Using Tele-practice to support early hearing aid fittings for infants Karin Gillies Australian Hearing, Melbourne, Victoria, Australia Australasian Newborn Hearing Screening Conference, Melbourne, Australia - 2017
Australian Hearing Who are we? National program Funded to provide hearing services to eligible adults and young adults Sole provider of funded hearing services for children with hearing loss
Infant Services at Australian Hearing Introduced into 4 large Paediatric Hearing Centres in Victoria/ Tasmania (national rollout) 2005 2011 Tele-practice used to support Infant Extended to an additional services metro & regional Paediatric Hearing Centres Initial appointment conducted over the 2016 phone or in-centre
Clinical Training Program School-age children Pre-school-age children and babies >7 months Infants under 7 months of age
Tele-practice: Equipment
Tele-practice: Documentation & support
Standards & Quality Measures Age at Fitting Critical Appointment intervals Fitting by 6 months of age for infants referred before 6 months of age Initial appointment within 2 weeks of referral Fitting by 12 months of age for children referred by 11 months of age Initial fitting appointment within 2 weeks of decision to fit hearing aids Initial follow-up appointment within 2 weeks of fitting appointment
Case Study 1 Referral from diagnostic clinic at 16 months the baby was tested following the family arriving in Australia Mild sensorineural hearing loss bilaterally Family living in a regional area
Case Study 1 Tele-practice session: Initial appointment: Experienced audiologist conducted appointment via video-link with local audiologist observing (video view) Local audiologist took impressions for hearing aid fitting In clinic appointments for ongoing program: Behavioural testing performed using Visual Reinforcement Orientation audiometry (VROA) Follow up appointment with local audiologist
Case Study 1 Outcomes by 18 months of age: Behavioural testing using VROA commenced Parents Evaluation of Aural/ oral Performance of Children (PEACH) indicated age-appropriate listening behaviour Goals for initial program negotiated with family and evaluated
Case Study 2 Infant referred by diagnostic clinic at 2 ½ months of age Moderate-severe mixed hearing loss in the right ear and a severe mixed loss in the left ear Seen for Initial appointment with Paediatric Audiologist within 2 weeks of referral Fitting appointment booked within 2 weeks but Paediatric Audiologist unavailable the week of this appointment due to illness
Case Study 2 Tele-practice sessions: The day prior to the fitting appointment Video-link session with clinician to program the hearing aids and prepare for fitting appointment (desktop view) Fitting appointment Video-link session to talk to parents and assist clinician with appointment activities (video view) Positive feedback from parents that fitting appointment was able to go ahead as scheduled, and about the use of remote support for the appointment
Case Study 2 Outcomes by 12 months of age: Aided cortical assessment had been performed Behavioural testing using VROA commenced PEACH indicated age-appropriate listening behaviour Goals for initial program negotiated with family and evaluated
Case Study 3 Referred by diagnostic clinic at 3 ½ months Normal hearing in the left ear and a mild to severe sensorineural loss in the right ear Family lives in a regional area and the most convenient Paediatric centre > 4 hours drive away Appointments scheduled to coincide with other medical appointments to reduce travel burden for family Seen for Initial appointment and fitting appointment and then requested a closer centre
Case Study 3 Tele-practice session: Follow-up appointment: Remote support with clinician to review management, discuss progress & early intervention agencies with the parents and do a PEACH to evaluate functional listening (video view) In clinic sessions for ongoing program: Ear impressions in their local centre with on-site expert support Commenced behavioural testing at 9 months with on-site support Good case continuity with local audiologist and experienced audiologist
Case Study 3 Outcomes by 12 months of age: Behavioural testing commenced PEACH indicating age-appropriate listening behaviour Goals for initial program negotiated with family and evaluated
Summary Tele-practice can be successfully used in infant appointments Parents respond positively to the use of tele-practice in appointments Good outcomes can be achieved tele-practice is used for infant appointments
Next steps Tele-practice for VROA appointments
Thank you for listening For more information: karin.gillies@hearing.com.au http://www.hearing.com.au