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Communication is Key
Approximately 100 babies in Louisiana are identified as deaf or hard of hearing each year. Identifying these babies as early as possible through newborn hearing screening is important to prevent developmental delays. Children who are deaf or hard of hearing should receive early intervention services as soon as possible - at least before a baby is 6 months old, but earlier is better - in order to develop communication and language skills similar to their peers.
It takes a team of healthcare professionals to get a child through the Early Hearing Detection and Intervention (EHDI) process, from the initial screening to enrollment in early intervention services. The EHDI process helps to ensure that all families of deaf or hard of hearing children receive the support they need to help their children learn, grow and thrive. They follow the recommendations of the Joint Committee on Infant Hearing's Position Statement to guide this process. View the EHDI fact sheets for the latest data on our program.
Resources To Share
We have created a suite of resources for providers to share with families as they move through the hearing diagnosis process. You can print these on demand or email us at firstname.lastname@example.org to receive copies in bulk.
- Newborn Hearing Screening: all families should have received a copy of this on the back of their Newborn Hearing Screening form.
- Rescreening Information: share this with families of children who need to be rescreened to help them understand what to expect.
- Diagnostic Testing: share this with families of children who need to receive diagnostic testing so they know what to expect and how to prepare.
- Diagnosed As Deaf or Hard of Hearing Resource: share this with families of children who were identified as deaf or hard of hearing to give them an idea of what's to come. (en Espanol)
- Diagnosed with Unilateral Hearing Loss: share this with families of children who were identified as being deaf or hard of hearing in one ear to emphasize the importance of early intervention and give them an idea of what's to come.
- Communication Options Guide: families can use this guide to start exploring the different ways deaf and hard of hearing children can learn how to communicate.
Below is an overview of what each of the different types of providers involved in the EHDI process are responsible for.
All newborn babies should receive a hearing screening before they leave the hospital. Providers at the birthing facility are responsible for the following tasks when conducting a newborn hearing screening:
- Communicate newborn hearing screening information and parental options to parents prior to screening.
- Test all infants for hearing loss prior to discharge. Infants born outside of a birthing facility should receive a hearing screening by an audiologist or physician.
- Document all hearing screening results using LEERS.
- Inform parents, primary care providers, and the EHDI program of the hearing screening results within 7 days of screening.
- Schedule a follow-up appointment within 1-2 weeks for infants who need follow-up testing after the initial screening.
Review the Louisiana Birthing Facilities Newborn Hearing Screening Guidelines for more information.
Primary Care Providers
A coordinated, family-centered approach is recommended for treating deaf or hard of hearing babies. It is important to tell parents that continuous interaction and communication are critical to their child meeting developmental milestones. Both verbal and non-verbal communication will help parents bond with their baby and lay the groundwork for the baby's language and communication skills. Providers can keep this Hearing Screening Follow Up Protocol on hand to determine next steps for their patient based on their newborn hearing screening results.
Below are some of the core responsibilities a pediatrician has in the EHDI process:
- Ensure infants who need follow-up testing get rescreened and/or receive diagnostic testing in a timely manner.
- Review a child's medical history for risk indicators that require monitoring for late-onset or progressive hearing loss. If risk indicators are present, make sure an audiological evaluation is completed before the child turns 2 years old.
- Conduct regular surveillance of developmental milestones, auditory skills, parental concerns, and middle ear status consistent with the AAP pediatric periodicity schedule.
The main roles of an audiologist are to rescreen babies who need follow-up testing after the initial newborn screening, perform diagnostic testing to confirm or rule out hearing loss, and fit children for hearing aids. Babies who are deaf or hard of hearing may need to learn alternative ways of communicating, such as sign language. Audiologists should make sure families know their options and can help them begin the process of determining the best ways to communicate with their baby.
When working with children diagnosed as deaf or hard of hearing, it is important to:
- Ensure parents understand the results of their child's hearing test.
- Report test results in LA EHDI-IS.
- Provide timely fitting and monitoring of amplification devices.
- Refer families to appropriate intervention services and inform the child's primary care physician. Babies who are deaf or hard of hearing should be enrolled in early intervention and support services as soon as possible.
For more information, check out our Pediatric Audiology Guidelines.
Reporting and Accessing Results
Audiologists are required to report the following:
- Newborn hearing screening results on all infants who were initially screened outside of their birthing facility, regardless of results.
- Rescreening results on all infants with a “further testing needed” result from an initial newborn hearing screening, regardless of results.
- Diagnostic testing results on all children age 0-5 identified with a hearing loss for the first time.
- A change in hearing status for any child age 0-5 (ex. original diagnosis - unilateral, now bilateral, or original diagnosis - mild, now severe).
- Any child age 0-5 fitted with a hearing aid or cochlear implant for the first time.
- Any child that is considered lost to follow-up for your facility. Report information on any child who failed to keep their rescreening, diagnostic testing, or hearing aid fitting appointment.
Report screening and diagnostic testing to Louisiana Early Hearing Detection and Intervention (LA EHDI) on the EHDI Follow-up Services Report (FSR) Form. For children diagnosed with permanent childhood hearing loss, forms must be submitted within 2 days of diagnosis. All other results must be submitted within 7 days of testing.
LA EHDI-IS is the database used to access newborn screening, diagnostic testing, amplification, early intervention and family to family support information for their patients. Hospital staff, audiologists, and pediatricians can request access to the LA EHDI-IS Database.