linked to a medical home.
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Information at all stages of the EHDI process is to be
communicated to the family in a culturally sensitive and
understandable format.
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Individual hearing-screening information and audiology
diagnostic and habilitation information should be promptly
transmitted to the medical home and the state EHDI coordinator.
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Families should be made aware of all communication options and
available hearing technologies (presented in an unbiased
manner). Informed family choice and desired outcome guide the
decision-making process.
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Information
infrastructure
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States
should implement data-management and -tracking systems as part
of an integrated child health information system to monitor the
quality of EHDI services and provide recommendations for
improving systems of care.
-
An
effective link between health and education professionals is
needed to ensure successful transition and to determine outcomes
of children with hearing loss for planning and establishing
public health policy.
The entire Year 2007
Statement can be viewed at:
http://www.asha.org/docs/html/PS2007-00281.html
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