Communication Sciences and Disorders Commons^™

Monitoring Spoken Language In Infants And Toddlers Who Are Deaf Or Hard Of Hearing Using The Lena Developmental Snapshot, Monika-Maria Oster, Kimberly A. Peters

Journal of Early Hearing Detection and Intervention

Purpose: This retrospective analysis evaluates the Developmental Snapshot as a language monitoring tool for infants and toddlers with bilateral hearing loss who use listening and spoken language.

Method: Data were obtained from the educational and clinical records of 147 children with bilateral hearing loss. For each child, the LENA (Language ENvironment Analysis) Developmental Snapshot, a standardized online language assessment that relies on parent report, had been completed at least once. When available, scores from other standardized language assessments (PLS-5, CDI, and DAYC-2) were also obtained.

Results: LENA Developmental Snapshot standard scores were characterized by high variability and mean scores in …

A Survey Study On Physiological Hearing Assessment Practice In The Usa, Malina Mangrum, Hasan Saleh, Sangamanatha Ankmnal Ankmnal Veeranna, Kimberly Ward, Charles G. Marx

Journal of Early Hearing Detection and Intervention

Background: In the United States, limited information exists regarding the physiological measures and testing parameters used in infant hearing assessments. To address this gap, we conducted a nationwide survey to identify the types of physiological tests and procedures currently employed by audiologists.

Method: A structured survey was distributed to audiologists across the country to gather information about the auditory tests and recording parameters used in infant hearing evaluations.

Results: Most respondents reported using Auditory Brainstem Responses (ABRs) to estimate infant hearing thresholds, primarily relying on traditional stimuli rather than chirp stimuli. The Auditory Steady-State Response (ASSR) was not widely used …

The Influence Of Early Detection And Intervention Providers' Actions And Communication On Parental Emotions And Early Intervention Engagement After A Child Is Diagnosed With Hearing Loss: A Scoping Review, Charlene M. Watson, D. Ellen Rick, Jillian Ingratta, Patti-Jo Sullivan, Xurong Zhao, Sheila Moodie

Journal of Early Hearing Detection and Intervention

Despite well-intentioned early hearing detection and intervention (EHDI) programs, parents receiving a newborn hearing loss diagnosis often experience distress, uncertainty, and fear, which can impact their readiness to engage in early intervention. The communication and support provided by clinicians in early hearing detection and intervention play a critical role in helping families navigate emotions, overcome barriers, and actively participate in EHDI programs. The purpose of this scoping review is to advance our knowledge of the following: For parents who have a newborn newly diagnosed with hearing loss, how do the actions/behaviors and communication (or lack thereof) of EHDI providers influence …

Fine And Gross Motor Skills Assessment, From A Caregiver's Perspective, In Children With Hearing Loss Using A Modified Ages And Stages Questionnaire (Asq-3), Steven M. Doettl, Patrick N. Plyler, Erin Plyler, Kelly R. Yeager, Leeann Hutker, Ginger Tallmadge, Aspen Gutknecht, Amy Becker

Journal of Early Hearing Detection and Intervention

Purpose: The purpose of this study was to determine if there is a significant difference on ASQ-3 (Ages and Stages Questionnaire version 3) Gross (ASQ G) and Fine (ASQ F) Motor scores between children with sensorineural hearing loss (SNHL) and children with normal hearing.

Methods: Data was gathered from the ASQ-3 as reported by parents/caregivers of 61 children (28 normal hearing children and 33 children with SNHL) ages 6-36 months. Results were averaged across the participants for both groups. Independent sample t-Tests were used to assess for any statistically significant difference in the ASQ scores between groups. Chi-square analysis …

From Policy To Practice In Deaf Education: American Sign Language And Spoken English Outcomes Of Deaf And Hard Of Hearing Children In Kansas, Jena Mcdaniel, Shreyas Teegala, Rebecca Maloney, Angie Walker, Mary S. Dietrich, Matthew L. Hall, Leah C. Geer, Julie Bustos

Journal of Early Hearing Detection and Intervention

Purpose: In the context of the recent expectation for state Early Hearing Detection and Intervention programs to track language milestones of deaf and hard of hearing (DHH) children, we examine how to leverage statewide assessment programs for improving language outcomes of DHH children. We present the degree to which DHH children in Kansas are meeting their language milestones for American Sign Language (ASL) and English and the influence of two measurement features.

