Communication Sciences and Disorders Commons^™

Audiologic Clinical Practice Patterns: Infant Assessment, Ursula M. Findlen, Nicole D. Schuller

Journal of Early Hearing Detection and Intervention

The purpose of the present study was to report the current clinical practice patterns for assessment of infants after a referred newborn hearing screening within the context of available guidelines and to examine how the advent of newer stimuli, technology, and/or instrumentation has changed clinical practice patterns for audiologic infant assessment. A mixed-method survey that included both quantitative and qualitative questions was disseminated to pediatric audiologists in 2017. Quantitative data were analyzed via descriptive statistics while qualitative questions were analyzed via content analysis and combined with associated quantitative data. Lastly, infant assessment test battery categorization was completed to ascertain the …

Neonatal Abstinence Syndrome And Infant Hearing Assessment: A Kids’ Inpatient Database Review, Liza Creel, Adam Van Horn, Alex Hines, Matthew L. Bush

Journal of Early Hearing Detection and Intervention

Objective: Neonatal abstinence syndrome (NAS) has become an epidemic. This study assesses documented rates of failed newborn hearing screening (NBHS) or hearing loss diagnosis (HL) in NAS infants, and sociodemographic factors associated with abnormal inpatient hearing results.

Methods: The 2016 HCUP/KID national database was used to identify a weighted sample of infants with failed NBHS/HL during birth hospitalization. Independent variables included diagnoses of NAS/in-utero opioid exposure, HL risk factor presence and sociodemographic data. Univariate analyses and multivariate logistic regression were used to determine associations between NAS and abnormal hearing assessment.

Results:NAS infants had lower odds ratio (OR) of documented …

Access To Pediatric Audiological Evaluation Facilities For Infants And Young Children In The United States: Results From The Ehdi-Pals System, Naveen K. Nagaraj, Emilee Mertens, Beula Magimairaj, Randi Winston Gerson, John Whicker, Karl R. White

Journal of Early Hearing Detection and Intervention

Early Hearing Detection and Intervention - Pediatric Audiology Links to Services (EHDI-PALS) is a web-based national directory of pediatric audiology facilities in the United States, created by an expert committee and launched in October 2012. In this study, data from 1,232 audiology facilities were analyzed to identify the number of registered facilities, types of diagnostic hearing tests offered, and the number of children under 5 years of age who were diagnosed with hearing loss. Some states had almost 15 times as many registered facilities as other states, suggesting that access to quality diagnostic hearing testing for infants and young children …

Engaging Parents Of Children With Mild Bilateral Or Unilateral Hearing Loss: Counseling Considerations, Karen F. Munoz, Clarissa W. Ong, Michael P. Twohig

Journal of Early Hearing Detection and Intervention

A notable percentage of children identified with hearing loss through newborn hearing screening have mild bilateral or unilateral hearing loss (MB/UHL). Caregivers’ appropriately strong emotions, fears, and personal struggles may inadvertently interfere with their engagement with audiologists and other professionals, as well as adherence to jointly determined intervention protocols. Researchers have shown variable outcomes for children with MB/UHL, counseling that includes addressing emotional and cognitive factors is essential for effectively engaging parents. The aim of this article is to describe counseling attributes and strategies that providers can incorporate when working with parents of children with MB/UHL to improve parent engagement …

Social Validity Of Technology Assisted Spoken Language Intervention For Deaf And Hard-Of-Hearing Children, Sandra Grether Phd, Lisa L. Hunter Phd, Robert C. Gibler M.A., Susan Wiley, Bethany Wysocki Au.D., Rajvi Desai Msw, Jareen Meinzen-Derr

Journal of Early Hearing Detection and Intervention

Children who are Deaf or Hard-of-Hearing (DHH) are at-risk for language delays and associated developmental challenges that impact academic, social, and communication skills. Technology Assisted Language Intervention (TALI) is a novel approach that focuses on using augmentative and alternative communication (AAC) as an intervention for children who are DHH. Results from a recent pilot study suggested that TALI may be a viable approach for enhancing spoken language and communication. In this study, we examined the social validity of TALI using interviews and focus groups. We collected qualitative data from parents, caregivers, and professionals working with children who are DHH to …

