2023 Early Hearing Detection & Intervention Conference
March 5-7, 2023 • Cincinnati, OH
3/09/2020 | 2:00 PM - 2:30 PM | Early Intervention intensity for children who are deaf/hard-of-hearing: Beyond EHDI benchmarks | Chouteau B
Early Intervention intensity for children who are deaf/hard-of-hearing: Beyond EHDI benchmarks
Background
Although earlier receipt of early intervention (EI) is associated with improved outcomes, little is understood regarding how content, intensity of EI services impacts outcomes.
Methods
We report on data from 1262 infants identified with hearing loss (born 2008-2014), enrolled in EI (Ohio Data Linkage Project). EI services potentially associated with hearing loss (HL) were selected. Cumulative service exposure, from Individualized Family Service Plan, was defined as total hours from EI enrollment to exit for a specific service and all selected services combined. Service hour quartiles were created across service categories and examined in regression models with preschool pre-literacy and kindergarten readiness. Factors included in models: EI entry age, maternal education, laterality, disability diagnosis, HL severity, insurance.
Results
The top 5 services included service coordination (89%), habilitative services for HL (66%), special instruction (65%), speech-language (54%), and family training (39%). The median cumulative EI hours for top 10 services combined was 57 [IQR 28-112] with 25% of families receiving 112 hours or more throughout EI duration. Factors associated with receipt of different services included (but not limited to) insurance, maternal education, diagnosis age, HL severity. By preschool, children who had received any habilitative services for HL (vs. none) and children with greater time spent in these services (highest quartiles) had significantly higher pre-literacy picture naming scores over time after adjusting for potential confounders. In kindergarten, children with greater time spent in habilitative services for HL (>18.6 service hours) were more likely to demonstrate kindergarten readiness (Odds Ratio 1.7 [95%CI: 0.98, 2.9]) after adjusting for the same confounders. Higher levels of other service types did not coincide with better outcomes.
Conclusion
Although children who enter EI at earlier ages have improved outcomes over entering later, by evaluating EI service types and intensities assigned, we can understand outcomes from a new perspective.
- Understand intensity (exposure over time) of different service types provided to children who are D/HH in early intervention
- Identify demographic and child characteristics associated with receipt of services, as well as receipt of higher levels of services
- Recognize association between specific EI service types and outcomes of children who are D/HH
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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 -
Nonfinancial -
Meredith Tabangin
(), Cincinnati Children's Hospital Medical Center, meredith.tabangin@cchmc.org;
Ms. Tabangin is an epidemiologist with Cincinnati Children's Hospital Medical Center
ASHA DISCLOSURE:
Financial -
Nonfinancial -
Mekibib Altaye
(), Cincinnati Children's Hospital Medical Center, mekibib.altaye@cchmc.org;
Dr. Altaye is a biostatistician at Cincinnati Children's Hospital Medical Center
ASHA DISCLOSURE:
Financial -
Nonfinancial -
Mallory Minter-Mohr
(), Bureau of Maternal, Child and Family Health, Mallory.Minter-Mohr@odh.ohio.gov;
Mallory Minter-Mohr is a Researcher for the Ohio Department of Health with the Bureau of Maternal, Child and Family Health. She provides data support to the Infant Hearing Program, as well as Children’s Hearing & Vision, Adolescent Youth Surveys, and Birth Defects.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Allyson Van Horn
(), The Ohio Department of Health, Allyson.VanHorn@odh.ohio.gov;
Allyson Van Horn, MPH, MEd is the State of Ohio Early Hearing Detection and Intervention Coordinator and manages the Infant Hearing Program, Children’s Hearing Program, Children’s Vision Program and the Save Our Sight Program. Allyson has over 10 years’ experience with statewide programs that focus on early detection, diagnosis and treatment of children with hearing and vision problems. She has given many presentations on the importance of evidenced-based screening practices in the primary care, childcare and school settings. Allyson also participates on various statewide initiatives to improve hearing and vision screening, diagnostic and treatment rates.
ASHA DISCLOSURE:
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Nonfinancial -
Nathan DeDino
(), Department of Developmental Disabilities, nathan.dedino@dodd.ohio.gov;
Nathan DeDino is at the Department of Developmental Disabilities
ASHA DISCLOSURE:
Financial -
Nonfinancial -
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.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.