Method: Performance on the ASL/English Language Milestones for 198 children who were DHH (aged 1 to 8) was analyzed for attainment of age-expected language skills and …

The Radical Middle: Caregiver Beliefs About Language Access For Deaf And Hard Of Hearing Children, Monica Zmudzinski, Krystal L. Werfel

Journal of Early Hearing Detection and Intervention

The purpose of this study was to explore the communication choices of caregivers of deaf or hard of hearing (DHH) children. Specifically, we explored what communication options caregivers were presented with, identify what factors impacted a caregiver’s decision to pursue spoken language, and identify what barriers exist to learning sign language. We conducted semi-structured interviews with 20 caregivers of DHH children who had decision making power at the time of their child’s diagnosis. Transcripts were coded using an inductive approach with triangulation between authors. Many families reported that minimal to no information was provided about communication options at the time …

Evaluating Preschoolers Who Are Deaf/Hard Of Hearing Using Listening And Spoken Language To Determine Special Education Eligibility, Kameron C. Carden, R. A. Mcwilliam

Journal of Early Hearing Detection and Intervention

The aim of this study was to increase understanding of evaluation practices used when determining special education eligibility for preschoolers who are deaf/hard of hearing (DHH) using listening and spoken language (LSL), particularly during the early intervention to preschool transition. Specifically, we explored alignment of school-based practices with recommended practices from the National Association of State Directors of Special Education (NASDSE, 2018). An online survey was distributed to school-based special educators, including speech-language pathologists (SLPs), special education teachers, and teachers of the deaf within the United States that included a) evaluation practices, b) eligibility requirements, and c) practice demographics. Participant …

The Follow-Up Gap: Racial Disproportionality And Social Determinants Of Health In New Jersey’S Hearing Detection And Intervention Program, Maryrose Mcinerney, Wendy Zeitlin

Journal of Early Hearing Detection and Intervention

Objectives. To assess how race/ethnicity and social determinants of health are related to loss to follow-up (LTF) from NJ’s Early Hearing Detection and Intervention (EHDI) program.

Methods. All infants born in NJ between June 2015 and June 2017 referring for additional hearing healthcare after hospital discharge were considered for inclusion in this study. The sample consisted of 4,141 babies, 10.7% of which received no follow-up care. Step-wise multi-level logistic regression was used to determine how race/ethnicity, family-level, and community-level social determinants of health (SDOH) were predictive of LTF.

Results. In each model, the odds of being LTF were significantly higher …

Early Detection Of Pediatric Permanent Hearing Loss: A Population-Based Retrospective Cohort Study, Janet Olds, Elizabeth M Fitzpatrick, Stuart G. Nicholls, Laura C. Rosella, Sarah G. Spruin, Marie M. Pigeon, Joanne M. Whittingam, James Macdougall, David M. Schramm, Eric I. Benchimol

Journal of Early Hearing Detection and Intervention

Evidence has indicated that Early Hearing Detection and Intervention (EHDI) programs have lowered the age of identifying permanent hearing loss (PHL) in childhood, a first step to intervention. However, limited research has compared the age of diagnosis before and after implementation in one jurisdiction across the full range of PHL.

Methods: Children diagnosed with PHL in Ottawa, Canada were identified from the Child Hearing Lab database at the Children’s Hospital of Eastern Ontario and linked to Ontario health administrative data. Age of identification of PHL of children born in the pre-infant hearing program (IHP) era (1991-2002) was compared to those …

Improving Newborn Hearing Screening For Community Births: Update From The Michigan Midwives Newborn Hearing Screening Program, Shannon B. Palmer, Nan Asher, Gina Cooper

Journal of Early Hearing Detection and Intervention

Objectives. To determine the effectiveness of a hearing screening training program for midwives who attend community births.

