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Early Hearing Detection and Intervention in the Year 2000

Early Hearing Detection and Intervention in the Year 2000. Number of Hospitals Doing Universal Newborn Hearing Screening. Number of Programs. Why is Early Identification of Hearing Loss so Important?. Congenital hearing loss interferes with the most basic human need to communicate with others.

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Early Hearing Detection and Intervention in the Year 2000

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  1. Early Hearing Detection and Interventionin theYear 2000

  2. Number of Hospitals Doing Universal Newborn Hearing Screening Number of Programs

  3. Why is Early Identification of Hearing Loss so Important? • Congenital hearing loss interferes with the most basic human need to communicate with others

  4. "Blindness separates people from things. Deafness separates people from people." --- Helen Keller

  5. Why is Early Identification of Hearing Loss so Important? • Congenital hearing loss interferes with the most basic human need to communicate with others • Hearing loss is the most frequent birth defect

  6. Reported Prevalence Rates of Bilateral Permanent Childhood Hearing Loss (PCHL) in Population-based Studies 4.0 3.5 12 3.0 2.5 8 Prevalence per 1,000 9 2.0 3 4 1.5 5 7 2 1.0 11 10 .5 1 6 0 20 25 30 35 40 45 50 55 60 65 dB Threshold Level (loss criterion) 1. Barr (1980), n = 65,000 7. Parving (1985), n = 82,265 2. Downs (1978), n = 10,726 8. Sehlin et al. (1990), n = 63,463 3. Feinmesser et al. (1986), n = 62,000 9. Sorri & Rantakallio (1985), n = 11,780 4. Fitzland (1985), n = 30,890 10. Davis & Wood (1992), n = 29,317 5. Kankkunen (1982), n = 31,280 11. Fortnum et al. (1996), n = 552,558 6. Martin (1982), n = 4,126,268 12. Watkin et al. (1990), n = 51,250

  7. Percentage of Sensorineural Hearing Losses Which Are Unilateral # of Hearing Impaired Author (year) Children in Sample % Unilateral 1307 48% Kinney (1953) 1829 37% Brookhauser, Worthington & Kelly (1991) 171 35% Watkin, Baldwin, & Laoide (1990)

  8. Incidence per 10,000 of Congenital Defects/Diseases

  9. Why is Early Identification of Hearing Loss so Important? • Congenital hearing loss interferes with the most basic human need to communicate with others • Hearing loss is the most frequent birth defect • Undetected hearing loss has serious negative consequences

  10. Consequences of Hearing Loss Severe/Profound PCHL Losses 2 Mild Bilateral and Unilateral PCHL Losses 2 Fluctuating Conductive Loss 2

  11. Reading Comprehension Scores of Hearing and Deaf Students 10.0 ' Deaf 9.0 , ' Hearing ' 8.0 ' 7.0 ' 6.0 ' Grade Equivalents 5.0 ' 4.0 ' 3.0 ' , , , , , , , 2.0 , , , , 1.0 8 9 10 11 12 13 14 15 16 17 18 Age in Years Schildroth, A.N., & Karchmer, M.A. (1986). Deaf children in America . San Diego: College Hill Press.

  12. Effects of Unilateral Hearing Loss Normal Hearing Unilateral Hearing Loss Math Keller & Bundy (1980) (n = 26; age = 12 yrs) Language Math Peterson (1981) (n = 48; age = 7.5 yrs) Language Social Bess & Thorpe (1984) (n = 50; age = 10 yrs) Math Blair, Peterson & Viehweg (1985) Language (n = 16; age = 7.5 yrs) Math Culbertson & Gilbert (1986) Language (n = 50; age = 10 yrs) Social Average Results 0th 10th 20th 30th 40th 50th 60th Math = 30th percentile Percentile Rank Language = 25th percentile Social = 32nd percentile

  13. Effects of Mild Fluctuating Conductive Hearing Loss Teele, et al., 1990 194 children followed prospectively from 0-7 years. ) Days child had otitis media between 0-3 years assessed during normal visits to physician. ) Data on intellectual ability, school achievement, and language competency individually ) measured at 7 years by "blind" diagnosticians. Results for children with less than 30 days OME were compared to children with more than ) 130 days adjusted for confounding variables. Effect Size for Outcome Measure Less vs. More OME WISC-R Full Scale .62 Metropolitan Achievement Test Math .48 Reading .37 Goldman Fristoe Articulation .43 Teele, D.W., Klein, J.O., Chase, C., Menyuk, P., Rosner, B.A., and the Greater Boston Otitis media Study Group (1990). Otitis media in infancy and intellectual ability, school achievement, speech, and language at age 7 years. The Journal of Infectious Diseases , 162 , 685-694.

