2022 Early Hearing Detection & Intervention Virtual Conference

March 13 - 15, 2022

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3/09/2020  |   3:15 PM - 3:45 PM   |  Loan and Train – A Novel Approach to Improving Hearing Screening among Tennessee Infants Delivered By Midwives   |  Chouteau A

Loan and Train – A Novel Approach to Improving Hearing Screening among Tennessee Infants Delivered By Midwives

The number of home births has risen quickly in Tennessee, from 572 in 2008 to 1,021 in 2018. Infants born at home or delivered by midwives, in general, are less likely to receive hearing screening. The Tennessee Newborn Screening Program (NSP) strives to improve hearing screening among all infants, including special populations such as home births. An opportunity arose in 2016 when 31 OAE units were transferred from Tennessee Department of Education to the NSP. Collaborating with the University of Tennessee Center on Deafness, a Loan and Train project was launched in January 2017 to train midwives to use the loaned OAE units conducting newborn hearing screening. From January – June 2017 participating midwives completed a3.5-hour in-person workshop on hearing screening protocol, equipment use/maintenance, and data reporting. Since July 2017, midwives have completed the Newborn Hearing Screening Training Curriculum on the National Center for Hearing Assessment and Management (NCHAM) website (infanthearing.org). After completing the online training, they receive technical assistance with a 1.5-hour online webinar by the Tennessee EHDI audiologist consultant to review hearing screening and reporting protocol in Tennessee, learn about OAE equipment, practice using the unit, and develop a plan when follow-up screening and referral to local audiologist is needed. Thirty-six midwives completed the in-person training or the online training. The screening rate increased by 11 percentage points from pre-training (78%) to post-training (89%), and the difference was statistically significant. During the same time period of 2016-2018, the screening rate among infants delivered by participating midwives increased from 76% in 2016 to 87% in 2018. In contrast, the screening rate among infants delivered by non-participating midwives stayed constant (from 76% in 2016 to 79% 2018), suggesting the increase in the screening rate among infants delivered by trained midwives was likely due to the Loan and Train program.

  • Learn about the Tennessee EHDI’s efforts in improving hearing screening among home births
  • Evaluate the impact of the Loan and Train project
  • Apply the findings from the study to your state’s EHDI program

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Presenters/Authors

Vickie Miller (), University of Tennessee Knoxville, vmiller8@utk.edu;
Vickie Miller is the audiology consultant for the Newborn Hearing Program at University of Tennessee Knoxville Center on Deafness since 2015 providing consultation and training to providers across the state related to early hearing detection and intervention (EHDI) services for children birth to three who are suspected to have or have hearing loss. She leads and/or collaborates on projects and activities related to EHDI initiatives or improvements related to hearing screening, follow-up screening, diagnostic evaluations, early intervention and family support. She was with the Department of Education as a Service Coordinator and then a Developmental Specialist for Tennessee’s Early Intervention System where she facilitated service plan meetings, the development of Individual Family Service Plans and conducted eligibility evaluations for early intervention services for children birth to three. Vickie received a Bachelor of Arts degree in Speech Pathology and Master of Arts in Audiology at the UT Knoxville.


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Yinmei Li (), Tennessee Department of Health, yinmei.li@tn.gov;
Yinmei Li is an epidemiologist with the Tennessee Department of Health (TDH) who has provided epidemiological support to the Department and its statewide partners for more than fifteen years. In the first three years with TDH she worked as the chronic disease epidemiologist. Later on she expanded her scope of work to include maternal and child health and injuries as the director of the Surveillance, Epidemiology and Evaluation section within TDH’s Division of Policy, Planning and Assessment. Dr. Li is now with the Division of Family Health and Wellness supporting the State’s Newborn Screening Follow-up Program and Children’s Special Services Program. She received an MD equivalent degree from Shanghai Medical College, Fudan University in China, and both a Master’s degree in Experimental Statistics and a PhD in Veterinary Medical Sciences from Louisiana State University.


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