Early Hearing Detection and Intervention A roadmap to success

Medical home

Introduction

Review Newborn Hearing Screening results at first Well Child visit

Confirm that follow-up appointments have been scheduled

Complete the Patient Checklist for Primary Care Providers with families who need further screening for hearing loss

Ensure follow-up appointments are completed and results received

Complete Parent Roadmap for families with a child identified with hearing loss

Streamline authorizations to eliminate delay to specialty providers such as ORL, ENT, and genetics 

Offer and provide referral to Minnesota Hands & Voices

Refer to Early Intervention through Help Me Grow

Respond promptly to Minnesota Department of Health requests for follow-up information and plans

Closing The Follow-Up Gap: Medical Home


Role of the Medical Home

According to the Joint Principles of the Patient-Centered Medical Home, March 2007, "The Patient-Centered Medical Home (PC-MH) is an approach to providing comprehensive primary care for children, youth and adults.  The PC-MH is a health care setting that facilitates partnerships between individual patients and their personal physicians, and when appropriate, the patient's family."

"The medical home concept includes these characteristics:  accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective care."

---------------------------

The role of the primary care provider in EHDI:  "The primary care physician must assume responsibility to ensure that audiological assessment is conducted on infants who do not pass screening and must initiate referrals for medical specialty evaluations necessary to determine the etiology of the hearing loss."  Joint Committee on Infant Hearing, 2007

A Clinician's Pledge: Follow Up on Audiology Evaluations 
As a part of the CDC Expert Commentary Series on Medscape, Dr Georgina Peacock discusses the '1-3-6' approach to help close the gap for infants who fail their hearing screening.


Tips for Improvement

Misconception:  Parents can tell if their child has a hearing loss by the time their child is 2-3 months old.

Clinical Fact:  Before newborn hearing screening, most children were not found to have a hearing loss until 2-3 years of age.  Children with milder hearing loss were not found until 4 years of age.

---------------

Misconception:  Hearing loss risk factor assessments will identify all children with hearing loss.

Clinical Fact:  As many as 50% of infants born with hearing loss have no known risk factors.

---------------

Misconception:  If infants pass the newborn hearing screening, they do not require ongoing hearing surveillance.

Clinical Fact:  It is estimated that by school age, new cases of permanent hearing loss occur in approximately 6 per 1000 children in addition to the 3 per 1000 likely to be detected at birth. American Speech-Language-Hearing Association. Guidelines for audiology services in the schools.  ASHA. 1993: 35(suppl 10); 24-32.

---------------

Misconception: There is no rush to identify hearing loss.

Clinical Fact: Children identified with hearing loss after 6 months of age are more likely to have speech, language, and cognitive delays than children identified before 6 months.  Children identified early can avoid these delays through evidence-based early intervention programs.

More Hearing Screening Myths