Early Childhood Hearing Outreach ( ( ( ECHO ) ) ) Project

1. Early Childhood Hearing Outreach (((ECHO)))Project Virginia 2007 Claire Jacobson, AuD, CCC-A Professor, Pediatric Audiologist James Madison University

3. Goal of NCHAM-National Center for Hearing Assessment & Management “ Ensure all infants & toddlers with hearing loss are identified a early as possible and provided with timely and appropriate audiological, educational & medical intervention” ECHO Team Training Manual 11/1/2004

4. Goal of NCHAM-National Center for Hearing Assessment & Management • As many as 1 in 300 children have hearing loss…..hearing loss is an invisible handicap • When present at birth it can go undetected speech, language and learning is compromised • Prior to implementation of newborn hearing screening programs the AVERAGE AGE of IDENTIFICATION was 2 1/2 years old! ECHO Team Training Manual 11/1/2004

5. Newborn Hearing Screening History…. • Virginia was the 8th state to pass legislation • HB 585 July 1, 2000 all infants born in VA hospitals require hearing screening prior to discharge • Infants who do not pass must be referred to an audiologist for diagnostic testing 1 month post discharge • Intervention no later than 6 months old

7. Newborn StatisticsVirginia January 1, 2005 and December31, 2005. * Live Births: 102,247 * Screened Before 1 Month of Age: 98.4% * Infants who did not pass the screening: 3.1% * Infants who received follow-up: 83% Head Start can help find the missing 17% * infants passed screening, but at-risk for progressive or delayed-onset 1.9% Head start can help follow those children * Born in 2005, who have been identified with hearing loss: 107 * Average age at diagnosis: 5.2 months * Median age at diagnosis: 3.8 months * Minimum age at diagnosis: 0.7 months * Maximum age at diagnosis:15.5 months (includes later onset)

8. ECHO Program Background • NCHAM National Center for Hearing & Management • Funded by Administration for Children and Families, Head Start Bureau • Pilot project conducted in Oregon, Utah, and Washington 2001-2004 • Update hearing screening of Migrant, American Indian and Early Head Start grantees • Perform otoacoustic emissions (OAE) hearing screening age 0-3 • children not passing the screening • ensure appropriate follow-up diagnostic and intervention (medical & audiological • Pilot project culminated in collaborations with state Early Childhood Hearing Outreach (ECHO) Teams • serve as sustainable systems of training & technical assistance • extend benefits of updated screening practices to more Head Start programs

9. What is an OAE and how does it work?

10. Performing OAEs

11. Benefits of OAEs • Provides objective reliable information regarding status of middle and inner ear • Can detect child with chronic middle ear disease or permanent hearing loss to enable appropriate referrals • Not dependent on child’s ability to respond • When presented to child in a friendly manner, usually well accepted • Non-invasive & EASY to perform on a relatively cooperative child • Allows Head Start programs to make appropriate referrals for follow-up to pediatric audiologist and medical personnel • May identify children who have either been “lost to follow-up” or have later onset or progressive hearing loss

12. Early Childhood Hearing Outreach ECHO • Principle objectives • Develop & implement strategies for establishing state-based teams with the resources and skills to extend the benefits of OAE hearing screening to 0-3 year-old children served by Migrant, American Indian and Early Head Start grantees nationwide • Build capacity of existing resources to provide training and support to Head Start grantees

13. Early Childhood Hearing Outreach ECHO The following objectives will be accomplished To achieve the principle objective- : • Establish sustainable EARLY CHILDHOOD HEARING OUTREACH (ECHO) teams with representation from the state EHDI system, pediatric audiology & Head Start • Provide materials, “hands-on” training experience, & additional support the state ECHO team as they assist Head Start grantees in updating their hearing screening practices • Provide outreach to EHDI systems, Head Start grantees, Head Start Advisory Committees and Head Start State Collaboration Offices, along with other key stakeholders in all 50 states and territories, to lay the groundwork for updating hearing screening practices nationwide

14. Progress on ECHO Training First Virginia ECHO Training in Early Head Start • August 2, 200 Child Development Resources Center Williamsburg, VA • Second training in Northern Virginia- September 2007 TBA

15. ECHO Project Virginia • Collaboration between National Center for Hearing Assessment and Management, Virginia Head Start Association & James Madison University- Audiology • NCHAM, VA Head Start & JMU to establish plans for sustaining & expanding the training and technical assistance to Head Start & others serving the early childhood population in Virginia

16. Meet yourVirginia ECHO TEAM

17. Meet yourVirginia ECHO TEAM • Maxine McKinney, Executive Director Virginia Head Start Association • Claire Jacobson, Professor, Audiology, James Madison University • Bethany Geldmaker, Program Director Early Childhood Health • Marna Zok, Health Services Specialist • Fredia Helbert, Audiologist Wise County Schools • Mani Aguilar, Audiologist UVA SLPH Center • Deborah Minnis Audiologist, Sentara Health Care • Kathryn Rios, Audiologist Private Practice