Assessment Of Factors Involved In Non-Adherence To Infant Hearing Diagnostic Testing, Anita Shanker, Marcia Vanessa Rojas-Ramirez, Julie A. Jacobs, Jennifer B. Shinn, Cathy Lester, Philip M. Westgate, Matthew L. Bush

Journal of Early Hearing Detection and Intervention

Abstract

Introduction: Delayed diagnosis of pediatric hearing loss can cause delays in cognitive and social development. This study described the sociodemographic factors associated with delayed timing of a final hearing diagnosis after an abnormal newborn hearing screening (NBHS). Methods: Parent-infant dyads were recruited after being referred for further audiologic testing on an abnormal result from the NBHS. Results: Of the 53 participants, 55% (n=29) did not receive a final diagnosis by the recommended 3 months of age. Of those with a delayed diagnosis, 45% (n=13) had their first appointment within 3 months, but a delay was caused by an inconclusive …

Pediatric Amplification Management: Parent Experiences Monitoring Children’S Aided Hearing, Karen F. Munoz, Makynzie Larsen, Lauri Nelson, Sarah E. Yoho, Michael P. Twohig

Journal of Early Hearing Detection and Intervention

Objective: Investigate parents’ experiences monitoring aided hearing for children who use hearing aids, bone conduction hearing aids, and cochlear implants.

Design: A cross-sectional survey design, using three survey instruments, was used to collect parent data.

Study Sample: A total of 178 parents of children birth to six years were included in the analysis (81 hearing aid; 61 cochlear implant; 36 bone conduction hearing aid).

Results: Surveys explored hearing device use and monitoring. Variability was found for hearing aid use, and many parents reported being unaware if their child’s device has data logging capability. Parents varied widely in how often they …

Involvement Of Adults Who Are Deaf Or Hard Of Hearing In Ehdi Programs, Elizabeth Shuler-Krause, Karl R. White

Journal of Early Hearing Detection and Intervention

Consistent with a position statement of the Joint Committee on Infant Hearing (JCIH, 2007), several key organizations and groups have supported involving deaf and hard of hearing (DHH) adults in Early Hearing Detection and Intervention (EHDI) systems, including providing families of children who are DHH with opportunities to interact with adults who are DHH. This article reviews the available data on the involvement of adults who are DHH in EHDI systems to determine the availability of opportunities for families who have children who are DHH to interact with adults who are DHH, how families feel about these experiences, and to …

Family Impact Of Pediatric Hearing Loss: Findings From Parent Interviews And A Parent Support Group, Kristen L. Haddad, Wendy W. Steuerwald, Lori Garland

Journal of Early Hearing Detection and Intervention

Parents experience numerous stressors tied to their child's diagnosis as deaf or hard of hearing (DHH). This study sought to inquire about the lived experiences of parents with children who are DHH to inform the types of supports that should be provided within an audiology care coordination system. Semi-structured phone interviews were conducted with parents of children under the age of five who are DHH and patients of the Division of Audiology at Cincinnati Children’s Hospital Medical Center (CCHMC). Interview findings informed focus group questions, which were facilitated in a parent support group with parents of children who are DHH …

Newborn Hearing Screenings For Babies Born At Home: Report From An Initiative In Michigan, Shannon B. Palmer, Jill L. Adelson, Brittany F. Crawford, Nan Asher, Wendy Switalski

Journal of Early Hearing Detection and Intervention

Objective: Babies born in an out-of-hospital setting (e.g., homebirth) often do not receive a universal newborn hearing screening (UNHS). The purpose of this study was to evaluate the effect of providing training and equipment for newborn hearing screening to midwives who attend homebirths.

Study Design: Midwives from around the state of Michigan were invited to participate in a two-part UNHS training. Hearing screening data from all midwives who attended homebirths (N=112) during the 2015 and 2016 calendar years were analyzed using a two-level multilevel model. Estimated odds of babies being screened were calculated based on midwife group.