Methods. The data for this study was obtained from the mandatory reporting data to the Michigan Early Hearing Detection and Intervention Program (MI EHDI). Data included the total births and screening rates of babies born at home or in a birthing center in Michigan in the years 2020 and 2021. There were 90 birth attendants who oversaw 2711 community births across the two study years.

Results. The results of this study found that having a midwife who possessed a hearing screening machine increased …

Supporting Entry-Level Speech-Language Pathologists Who Serve Children Who Are Deaf Or Hard-Of-Hearing In Early Intervention, Kristina Blaiser, Hannah Daw, Blair Richlin, Jenn Gallup

Journal of Early Hearing Detection and Intervention

The aim of this study was to increase understanding of what is considered key information for entry-level speech-language pathologists (SLPs) serving children who are DHH. Specifically, this study explored skills and strategies that could be integrated into SLP graduate curriculum to increase entry-level provider confidence and knowledge. An online survey was distributed to providers of the DHH within the United States and included a) key skills and strategies recommended for entry-level providers serving children who are DHH b) barriers experienced by entry-level providers and c) demographics. The skills and strategies that emerged as most important according to participants (n …

Documented Newborn Hearing Screenings In Florida Administrative Hospital Data: State Policy Compliance By Hospital Types, Teresa Anthony, Blake Barrett, Adam Brown, Jessica Ryan

Journal of Early Hearing Detection and Intervention

Purpose: Florida policy mandates newborn hearing screenings (NBHS) in hospitals. U.S. inpatient administrative hospital data reflects low rates of documented screenings. This analysis investigates inconsistencies between Florida policy and administrative records.

Method: Analysis of Florida statutory language was completed. Florida hospital administrative data was retrospectively analyzed using various statistical methods to explore differences in proportions of documented NBHS among distinct hospital types based on profit and teaching statuses.

Results: Florida mandate requires NBHS completion in the hospital prior to discharge from the birth facility or within 21 days after birth and allows for billing a third-party payer. …

Cost-Effectiveness Analysis: Automated Auditory Brainstem Response (Aabr) Diagnostic Test Compared To Transient Evoked Otoacoustic Emission Screening (Teoae) For Universal Newborn Hearing Screenings (Unhs) In High-Risk Neonates, Teresa Anthony, Troy Quast, Sarah Warren

Journal of Early Hearing Detection and Intervention

Purpose: Comorbidities and ototoxic medications increase risk of hearing loss (HL) in infants admitted to neonatal intensive care units (NICU; 6 per 1000 births) compared to well-babies (1.7 per 1000 births). For newborn hearing screening (NBHS), transient evoked otoacoustic emissions (TEOAE) testing is more efficient and less costly. Automated auditory brainstem response (aABR) testing yields higher sensitivity and specificity. This study will identify if aABR is cost-effective compared with TEOAE for NBHS in high-risk neonates.

Methodology: Cost-effectiveness analysis was conducted from a healthcare system perspective. Prevalence and outcomes data for aABR, TEOAE, and auditory brainstem response (ABR) were obtained …

Diagnostic Overshadowing: A Delayed Diagnosis Of Autism Spectrum Disorder In A Deaf Child, Quynh-Chi Dang, Michael Hoffman, Rachel St. John

Journal of Early Hearing Detection and Intervention

Diagnostic overshadowing occurs when a patient with a pre-existing diagnosis presents with symptoms that are attributed to the diagnosis, but actually reflect a separate issue. This diagnostic overshadowing can lead to delays in diagnosis, as well as disparities in health care and outcomes. The following case will provide an example in which diagnostic overshadowing contributed to the delay of an autism diagnosis in a child who is deaf. With at least 40 to 50% of children who are deaf or hard of hearing having at least one co-existing medical/developmental condition, and the current prevalence of autism at 1 in 36 …

