19th ANNUAL EARLY HEARING DETECTION & INTERVENTION MEETING
March 8-10, 2020 • Kansas City, MO

3/10/2020 | 1:45 PM - 2:15 PM | Evaluating EHDI benchmarks: is it as easy as 1-3-6 for improved outcomes? | Chicago A

Evaluating EHDI benchmarks: is it as easy as 1-3-6 for improved outcomes?

Background Early hearing detection and intervention (EHDI) programs have significantly reduced the identification age and intervention by implementing 1-3-6 benchmarks (EHDI136). Outcome benefits of earlier benchmarks (diagnosed before 2, EI enrolled before 3 months-EHDI123) for infants who are deaf/hard-of-hearing (D/HH) are unknown. Methods This study expands upon the Ohio EHDI Data Linkage Project, following 1262 infants identified at birth between 2008 and 2014 who enrolled in early intervention (EI). Children were classified by benchmarks achieved: EHDI123, EHDI136, EI<6 months, EI>6 months. Outcomes included EI language quotients (LQ), preschool pre-literacy. Repeated measures models were constructed, evaluating outcomes over time by benchmark categories, controlling for confounders. Results 124 children (10%) met EHDI123, 267 (21%) EHDI136, 26% EI<6months.2, 43% EI>6 months. Characteristics were similar between EHDI123 and EHDI136. Both groups were more likely to be Caucasian, have private insurance, higher maternal education, severe/profound hearing levels compared to EI<6 or >6. After controlling for confounders, EHDI123 had baseline (EI enrollment) mean receptive LQ (100.3), maintaining this over time. EHDI136 had baseline LQ of 89.5, maintaining this over time. Both EHDI benchmarks had significantly (p<0.05) higher baseline language than EI<6 (81.6) and EI>6 (80.8). Although EI<6 and EI>6 made significant “catch up” progress, they did not achieve EHDI123 levels. At age 3 years, EHDI123 had higher pre-literacy levels regarding picture naming abilities than other groups. By age 5 years, EHDI123 and EHDI136 had significantly higher picture naming abilities, performing similar to all Ohio preschoolers. Unfortunately EI<6 and >6 groups exited preschool with lower pre-literacy skills than their early EHDI counterparts. Conclusions Early attainment of EHDI benchmarks are associated with higher language and pre-literacy skills. Future work should focus on supporting high risk families for late benchmark attainment and helping at-risk families access EHDI supports.

1) Understand the benefits from data linkage from Part C early intervention to Part B in understanding long-term outcomes in children who are D/HH
2) Understand the positive outcomes associated with meeting the EHDI 136 benchmarks and the potential benefits of earlier benchmarks (1-2-3) on outcomes
3) Recognize characteristic and demographic differences in infants who are able to meet an earlier set of important cutoffs for EHDI (1-2-3) vs. those who meet the 1-3-6 benchmarks and those are enrolled in early intervention later

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Presenters/Authors

Jareen Meinzen-Derr (), Cincinnati Children's Hospital Medical Center, jareen.meinzen-derr@cchmc.org;
Dr. Meinzen-Derr is quantitative epidemiologist at the Cincinnati Children's Hospital Medical Center. She has focused her research on outcomes of children who are deaf or hard of hearing, and specifically those who have additional developmental disabilities.

ASHA DISCLOSURE:

Financial -
• Receives Grants for Other activities from NIDILRR, CDC.

Nonfinancial -
No relevant nonfinancial relationship exist.

Susan Wiley (), Cincinnati Children's Hospital Medical Center, susan.wiley@cchmc.org;
Dr. Susan Wiley is a developmental pediatrician with extensive expertise in children who are deaf/hard of hearing. She has many years of experience serving children with multiple disabilities. Dr Wiley provides leadership and guidance to the National American Academy of Pediatrics, the Ohio Department of Health Early Hearing Detection and Intervention Program, the Ohio Center for Deaf-Blind Education, and the Outreach Center for Deafness and Blindness in the Ohio Center for Low Incidence.