Results: …

Effects Of Frequency Of Early Intervention On Spoken Language And Literacy Levels Of Children Who Are Deaf Or Hard Of Hearing In Preschool And Elementary School, Ann E. Geers, Jean S. Moog, Amanda M. Rudge

Journal of Early Hearing Detection and Intervention

Language delays associated with hearing loss during infancy may have a negative impact on academic development throughout childhood. Early intervention provided by the Moog Center for Deaf Education prior to 36 months of age was quantified, and associations with later outcomes were examined for 50 students who are DHH representing Moog Center alumni. The objective was to determine whether the amount of early intervention (referred to hereafter as dose of early intervention received at the Moog Center during the time children were 0-36 months of age) contributed uniquely to outcomes in preschool (4–6 years) and in elementary school (8–14 years). …

21st Century Teenagers And Young Adults Who Are Deaf Or Hard Of Hearing: Outcomes And Possibilities, Jean S. Moog, Amanda M. Rudge 3730756

Journal of Early Hearing Detection and Intervention

The purpose of this study was to document demographics, characteristics, and long-term outcomes of teenagers and young adults who are deaf or hard of hearing (DHH) and who all attended the Moog Center for Deaf Education for preschool and/or a portion of elementary school. Data were obtained via an online survey that was designed to assess educational, personal, and professional outcomes of individuals who were currently in high school and beyond. Survey questions were about the lives of these individuals after leaving the Moog Center. Participants included 108 individuals who were DHH, ranging from 15 to 32 years of age. …

Use Of Hearing Protection In Neonatal Intensive Care Unit Patients: A Systematic Review Of The Evidence, Nathalie Chouery, Kathleen T. Dunckley

Journal of Early Hearing Detection and Intervention

Neonatal intensive care unit (NICU) settings present neonates with many environmental hazards, including exposure to dangerous sound intensity levels. Noise levels in NICUs worldwide overwhelmingly exceed the recommendations for safe exposure by the American Academy of Pediatrics. Environmental modifications and staff behavioral changes have proved ineffective to sufficiently reduce infant noise exposure. A systematic review of the literature was undertaken to answer if earmuffs improves physiologic stability, behavioral response, and sleep behavior, which are markers of stress response in NICU patients. Seven databases were searched for pertinent records using a specific search protocol. Seven studies met the review’s inclusion criteria …

Hispanic Parents’ Beliefs, Attitudes And Perceptions Toward Pediatric Hearing Loss: A Comprehensive Literature Review, Ana Caballero, Karen F. Munoz, Jared Schultz, Laurel Graham, Alex Meibos

Journal of Early Hearing Detection and Intervention

Objective: The purpose of this review was two-fold: (a) to understand research findings about Hispanic parents’ beliefs, attitudes, and perceptions related to hearing loss after having children who are deaf or hard of hearing, and (b) to inform future research needs that could expand audiologists’ ability to provide patient-centered care with this population.

Design: A comprehensive review of the literature was used to identify relevant articles for the review.

Study Sample: Five research articles met the inclusion criteria.

Results: Three primary themes emerged: (1) deafness causality, parents tended to describe the cause of the hearing loss in terms of religion …

Progress In Documented Early Identification And Intervention For Deaf And Hard Of Hearing Infants – Cdc’S Hearing Screening And Follow-Up Survey, United States, 2006–2016, Krishnaveni Subbiah, Craig A. Mason, Marcus Gaffney, Scott D. Grosse

Journal of Early Hearing Detection and Intervention

The national EHDI 1-3-6 goals state that all infants should be screened for hearing loss before 1 month of age; with diagnostic testing before 3 months of age for those who do not pass screening; and early intervention (EI) services before 6 months of age for those with permanent hearing loss. This report updates previous summaries of progress on these goals by U.S. states and territories. Data are based on the Hearing Screening and Follow-up Survey (HSFS) conducted annually by the Centers for Disease Control and Prevention for the years 2006–2016. Trends were assessed using 3-year moving averages, with rates …