Understanding Barriers To Timely Enrollment Of Early Intervention Services For Children Who Are Deaf And Hard Of Hearing, Krystal L. Werfel, Eddie Okosi, Brittany Grey, Cora Swindale, Emily Lund

Journal of Early Hearing Detection and Intervention

Although the Joint Committee on Infant Hearing guidelines recommend that children who are deaf and hard of hearing should begin early intervention by six months of age, prior work has revealed a substantial percentage of children who receive a diagnosis of hearing loss by three months of age but do not enroll in early intervention by six months of age (Grey et al., 2022). To further understand barriers to enrollment in early intervention for these families, we completed qualitative semi-structured interviews with 10 caregivers of children who were diagnosed with hearing loss by three months of age but did not …

A Review Of Social Media Platforms Of State Early Hearing Detection And Intervention Programs In The United States, Rohit Ravi, Karl R. White

Journal of Early Hearing Detection and Intervention

Purpose: Social media tool is increasingly used to support good health practices. Almost every Early Hearing Detection and Intervention program has a website, and it would be useful to know how they are using social media. The aim of this article was to analyse how social media is being used by Early Hearing Detection & Intervention programs in the United States, as well as how frequently.

Method: The present study analysed existing social media handles of the Early Hearing Detection and Intervention programs. The search for social media accounts & data extraction was carried out between 1st January 2022 to …

A Retrospective Analysis Of Hearing Screening Outcomes In Infants Whose Mothers Were Covid-19 Positive During Pregnancy, Sangamanatha Ankmnal Ankmnal Veeranna, Charles G. Marx, Hwanseok Choi, Clinton White, Kimberly Ward

Journal of Early Hearing Detection and Intervention

Background: This study examined hearing screening referral rates over a three-year period, including testing performed pre-pandemic (2019) and during the first two years (2020 and 2021) of the onset of the spread of COVID-19.

Methods: This study conducted a retrospective analysis of 8,130 hearing screening referral records from 2019 – 2021, obtained from a large regional level II trauma center. These records were generated from the universal hearing screening process which utilized automated auditory brainstem response devices.

Results: There was no significant change in the number of infants screened for hearing loss and hearing screening outcomes between the pre-pandemic and …

Factors Contributing To Late Identification Of Deaf/Hard Of Hearing Children In Louisiana, Danielle D. Mercer, Tri Tran, Dawne Mccabe, Terri Ibieta, Dana Hubbard

Journal of Early Hearing Detection and Intervention

To ensure children who are Deaf/Hard of Hearing (D/HH) receive supports they need to reach their full potential, it is imperative that they be identified as early as possible. Early Hearing Detection and Intervention benchmarks stipulate children who are D/HH be enrolled in early intervention no later than 6 months of age. A major barrier to early enrollment is late identification. We reviewed records of children identified as D/HH in Louisiana after 6 months of age for 2015-2020 birth cohorts to determine factors contributing to the late identification. Cases were examined in-depth after it was determined that a diagnosis was …

Early Experiences Of Parents Of Children Who Are Deaf Or Hard Of Hearing: Navigating Through Identification, Intervention, And Beyond, Gabriella Reynolds, Krystal L. Werfel, Morgan Vachio, Emily A. Lund

Journal of Early Hearing Detection and Intervention

Guidelines created by the Joint Committee on Infant Hearing ([JCIH], 2019) were designed to aid in the early identification of infant hearing loss. Despite these guidelines, a quarter of children who fail their initial screening are lost to the follow-up process and many more do not receive care in line with the 1-3-6 guidelines (Centers for Disease Control and Prevention [CDC], 2018; JCIH, 2019). To acquire more information about the experiences of families and identify specific barriers to timely diagnosis and intervention, interviews were conducted with 13 parents of children who are deaf or hard of hearing whose children were …

The Signed Linguistic Input Of Hearing Mothers To Children Who Are Deaf Or Hard Of Hearing, Aleah S. Brock

