Identifying Infants who are Deaf or Hard of Hearing Early Helps Children Reach Their Full Potential Nebraska Infant Hearing Act was Passed in 2000 10/1/2019 Nebraska Early Hearing Detection & Intervention (NE-EHDI) Recharge for Resilience Conference Helping People Live Better Lives. Helping People Live Better Lives. Nebraska Early Hearing Detection and Intervention Program Objectives • BRIEF Overview of NE-EHDI History & Purpose • Why Newborn Hearing Screening is Important • Collaboration with Home Visitors & Early Childhood Professionals Helping People Live Better Lives. Helping People Live Better Lives. Nebraska Infant Hearing Act: Tasks Implement hearing screening as the standard of care for infants Educate parents Have birthing facilities and audiologists report data to DHHS DHHS develop a system to track babies identified as deaf or hard of hearing Establish and meet guidelines for early intervention referrals Develop a mechanism for compliance review Provide an annual report to the legislature Apply for all available federal funding Helping People Live Better Lives. Helping People Live Better Lives. 1
10/1/2019 NE-EHDI Mission The Nebraska Early Hearing Detection and Intervention Program develops, promotes, and supports systems to ensure all newborns in Nebraska receive hearing screenings, family-centered evaluations, and early intervention as appropriate. NE-EHDI, also known as Newborn Hearing Screening is an unbiased program. NE-EHDI informs parents of the resources available so they can utilize what is best for their family. Helping People Live Better Lives. Helping People Live Better Lives. Why is Newborn Hearing Screening Important? The earlier, the better! Synaptogenesis – nerve cells (neurons) in the brain forming new connections. • Research done by the Institute for Learning & Brain Sciences-University of Washington suggests: o babies begin to absorb language inside the womb during the last 10 weeks of pregnancy o the brain starts to map itself for language and communication about 30 weeks gestational age • Before babies are even born, they begin acquiring language. Helping People Live Better Lives. Helping People Live Better Lives. Why is Newborn Hearing Screening Important? • The development of a child’s brain architecture provides the foundation for all future learning, behavior, and health. • The basic architecture of the brain is constructed through an ongoing process that begins before birth and continues into adulthood. • The early years are the most active period for establishing neural connections, but new connections can form throughout life and unused connections continue to be pruned. Helping People Live Better Lives. Helping People Live Better Lives. 2
Joint Committee on Infant Hearing (JCIH) 1-3-6 The timing is genetic, but early experiences determine whether the the Developing Child circuits are strong or weak. Source: C.A. Nelson (2000). Credit: Center on 10/1/2019 Why is Newborn Hearing Screening Important? Sensory pathways like those for basic vision and hearing are the first to develop , followed by early language skills and higher cognitive functions. - InBrief: The Science of Early Childhood Development , Harvard University Helping People Live Better Lives. Helping People Live Better Lives. Why is Newborn Hearing Screening Important? The earlier, the better! • When left undetected, a hearing loss can delay a child’s speech and language development as well as his or her thinking, learning, and social skills. • The earlier children are identified with hearing loss and start receiving early intervention, the more likely they will stay on track with their hearing peers and reach their full potential. Helping People Live Better Lives. Helping People Live Better Lives. EHDI System • Hearing Screening • Inpatient • Outpatient • Audiological Diagnostic Evaluation • Early Intervention • Family Support • Data tracking and reporting Helping People Live Better Lives. Helping People Live Better Lives. 3
