about Pediatric Medical Care
Hearing loss is the most common congenital condition in the United States. Each year, an estimated three in 1000 infants are born in the US with some type of hearing loss. Without early detection and intervention, children with hearing loss experience delayed development in language, learning, and speech. Children with hearing loss should be identified as quickly as possible after birth so that appropriate services can be started and assistive listening devices can be obtained if appropriate.
Comprehensive pediatric medical care is a core component in the early hearing detection and intervention process. Pediatric medical providers serve children who are suspected or diagnosed with hearing loss through the American Academy of Pediatrics’ Medical Home model.
A medical home is an approach to providing comprehensive primary care that facilitates partnership between patients, physicians, and families. The American Academy of Pediatrics (AAP) believes that every child deserves a medical home, where care is accessible, continuous, comprehensive, patient- and family-centered, coordinated, compassionate, and culturally effective. Over the past year the AAP has been at the forefront of numerous initiatives to promote the adoption and spread of the patient- and family-centered medical home.
The Medical Home model operates through professional partnerships with all healthcare and early intervention providers to assist the family and newborn or young child suspected or diagnosed with hearing loss. The primary care medical home provider assists the family in accessing specialty and sub-specialty care, early intervention and/or educational services, family support and other public and private therapeutic and/or community services. This coordination is extremely important to the overall health of the child and family.
Caring for Young Patients with Hearing Loss
This video discussed effective care for young patients who are deaf or hard of hearing. Research in the areas of critical timelines for early hearing detection and intervention and language development are discussed. AAP EHDI guidelines for medical home providers to support families navigating the EHDI process are detailed as well. The Joint Committee on Infant Hearing risk factors and late-onset considerations are also included in this module.
Medical Home for EHDI: Physicians’ Perspectives and Practices
This video supports physicians’ ability to provide comprehensive medical care to infants or toddlers who are suspected or diagnosed with hearing loss. Findings from an important research project focused on gaining better understanding of primary care physicians appreciation for newborn hearing screening is covered. Highlights from the Joint Committee on Infant Hearing, Year 2007 Position Statement and Texas House Bill 411 physician requirements are also covered.
Pediatric Medical Providers “Champion” the EHDI Cause
In 2001 the American Academy of Pediatrics (AAP) implemented a program, “Improving the Effectiveness of Newborn Hearing Screening, Diagnosis, and Intervention through the Medical Home”, funded through a cooperative agreement from the Maternal and Child Health Bureau (MCHB), Health Resources and Services Administration (HRSA), and the Centers for Disease Control and Prevention (CDC) National Center on Birth Defects and Developmental Disabilities (NCBDDD) respectively, for the planning, ongoing management, and implementation of its Early Hearing Detection and Intervention (EHDI) program. This cooperative agreement focused on increasing the involvement of primary care pediatricians and other child health care providers by linking follow-up services more closely to the newborn’s medical home. As part of EHDI and this program, the AAP worked to identify one pediatrician in each state’s chapter to champion this cause. Since 2001, more than 60 chapter champions have been identified and are actively participating in the program at the national and state/chapter levels. In Texas, Rachel St. John, M.D. serves as our state AAP Chapter Champion.
Pediatricians Play a Key Role in Improving Loss to Follow-Up
Since 2000, the percentage of newborns screened for hearing loss dramatically increased from 52% to 95%. However, almost half of the children who “do not pass” on a newborn hearing screening test lack a documented diagnosis. The infant’s primary care medical home provider plays an important role in ensuring that timely follow-up and the appropriate documentation of that follow-up occur. Without the active assistance of the medical home, the infant may be considered “lost” in the EHDI system, which undermines the potential benefits of newborn hearing screening. A “wait and see” approach is never appropriate. An infant who does not pass his/her newborn hearing screening has a potential developmental emergency! Please review the Guidelines for Medical Home Providers in Reducing Loss to Follow-up/Documentation in Newborn Hearing Screening to ensure your patients’ access to comprehensive care within the EHDI process.
*Do not pass includes infants who have “failed” or missed the hearing screening or those who had an invalid, uninterpretable result.
The American Academy of Pediatrics and the National Center for Hearing Assessment and Management have additional information and resources for pediatric medical home providers to assist them in effectively caring for young patients with suspected or diagnosed hearing loss.