19th ANNUAL EARLY HEARING DETECTION & INTERVENTION MEETING
March 8-10, 2020 • Kansas City, MO
Referred Newborn Hearing Screening and Otologic Referral: Louisiana EHDI’s Pilot of Specialized PCP Faxes for this Population
Infants with middle ear fluid who refer on the newborn hearing screening present unique challenges to EHDI programs. An early otologic referral may result in the diagnostic evaluation being delayed until medical management is complete. We reviewed the records of all children born in Louisiana in 2017 and 2018 who were diagnosed with a permanent hearing loss to determine the proportion that exhibited co-existing middle ear fluid during the screening and diagnosis period. We found that 11% of those children diagnosed with a permanent hearing loss also had middle ear fluid noted in their records (22/196). This number increases to 20% when including those likely to have middle ear fluid due to findings of flat tympanometry and/or transient conductive hearing loss (39/196). In addition, 21 children (11%) from this cohort who were diagnosed late were either confirmed or suspected of having middle ear fluid. Most of these hearing losses were bilateral (17/21) and more than half were bilateral severe to profound (11/21). Thirteen were diagnosed after 6 months of age. To address this problem, we convened a learning community of various physicians and EHDI advisory council members for guidance on how to increase responsiveness from this group. The learning community members worked with EHDI staff to revise the content in the letters faxed to PCPs (primary care providers) to include information specific to timely diagnosis in infants with otologic referrals. We recently began piloting these new faxes. Preliminary results suggest improved responsiveness from PCPs. Over the next several months we will continue to track responses and follow-up outcomes on these children.
- Explain why the presence of middle ear fluid in infancy presents challenges to meeting EHDI 1-3-6 benchmarks.
- Specify the prevalence of co-existing middle ear fluid and permanent hearing loss in infancy.
- Explain why diagnostic audiological evaluation may miss a permanent hearing loss in an infant with middle ear fluid.
Poster:
21060_12631DanielleMercer.pdf
Presenter: Danielle Mercer
Danielle Mercer, AuD System Development Coordinator
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Tri Tran, MD, MPH Senior Epidemiologist
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Dawne McCabe, BS Data Coordinator
ASHA DISCLOSURE:
Financial -
Nonfinancial -
Susannah Boudreaux, Program Manager BS
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Terri Ibieta, M.Ed. LA EHDI Program Coordinator
ASHA DISCLOSURE:
Financial -
Nonfinancial -