The Past, Present And Future Of Universal Newborn Hearing Screening In Taiwan, Lin Hung-Ching, Hsiu-Wen Chang, Wen-Hui Hsieh

Journal of Early Hearing Detection and Intervention

In Taiwan, the Taipei Mackay Memorial Hospital, in collaboration with the Children’s Hearing Foundation, initiated a free newborn hearing screening program using transient evoked otoacoustic emissions (TEOAE) in 1998. During 2003-2013, there were four major phases of implementation and promotion of universal newborn hearing screening program (UNHS) in Taiwan initiated by the government’s Bureau of Health Promotion. These included (1) establishment of “2004 Taiwan Guidance of Newborn Hearing Screening Program” ; (2) completion of “2008 Taiwan Consensus Statement on Newborn Hearing Screening”; (3) implementation of national government-funded UNHS program in 2012; (4)“2014 Taiwan UNHS revised guidelines”. In summary, in 2016, …

Where Do We Go From Here? The Need For Genetic Referrals In Patients Who Are Deaf Or Hard Of Hearing: Findings From A Regional Survey, Tyson S. Barrett, Amanda Wylie, Beth Vogel, Kunal Sanghavi, Melissa Raspa, Kathryn P. Aveni, Kathryn Tullis, Michele Caggana, Karl R. White, Joann Bodurtha

Journal of Early Hearing Detection and Intervention

Purpose: The purpose of this study was to assess primary health care providers’ knowledge and use of genetic services for children whose hearing screening indicates they may be deaf/hard of hearing (D/HH) and identify areas in which health care providers can be supported to increase family education and referral of families for genetic consultation.

Methodology: A survey was developed on current practices, knowledge, and perceived beliefs regarding genetic education and referrals for deafness. The surveys were distributed to pediatricians, family medicine physicians, nurse practitioners, and physician assistants in DC, DE, MD, NJ, NY, PA, VA, and WV.

Results: Among 266 …

Identification Of Oral Clefts As A Risk Factor For Hearing Loss During Newborn Hearing Screening, Patricia L. Purcell, Kathleen Cy Sie, Todd C. Edwards, Debra Lochner Doyle, Karin Neidt

Journal of Early Hearing Detection and Intervention

Objective: This study assessed whether children with oral clefts are appropriately classified as at-risk for hearing loss at the time of newborn hearing screening and describes their screening and diagnostic results.

Design: Birth certificates were used to identify children with cleft lip and palate or isolated cleft palate born in Washington State from 2008–2013. These were cross-referenced with the state’s Early Hearing Detection, Diagnosis and Intervention (EHDDI) database. Multivariate logistic regression was used to examine associations.

Results: Birth records identified 235 children with cleft lip and palate and 116 with isolated cleft palate. Six children were listed as having both …

Pediatric Hearing Device Management: Professional Practices For Monitoring Aided Audibility, Karen F. Munoz, Lauri Nelson, Kacy Herald

Journal of Early Hearing Detection and Intervention

Objective: The purpose of this study was to explore professional practices for monitoring aided audibility for children who are deaf or hard of hearing (DHH).

Design: A cross-sectional survey design was used to identify providers’ self-reported practice patterns for monitoring aided audibility for children who use hearing aids, cochlear implants, and bone-conduction hearing aids. Three surveys were used.

Study Sample: Practicing audiologists, speech-language pathologists, and deaf educators providing services to children birth to six years of age who use hearing technology were recruited to participate. A total of 184 surveys were included in the analysis (96 hearing aid; 47 cochlear …

Some Permanent Hearing Loss Is Missed When "Switched Ear" Passes Are Used To Determine Screening Results, Beverly G. Lim, Maria Perez-Abalo, Jillian Gerstenberger, Shauna Morales Flowers

Journal of Early Hearing Detection and Intervention

A common practice in Universal Newborn Hearing Screen (UNHS) programs is rolling up non-simultaneous passing results in each ear (SW_EAR) from repeat automated screens into a bilateral pass. This study aims to provide evidence-based criteria for best practices regarding SW_EAR screens. From January 2010 to May 2013, infants with SW_EARs results were prospectively monitored by MEDNAX-Pediatrix’s nationwide UNHS program, which combine inpatient/outpatient screens utilizing automated auditory brainstem response (AABR). The tracked audiologic evaluations of 16,129 refer infants (2,334 due to SW_EAR) out of the total infant population screened (2,492,314) were analyzed retrospectively. A high proportion of hearing loss (354/2334, 15%) …