Journal of Early Hearing Detection and Intervention

This study investigated the distribution of ten facilitative language techniques (FLTs) in the linguistic input of hearing, signing mothers to their children who are deaf or hard of hearing (DHH). Four hearing mothers and their DHH children under the age of three participated in six, ten-minute caregiver-child interaction sessions via Zoom. The recorded sessions were coded for mother FLTs and child utterances. Results indicated that the mothers tended to use more initiative than responsive types of FLTs, consistent with findings of previous studies that examined the input of mothers who were using spoken-only language with their children who are DHH. …

Improving South Dakota Parents’ Knowledge Of Congenital Cytomegalovirus, Hannah M. Williams, Jessica Messersmith, Jacynda Gellhaus

Journal of Early Hearing Detection and Intervention

Introduction: Congenital cytomegalovirus (cCMV) is the most common infectious condition present at birth and the leading non-genetic cause of sensorineural hearing loss in children. Despite CMV being common and preventable, knowledge of CMV remains low among individuals in the United States (Doutre et al., 2016). Sudden infant death syndrome (SIDS) is also common among infants in the United States, but unlike cCMV, several studies have researched which educational methods have been most effective for improving parents’ knowledge of safe sleep practices. The purpose of this study was to investigate whether educational methods shown to be most effective for improving parents’ …

Adverse Childhood Experiences In Mothers And Their Children With Hearing Loss, Elizabeth A. Rosenzweig

Journal of Early Hearing Detection and Intervention

This study examined the relationship between maternal and child ACEs in children with hearing loss ages 3-12. One hundred twenty-four mother-child dyads completed assessments of mother and child ACEs. Adverse cChildhood eExperiences (ACEs) were measured using the Center for Youth Wellness Adverse Childhood Experiences Questionnaire (CYW ACE-Q; Burke Harris & Renschler, 2015).

Both maternal and child participants in this study reported higher levels of ACE exposure than previously reported in studies of the general population. Maternal and child ACEs were significantly correlated. White/Caucasian mothers experienced significantly fewer ACEs than mothers of other races/ethnicities. Children living in adoptive, foster, or guardianship …

An Assessment Of 50 State Early Hearing Detection And Intervention Websites: Is Needed Information Being Provided For Parent Decision Making?, Nichole Westin, Donna Sorkin

Journal of Early Hearing Detection and Intervention

Growth of the Internet as an information resource has provided expanded opportunities for families to easily gather information on a range of topics, including health related topics. State Early Hearing Detection and Intervention (EHDI) websites and other electronic data sources are an important opportunity to support families seeking information on options for their children who have been identified as deaf or hard of hearing. A review was undertaken between August and September 2021 of the 51 US EHDI (state and DC) websites and related information (such as links to others’ sites) to determine if information that is specifcally discussed in …

“It’S About Walking Alongside A Family”: Practitioner Perspectives On Caregiver Coaching With Families Of Children Who Are Deaf Or Hard Of Hearing, Dorie Noll, Sheila Moodie, Ian D. Graham, Beth Potter, Elizabeth M. Fitzpatrick

Journal of Early Hearing Detection and Intervention

Practitioners utilize caregiver coaching in early intervention services, but coaching principles and practices are not well understood in the context of listening and spoken language (LSL) services with families of children who are deaf or hard of hearing. The purpose of this study was to examine practitioners’ experiences with coaching, including definitions, training, and practices they utilize in their work with families. Using semi-structured, qualitative interviews and video observation discussions, this study examined the perspectives of 14 practitioners providing LSL services to families at three intervention sites in the US and Canada. Results indicate that practitioners’ underlying beliefs about their …

Application Of Intervention Mapping To Address Lost To Intervention In Early Hearing Detection And Intervention, Torri Ann Woodruff-Gautherin, Kathleen Cienkowski

Journal of Early Hearing Detection and Intervention

Abstract

Purpose: Detail the application of intervention mapping as a protocol for developing a novel way to address lost to intervention within the early hearing detection and intervention systems.