  14. Why is Early Identification of Hearing Loss so Important? • Hearing loss is the most frequent birth defect • Undetected hearing loss has serious negative consequences • There are dramatic benefits associated with early identification of hearing loss

  15. Yoshinaga-Itano, et al., 1996 Compared language abilities of hearing-impaired children identified 6 before 6 months of age (n = 46) with similar children identified after 6 months of age (n = 63). All children had bilateral hearing loss ranging from mild to profound, 6 and normally-hearing parents. Language abilities measured by parent report using the Minnesota 6 Child Development Inventory (expressive and comprehension scales) and the MacArthur Communicative Developmental Inventories (vocabulary). Cross-sectional assessment with children categorized in 4 different 6 age groups. Yoshinaga-Itano, C., Sedey, A., Apuzzo, M., Carey, A., Day, D., & Coulter, D. (July 1996). The effect of early identification on the development of deaf and hard-of-hearing infants and toddlers . Paper presented at the Joint Committee on Infant Hearing Meeting, Austin, TX.

  16. Expressive Language Scores for Hearing Impaired Children Identified Before and After 6 Months of Age 35 30 25 Language Age in Months 20 15 10 Identified BEFORE 6 Months 5 Identified AFTER 6 Months 0 13-18 mos 19-24 mos 25-30 mos 31-36 mos (n = 15/8) (n = 12/16) (n = 11/20) (n = 8/19) Chronological Age in Months

  17. Vocabulary Size for Hearing Impaired Children Identified Before and After 6 Months of Age 300 250 200 Vocabulary Size 150 100 Identified BEFORE 6 Months 50 Identified AFTER 6 Months 0 13-18 mos 19-24 mos 25-30 mos 31-36 mos (n = 15/8) (n = 12/16) (n = 11/20) (n = 8/19) Chronological Age in Months

  18. Boys Town National Research Hospital Study of Earlier vs. Later 129 deaf and hard-of-hearing children assessed 2x each year. ) Assessments done by trained diagnostician as normal part of early intervention program. ) 6 Identified <6 mos (n = 25) 5 Identified >6 mos (n = 104) 4 3 Language Age (yrs) 2 1 0 0.8 1.2 1.8 2.2 2.8 3.2 3.8 4.2 4.8 Age (yrs) Moeller, M.P. (1997). Personal communication , moeller@boystown.org

  19. Implementing Effective EHDI Programs out Then a miracle occurs Start Good work, but I think we might need just a little more detail right here.

  20. 3 Status of Universal Newborn Hearing Screening in the United States . Percentage of Births Screened . 90%+ 51 - 90% 21 - 50% 1 - 20%

  21. Tremendous ProgressDuring the Last Decade • Less than 30 with UNHS in 1993; compared with almost 1400 today • Almost 2 million babies are screened every year prior to discharge • 32 states have passed legislation related to newborn hearing screening

  22. The Other Side of the Coin . . . . • 2,700 hospitals are not yet screening for hearing loss • More than 2 million babies are NOT screened every year prior to discharge • Most states who have passed legislation have not yet implemented it • Only 9 states (accounting for 7% of the births) have implemented reasonable state wide programs

  23. Some babies are born listeners . . . Others need your help! www.infanthearing.org

  24. 1. There are resources available to help you

  25. Screening is only the first part of an Early Hearing Detection and Intervention System OAE Screening Prior ABR Comprehensive Hearing Evaluation Before 6 Months of Age to Hospital Screening Fail Fail Discharge

  26. 3. Just Do It!

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