Measuring Nurses' Knowledge And Understanding Of Universal Newborn Hearing Screenings, Caitlyn Roberts, Alisha L. Jones

Journal of Early Hearing Detection and Intervention

The present study was conducted to investigate the knowledge and understanding of Universal Newborn Hearing Screening (UNHS) in nursing professionals. A group of 15 adult, licensed nurses with varied professional experience participated in the study. Participants completed both objective and subjective measurements to evaluate their current knowledge of training procedures. A free online UNHS training program offered through the National Center for Hearing Assessment and Management (NCHAM) served as both the objective measure and training module. Participants completed pre- and post-surveys as the subjective measure of their UNHS training. Results of these surveys were compared across the participants to determine …

Parental Satisfaction And Objective Test Measurements Associated With Post-Partum Versus Nursery Newborn Hearing Screening, Jennifer E. Bentley, Wenyang Mao, Wendy Timpson, Jane Stewart

Journal of Early Hearing Detection and Intervention

Beth Israel Deaconess Medical Center (BIDMC; Boston, MA) initiated a change to the newborn hearing screening program in 2013 to encourage increased parental presence at the time of screening and support a more family centered hospital environment. Newborn hearing screening program technicians were encouraged to conduct all hearing screens in the parent’s post-partum rooms instead of in the nursery. To measure the effect of this change on the families and screening measures, satisfaction surveys and retrospective data was collected over a 2 year period and compared. Newborn hearing screening program technicians and mother-baby nursing staff were surveyed to determine influence …

Are Audiologists Directly Referring Children With Hearing Loss To Early Intervention?, Natalie Loyola, Bridget Shanahan, Cailin Shanahan, Kosuke Kawai, Derek J. Stiles

Journal of Early Hearing Detection and Intervention

This article describes the ways that pediatric audiologists are directing infants into Early Intervention, and the related barriers and facilitators. Over one hundred pediatric audiologists responded to an online survey including questions on how audiologists provide direct and indirect referrals to Early Intervention for those infants that are diagnosed with hearing loss. Most respondents agreed that audiologists are the best person to provide this referral, but many audiologists did not make the direct referral. Barriers to direct referral included time constraints and resistance from parents. Opportunities identified to improve referral included online referral systems and national guidelines for what qualifies …

Effectiveness Of Dexmedetomidine For Sedation In Auditory Brainstem Response Testing, Laura Sherry, Eric Levey, Carolyn Gillen, Joseph P. Pillion

Journal of Early Hearing Detection and Intervention

Sedation is widely used for auditory brainstem response (ABR) testing for infants or young children who are unable to sleep or remain adequately quiet for testing. Because chloral hydrate is no longer readily available, dexmedetomidine has been proposed as an alternative medicinal agent to achieve moderate levels of sedation without risk of respiratory depression. The purpose of the study was to assess the effectiveness of dexmedetomidine in terms of the completeness of the audiologic data obtained in achieving moderate levels of sedation for auditory brainstem response testing. A retrospective chart review was conducted on ninety-nine patients at Kennedy Krieger Institute. …

Implementing A Two Class System For Monitoring Risk Indicators For Delayed-Onset Hearing Loss, Jessica Renee Stich-Hennen, Gabriel Anne Bargen

Journal of Early Hearing Detection and Intervention

Purpose: This manuscript discusses the importance of establishing risk indicator monitoring guidelines for state Early Hearing Detection and Intervention programs.

Method: Idaho Sound Beginnings (ISB) implemented a guideline which divided risk indicators associated with delayed-onset hearing loss into two classes (Class A and Class B). From 2012-2013, the incidence of delayed-onset hearing loss in the presence of Class A and Class B risk indicators were evaluated. For Class B risk indicators, ototoxic medication exposure and family history were analyzed.

