Educational Audiology and Hearing Screening; Social Determinants

justification criteria for screening a disorder (5)

1. prevalence of HL in infants in the US

2. evidence that the disorder will be detected earlier than without screening

3. availability of follow up assessments following failure of a screening

4. treatment accessibility immediately following a diagnosis

5. documented advantage to early identification

conditioned play audiometry

2-5 years

visual reinforcement audiometry

6-8 months - 2 years

Joint committee on infant hearing (JCIH)

recommended UNBHS and endorses objective measures: ABR and OAE (immittance for follow up)

risk factors for infants with HL

NICU, birth complications, low birth weight, family history, syndromes associated with HL

best for NICU babies

ABR, but won’t detect risk for later onset HL

if fail UNBHS OAE

problem with OHC

if fail UNBHS ABR

more than milk HL or retrocochlear path

critical period

auditory verbal therapy, listening and spoken language specialist

EHDI Goals

1 month screening, 3 month diagnosis, 6 month treatment

auditory neuropathy spectrum disorder (ANSD)

present OAEs, abnormal or absent ABR, absent acoustic reflexes, poor WRS in quiet and noise; dysfunction is not limited to the auditory nerve

ANSD risk factors

NICU stay, acquired due to age related HL, genetics

preschool hearing screening

detect HL that develops after birth, required by federal law, during preschool and then every one or two years after

goal of educational audiology

reduce negative effects of loss and disorder and to maximize children’s auditory learning and skills

physical and financial burdens associated with HL

social isolation, lower income, reduced cognitive function, poorer physical and psychological health, increased risk of falls and hospitalizations, worse patient and physician communication

hearing aid users wait _ before getting help

10 years

HA use and ownership not proportional by

race, sex, and socioeconomic status

social determinants of hearing care

financial, area of residence, health literacy, language differences, western medicine, stigma and perceptions of hearing

personal health literacy

degree to which individuals can find, understand, and use info and services to inform health related decisions and actions

organizational health literacy

how much organizations equitably enable individuals to find, understand, and use information and service to inform health related decisions and actions for themselves and others

cause of gap in hearing need and use

lack of access to intervention services like counseling