Hear Now! ND EHDI Announces the release of North Dakota s Early Intervention Module. Inside this issue:

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1 Volume 3, Issue 11 Jul-Sept 2010 Hear Now! ND EHDI Announces the release of North Dakota s Early Intervention Module NORTH DAKOTA EARLY HEARING DETECTION & INTERVENTION Even the best program to identify a hearing loss will be ineffective if a seamless referral and timely participation in an appropriate early intervention program do not follow. Sass-Lehrer Ph.D, M. (2002) Myths and Facts about Early Identification and Early Intervention, clerccenter.gallaudet.edu/clerc_center.html. July 22, Documents/Clerc/EI.pdf. After a long anticipated wait, ND EHDI is happy to announce the addition of an Early Intervention Module (EI Module) to the OZ esp system. Anyone with OZ access will now have the ability to send referrals to North Dakota s early interventionists in an efficient and timely manner. The primary referral providers will be hospital staff and Audiologists. The EI Module will work by allowing hospital staff to add an EI provider as a professional contact. Once the provider is added he/she will receive an showing a referral has been made for EI services. The provider will go into the OZ esp system and look at the referral information to begin the follow-up process. There are multiple levels and branches of early intervention within the state of North Dakota and the EI Module will allow for communication of referrals and follow-up to be easily relayed to the appropriate parties. Another aspect of the EI Module is the ability for EI providers to enter outpatient hearing screening information into the system. The outpatient information is important when trying to find North Dakota s loss to follow-up population and ensure proper follow-up for those children in need. Training on the utilization of the EI Module will be conducted on August 11 th, 2010 at 10 a.m., CST. The training will be conducted via the Internet so, travel is not necessary. If you are interested in participating in the training please send an with your contact information to: Jerusha.olthoff@minotstateu.edu. Inside this issue: Early Intervention & Hearing Health EI Module ND EHDI Summit 2 OZ Training Tips 3 Joint Committee on Infant Hearing Upcoming Events & Information 5 Contact Information 6 1 4

2 2010 ND EHDI Summit ND EHDI staff were pleased to host a recent ND EHDI Summit in Bismarck, ND on June 22 nd, A welcome was made by State Health Officer, Dr. Terry Dwelle and the meeting was facilitated by the Director of the National Center on Hearing Assessment and Management (NCHAM), Dr. Karl White. Also representing NCHAM was Dr. Terry Foust, AuD. Nearly thirty people with a vested interest in EHDI activities were in attendance to celebrate North Dakota s progress with their EHDI system; identify issues related to tracking, reimbursement, equipment and sustainability; and develop an action plan to address these issues. Thank you to those who were able to attend! The summit concluded with new ideas, insights and motivations that will be used to guide future EHDI activities for program improvement. Information about the meeting will be posted on our ND EHDI website in the near future ( Page 2 CHIMES

3 Upcoming Events 2010 October 2010 Investing in Family Support Conference: Kansas City Marriott Country Club Plaza, Kansas City, Missouri. October 10-12, OCTOBER AUGUST Sun Mon Tue Wed Thu Fri Sat Submission of HearNow Supplement ND EHDI staff recently submitted a grant proposal to the US Department of Health and Human Services: Health Resources and Services Administration (HRSA). The purpose of the grant is to reduce loss to follow-up after failure to pass newborn hearing screening. This funding would provide supplemental funds to the current Hear- Now project; allowing for the purchase of screening and diagnostic equipment, increased funds to provide additional trainings and technical assistance, and increased efforts for public awareness and materials development. If funded, the duration of the project would be September 1 st, 2010 until March 31 st, Look for announcements in our next issue of the Chimes and wish us luck! NOVEMBER SEPTEMBER Sun Mon Tue Wed Thu Fri Sat DECEMBER OCTOBER Sun Mon Tue Wed Thu Fri Sat Growth Charts are back in STOCK! If you are interested in receiving more Contact Upcoming Presentation at Minot Symposium Staff from ND HearNow will be presenting at the North Dakota Perinatal Symposium in Minot, ND. The Symposium is scheduled September 16 th & 17 th at the Grand International Inn. The title of the presentation is A Closer Look at the ND Early Hearing Detection and Intervention (EHDI) Program. Vickie.Brabandt@minotstateu.edu VOLUME 3, ISSUE 11 Page 5