Results: Of the 10,634 infants born, 1,175 were found to have passed the newborn hearing screening and have at least one …

Information Given To Parents Of Neonatal-Intensive Care Unit Graduates On Hearing, Cydney E. Gehring, Alisha L. Jones

Journal of Early Hearing Detection and Intervention

Preterm infants and neonatal intensive care unit (NICU) graduates are more likely to have risk factors associated with hearing loss than their full-term, healthy peers, making them more prone to experience hearing loss (Behrman & Butler, 2007). This study examined information presented to parents during and after the newborn hearing screening (NBHS). A 22 question survey was posted on NICU and preemie support websites for parents to access and participate in anonymously. Results of the survey were analyzed for respondents indicating that their child was born in the year 2007 to the present. Thirty-nine percent of responding parents were unaware …

Audiology Students’ Perception Of Hybrid Simulation Experiences: Qualitative Evaluation Of Debriefing Sessions, Ahmad A. Alanazi, Nannette Nicholson, Samuel R. Atcherson, Clifford A. Franklin, Naveen K. Nagaraj, Michael Anders, Laura Smith-Olinde

Journal of Early Hearing Detection and Intervention

Simulation-based research is still new in the audiology field and requires more research to better understand students’ perspectives on standardized patients/parents (SPs) and manikins use. There is also limited research about debriefing practices in audiology. This qualitative study used a baby simulator and SPs to evaluate audiology students’ reflection during three debriefing sessions conducted at the University of Arkansas for Medical Science (UAMS) Simulation Center. Seventeen Doctor of Audiology (AuD) students participated in the simulation event, and the data were collected using the transcripts of videotaped debriefing sessions. The qualitative content analysis of the transcripts revealed eight sub-themes: support, compassion, …

A Review Of Internet Resources Related To Spoken Language Intervention For Spanish-Speaking Parents Of Children Who Are Deaf Or Hard Of Hearing, Karen F. Munoz, Lauri H. Nelson Phd, Brittan Barker

Journal of Early Hearing Detection and Intervention

Objective: The purpose of this study was to identify website information related to hearing loss, hearing technology, and spoken language development available to Spanish-speaking parents of children who are deaf or hard of hearing (DHH).

Design: An exploratory, descriptive design was used to determine the presence or absence of parent education information on a variety of websites.

Study Sample: The study explored Internet resources provided by national, state, and parent support organizations in the United States.

Results: A total of 53 organization websites were identified that had information for parents of DHH children learning spoken language, eight of which were …

Infant Diagnostic Evaluation Via Teleaudiology Following Newborn Screening In Eastern North Carolina, Andrew Stuart

Journal of Early Hearing Detection and Intervention

Universal newborn hearing screening in North Carolina began in 2000 under the auspices of the North Carolina Department of Health and Human Services Early Hearing Detection and Intervention Program (NC-EHDI). Despite initial success, loss to follow-up/lost to documentation for diagnostic testing was problematic. To address this, the NC-EHDI received U.S. Department of Health and Human Services Health Resources and Services Administration lost to follow-up funding to in part fund a pilot “Teleaudiology Project” in 2010 to provide services for infants in eastern North Carolina. This part of the state is a traditionally underserved area. The project involved a partnership with …

How Many Babies With Hearing Loss Will Be Missed By Repeated Newborn Hearing Screening With Otoacoustic Emissions Due To Statistical Artifact?, Karl R. White, Lauri H. Nelson, Karen F. Munoz

Journal of Early Hearing Detection and Intervention

Objective: People who manage newborn hearing screening programs are often told that repeating OAE hearing screening more than two or three times per ear unacceptably increases the probability of false-negatives (i.e., passing babies who have permanent hearing loss). This study evaluated the accuracy of that recommendation.

Design: A 2.0 cc coupler and three human ears with hearing loss were used to estimate the number of false-negative results per 1,000 OAE screening tests. Using those results, together with the prevalence of hearing loss among newborns, we calculated the number of babies that would be missed due to repeated testing.

Results: If …