Design: Intervention mapping (IM) is an approach to behavior change that is typically utilized in public health initiatives. This six-step process walks health program developers, researchers, and policy makers through a rigorous research and community-based approach to understanding why a health concern or problem is present in a community. While using IM to address lost to intervention in Early Hearing Detection and Intervention programs, the focus is on why families, after …

A Systematic Review Of The Effects Of Lena-Based Feedback On Parent-Child Language Interactions In Families With Young Children, Beula M. Magimairaj, Naveen K. Nagaraj, Ana Caballero, Karen F. Munoz, Karl R. White

Journal of Early Hearing Detection and Intervention

Enhancing parent language interactions with children beginning in infancy is important because it results in better language abilities, social skills, and academic outcomes in children. A number of researchers have suggested that parent language interactions with children could be enhanced by giving parents feedback about their language interactions using the Language Environment Analysis (LENA) system. The LENA system records communication exchanges between a child and the adult caregiver and provides an automated analysis of adult word count, child vocalization count, and conversational turn count. We did a systematic review of the studies that investigated the use of LENA-based feedback to …

Nurses’ Perceptions Of The Universal Newborn Hearing Screening Program, Aaron Michael Roman, Michelle O'Connor Kensey

Journal of Early Hearing Detection and Intervention

This study explores the knowledge and perceptions of the newborn hearing screening (NBHS) program from the perspective of nurses and nursing support staff. Registered nurses and nursing support staff (n = 84) completed a digitally administered survey that queried their understanding of JCIH guidelines, perceptions around NBHS administration, and parental anxiety. The results demonstrated that while most respondents felt comfortable and confident about NBHS administration, there was a significant difference in their understanding of appropriate screening milestones compared to JCIH recommendations. Participants further demonstrated an interest in additional learning opportunities related to the NBHS.

Impact Of Social Determinants Of Health On Early Hearing Detection And Intervention Screening/Diagnosis Outcomes, Nannette Nicholson, Ellen A. Rhoades, Rachel E. Glade, Laura Smith-Olinde

Journal of Early Hearing Detection and Intervention

Purpose

We reviewed how Social Determinants of Health relate to health inequities and disparities for Early Hearing Detection and Intervention (EHDI) programs. Then, we examine links between specific sociodemographic factors (maternal age, maternal education, ‘race’/ethnicity) and hearing screening and diagnostic audiology follow-up for newborns in the U.S. and its territories.

Methods

Maternal demographic, hearing screening and diagnostic data extracted from publicly available Centers for Disease Control and Prevention (CDC) records were reported to CDC by personnel responsible for EHDI programs. Data were subjected to statistical analysis using analysis of variance and multiple regression techniques.

Results

Results showed no significant differences …

Likely Impact Of The Covid-19 Pandemic On Newborn Hearing Screening And Follow-Up Services In The United States In 2020, Kelly Dundon, Suhana Alam, Xidong Deng, Mia Morrison, Treeby Brown, Karl R. White, Linda Hazard, Macia Fort, Kirsten R. Coverstone, Craig Mason, Marcus Gaffney

Journal of Early Hearing Detection and Intervention

This perspective aims to highlight aspects of the Early Hearing Detection and Intervention (EHDI) newborn hearing screening and follow-up processes that were impacted by the COVID-19 pandemic and considers factors that likely impacted follow-up after newborn hearing screening among infants born in the United States during 2020. Efforts to minimize the potential impact of missed or delayed identification of hearing loss in infants and young children will also be discussed to help guide future program improvement activities.

Training The Next Generation Of Practitioners In Early Intervention And Telepractice: Three University Models, K. Todd Houston, Lauri Nelson, Kristina Blaiser

Journal of Early Hearing Detection and Intervention

The COVID-19 pandemic continues to shape the provision of family-centered early intervention services for children who are Deaf or Hard-of-Hearing and their families. In programs, schools, and centers, direct in-person contact with families have been significantly curtailed as a means to limit the exposure to and spead of the virus. Emergency remote learning has lead to an increase in telepractice, also referred to as teleintervention, as the designated model of service provision. Most early interventionists, speech-language pathologists, and teachers of the Deaf were not sufficiently trained to suddenly implement emergency remote teaching or telepractice services, but service providers had no …