4 (810) What is EHDI? EHDI (Early Hearing Detection & Intervention) programs are located in states and are designed to identify infants with hearing loss by universal screening. This allows identified infants to be enrolled in an early intervention program. These intervention programs are designed to help facilitate the development of visual and/or spoken language and the cognitive (thinking) skills needed to succeed academically and socially. Chime In! ND EHDI WEBSITE Check out the most updated ND EHDI website at for information or to meet the staff. If you have questions, find broken links or typos, or have suggestions, please let us know. Hear Now! Funded by the U.S. Department of Health and Human Services, Health Resources and Services Administration; Award No. H61MC

5 How to close an open audiologic session: On the Hearing tab, under the Assessment Section: Click on view/edit Assessment Data Click on Audiologic Assessments Click on View in front of the open assessment Click on Synopsis ; verify results entered Click on Save & Close OZ esp Training Tips NOTE: Once test results are entered as an Audiological Assessment, click on Save & Close (usual response) or Save & Return to Summary Save & Close will save the results and close the assessment Save & Return to Summary will save results and return to the Audiological Assessment tab without closing the assessment Audiological entry of Outpatient Screening and Assessment results with the same date: The OZ esp system tracks the screening and assessment process through three primary steps: 1. Birth Screening 2. Outpatient Screening 3. Audiological Assessment As each step is processed in OZ, it overrides the previous step. For example, the outpatient screening results will override the birth screening results and the assessment information will override outpatient screening results, therefore it is not necessary to enter hearing screening results in both the outpatient and assessment sections for testing provided on the same day. Also, once an assessment session is entered in OZ esp, all future test results including screenings need to be entered as an assessment. CDC iehdi Proposal NDCPD submitted a proposal on July 28 titled North Dakota Data Integration Project in response to a request for proposals from the Center for Disease Control and Prevention Agency on what they are calling an iehdi pilot study. The purpose of this contract is to obtain a limited set of existing, individual level data from a minimum of six states. Information in a limited data set is not directly identifiable and excludes direct identifiers, such as names or social security numbers, of the individual or of relatives, employers, or household members of the individual. Part of the CDC EHDI program mission is to support states in the development of tracking and surveillance systems and collect and maintain a database with aggregate hearing screening and follow-up data. Although this aggregate level data has enabled the generation of national estimates of hearing screening, diagnosis and enrollment in intervention, there are several limitations and questions that cannot be addressed with this data, which is why more detailed, pseudonymized, individual data is needed. NDCPD will work to develop a data use agreement with the Office of Vital Records and the State EHDI Coordinator as a first step to assembling this data file. Once completed we will begin to assemble a data base of Vital Records and ND EHDI data that will undergo a pseudonymization process that will remove identifiable information but still allow NDCPD staff to go back and update individual data sets. This is a two year contract that will offer CDC a different look at EHDI data because it will be of individuals not aggregate data. Neil Scharpe, NDCPD Service Contract Specialist will function as the Project Director. Page 3 CHIMES

6 Joint Committee on Infant Hearing (JCIH) Reminder: Joint Committee on Infant Hearing (JCIH) Reminder: The latest Position Statement released by the JCIH suggested several changes and recommendations to past hearing care protocol at the hospital and audiology levels. Please take time to review the recommendation below. Hearing screening and rescreening protocols: Separate hearing screening protocols are recommended for NICU and well-infant nurseries. Infants in the well-infant nursery who fail automated ABR testing should not be rescreened by OAE testing and "passed," because such infants are presumed to be at risk of having a subsequent diagnosis of auditory neuropathy/dyssynchrony. ABR technology is the only recommended appropriate screening technique for use in the NICU. High risk NICU infants (admitted for more than 5 days) are to have automated auditory brainstem response (ABR) included as part of their hearing 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 diagnostic ABR testing, rather than for general outpatient rescreening. For rescreening, a complete evaluation of both ears is recommended, even if only 1 ear failed the initial screen. 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 culturepositive sepsis), a repeat hearing screening is recommended before discharge. Diagnostic audiology evaluation: 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. The prior recommendation for follow-up audiology assessments every 6 months for all screen fails was felt to place a great burden on audiologists and could not be accomplished in most parts of the country. In addition, there are infants with "unknown risk factors who develop late onset hearing loss. Therefore, the responsibility for surveillance of all infants has been shifted to the primary care provider, who will refer to audiologists, as needed, any patient for whom there are concerns or findings consistent with 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. Many excerpts were taken directly from the JCIH Position Statement Pediatrics published and available online at: ijkey=oj9baleq21ola&keytype=ref&siteid=aapjournals PEDIATRICS Vol. 120 No. 4 October 2007, pp (doi: /peds ) Page 4 CHIMES