10/1/2019 Partners in the EHDI Process • Parents • Home Visitors and Early Childhood Professionals • Birthing Facilities • Audiological Confirmatory Testing Facilities & Tele-audiology • Primary Care Providers • Medical Specialists (ENT, genetics, ophthalmology) • Early Intervention (EDN-Part C, Regional Programs/Schools including Deaf Educators, Early Head Start, Speech-Language Pathologists, Private Providers) • Family-to-Family Support (Hands & Voices/Guide By Your Side, PTI-NE) • Deaf and Hard of Hearing Community Helping People Live Better Lives. Helping People Live Better Lives. Evidence Based Data - Importance of Universal Newborn Hearing Screening Before newborn hearing screening, many times childhood hearing loss was not identified • until 2-1/2 to 3 years of age. • 2016 CDC Data (most current national data) - 98% of U.S. born infants have a hearing screening usually before hospital discharge. • 2005-2018 NE-EHDI Data - Over 99% of Nebraska born infants have a hearing screening before hospital discharge. ~3 children per 1,000 are identified as DHH shortly after birth each year. • Helping People Live Better Lives. Helping People Live Better Lives. Comparison – National and Nebraska EHDI 1-3-6 Data *US – 2016 NE – 2016 % of babies screened by 1 month of age 94.8% 97.7% % of babies diagnosed by 3 months of age 75.8% 58.7% % of babies identified as D/HH - Enrolled 67.3% 78.0% in Early Intervention by 6 months of age *Most current national data posted by CDC Helping People Live Better Lives. Helping People Live Better Lives. 4
Collaboration with Home Visitors and Early Childhood Professionals NE-EHDI 1-3-6 Data for 2016-2018 Birth Years NE-EHDI Data for 2016-2018 Birth Years 10/1/2019 NE-EHDI Comparison Data for NE-EHDI NE-EHDI NE-EHDI 2016 – 2018 Birth Years 2016 2017 2018* 98% 98% 97% % of babies screened by 1 month of age 59% 63% 73% % of babies diagnosed by 3 months of age % of babies identified as D/HH & Enrolled 86% 78% 78% in Early Intervention by 6 months of age *Percentages for 2018 “1-3-6” are preliminary data and most likely will change slightly before the final data is reported to CDC 12/16/19. Helping People Live Better Lives. Helping People Live Better Lives. NE-EHDI Comparison Data for NE-EHDI NE-EHDI NE-EHDI 2016 – 2018 Birth Years 2018* 2016 2017 27,116 26,266 25,918 # of Births # Identified as D/HH 62 54 58 # Unresponsive after communication with EHDI 23 24 27 # Lost to follow-up 2 2 1 (No response to calls/letters from EHDI) *Percentages for 2018 are preliminary data and most likely will change slightly before the final data is reported to CDC 12/16/19. Helping People Live Better Lives. Helping People Live Better Lives. Important part of the EHDI Team to Help EDUCATE • Share with Pregnant Clients • Nebraska Newborn Hearing Screening Video – Did you know? https://www.youtube.com/watch?v=qnWjPJgOLjc#action=share • FREE NE-EHDI brochure “Can Your Baby Hear” http://dhhs.ne.gov/Pages/EHDI-Order-Literature.aspx • CMV information (online video and FREE handouts) http://dhhs.ne.gov/Pages/EHDI-Order-Literature.aspx Helping People Live Better Lives. Helping People Live Better Lives. 5
http://dhhs.ne.gov/EHDI More Possibilities for Collaboration brenda.coufal@nebraska.gov brenda.coufal@nebraska.gov Collaboration with Home Visitors and Early Childhood Professionals E-mail ideas to 10/1/2019 Important part of the EHDI Team to Help EDUCATE • Share with Clients with children up to age 3 who are identified as DHH • NE-EHDI Parent Resource Guide http://dhhs.ne.gov/Pages/EHDI-Parent-Resource-Guide.aspx • Nebraska Hands & Voices/Guide By Your Side Program • HearU Nebraska (Children’s Hearing Aid Loaner Bank) • Parent Training Information – PTI Nebraska Helping People Live Better Lives. Helping People Live Better Lives. • Invite NE-EHDI to present and/or exhibit at conferences, meetings, health fairs • NEW HRSA EHDI Funding for 4/1/2020 – 3/31/2024 Requirements: Expand our capacity to support hearing screening, diagnosis, and enrollment into EI for those infants who pass a newborn hearing screen but later develop hearing loss up to 3 years of age Required to develop a plan by 3/31/2022 Starting conversations to partner with Early Head Start Other ideas for partners who may be conducting hearing screens during early childhood? Other ideas for collaborations? Helping People Live Better Lives. Helping People Live Better Lives. Questions? Helping People Live Better Lives. Helping People Live Better Lives. 6
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