Military Audiology Association February 13, 2006

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(No Transcript)
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Military Audiology AssociationFebruary 13, 2006
John Eichwald, Team Lead
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Congenital Defects/DiseasesIncidence per 10,000
MACDP NCBDDD 2004
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Conditions Screened in the Newborn Incidence per
10,000
NNSGRC 2003
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Reading Comprehension Scores of Hearing and Deaf
Students
Grade Equivalents
Age in Years
Schildroth, A. N., Karchmer, M. A. (1986). Deaf
children in America, San Diego College Hill
Press.
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Study of Early versus Late Identification
129 deaf and hard-of-hearing children assessed 2x
each year.
Assessments done by trained diagnostician as
normal part of early intervention program.
Moeller, M.P. (1997). Boys Town National Research
Hospital
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Universal Newborn Hearing Screening Endorsement

• American Academy of Audiology (AAA)
• American Academy of Pediatrics (AAP)
• American Speech-Language-Hearing Association
  (ASHA)
• Centers for Disease Control and Prevention (CDC)
• Joint Committee on Infant Hearing (JCIH)
• Maternal and Child Health Bureau (MCHB)
• National Association of the Deaf (NAD)
• National Institutes of Health (NIH)

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CDC EHDI Vision and Mission

• The vision of the Early Hearing Detection and
  Intervention (EHDI) program is to promote
  communication from birth for all children.
• The mission of EHDI is for every state and
  territory to have a complete EHDI tracking and
  surveillance system that ensures children with
  hearing loss achieve communication and social
  skills commensurate with their cognitive
  abilities.

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Childrens Health Act of 2000Public Law 106310

• DIVISION ACHILDRENS HEALTH
• TITLE VIIEARLY DETECTION, DIAGNOSIS, AND
  TREATMENT REGARDING HEARING LOSS IN INFANTS
• The purposes of this title are to clarify the
  authority within the Public Health Service Act to
  authorize statewide newborn and infant hearing
  screening, evaluation and intervention programs
  and systems, technical assistance, a national
  applied research program, and interagency and
  private sector collaboration for policy
  development, in order to assist the States in
  making progress toward the following goals

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Childrens Health Act of 2000Public Law 106310

• (1) All babies born in hospitals in the United
  States and its territories should have a hearing
  screening before leaving the birthing facility.
• (2) All babies who are not born in hospitals in
  the United States and its territories should have
  a hearing screening within the first 3 months of
  life.
• (3) Appropriate audiologic and medical
  evaluations should be conducted by 3 months for
  all newborns and infants suspected of having
  hearing loss to allow appropriate referral and
  provisions for audiologic rehabilitation, medical
  and early intervention before the age of 6 months.

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Childrens Health Act of 2000Public Law 106310

• (4) All newborn and infant hearing screening
  programs and systems should include a component
  for audiologic rehabilitation, medical and early
  intervention options that ensures linkage to any
  new and existing state-wide systems of
  intervention and rehabilitative services for
  newborns and infants with hearing loss.
• (5) Public policy in regard to newborn and infant
  hearing screening and intervention should be
  based on applied research and the recognition
  that newborns, infants, toddlers, and children
  who are deaf or hard-of-hearing have unique
  language, learning, and communication needs, and
  should be the result of consultation with
  pertinent public and private sectors.

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Childrens Health Act of 2000

• DIVISION A CHILDRENS HEALTH
• TITLE VII EARLY DETECTION, DIAGNOSIS, AND
  TREATMENT REGARDING HEARING LOSS IN INFANTS
• Health Resources and Services Administration
  (HRSA) shall
• make awards of grants or cooperative agreements
  to develop statewide newborn and infant hearing
  screening, evaluation and intervention programs
  and systems

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Childrens Health Act of 2000

• The Centers for Disease Control and Prevention
  shall
• develop standardized procedures for data
  management
• provide technical assistance on data collection
  and management
• promote the sharing of data regarding early
  hearing loss with state-based birth defects and
  developmental disabilities monitoring programs

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Childrens Health Act of 2000

• The Centers for Disease Control and Prevention
  (CDC) shall
• develop standardized procedures for data
  management and program effectiveness and costs,
  such as to
• ensure quality monitoring of newborn and infant
  hearing loss screening, evaluation, and
  intervention programs and systems
• provide technical assistance on data collection
  and management
• to study the costs and effectiveness of newborn
  and infant hearing screening, evaluation and
  intervention programs and systems conducted by
  State-based programs in order to answer issues of
  importance to State and national policymakers

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Childrens Health Act of 2000

• National Institutes of Health (NIH) shall
• continue a program of research and development on
  the efficacy of new screening techniques and
  technology, including clinical studies of
  screening methods, studies on efficacy of
  intervention, and related research.

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87.2 Newborns Screened (2003)(n 47)
WA 81
ME 94
VT 93
MT 97
ND 95
MN 93
OR 95
NH 91
NY 92
WI 93
ID 83
MA 99
SD 90
MI
WY 98
RI 99
CT 97
PA 98
IA
NE 97
NV 99
OH 40
NJ 98
IL 100
IN 99
DE 83
UT 98
WV 98
VA 96
CO 97
MD 91
MO 99
CA 56
KS 97
KY 99
NC 96
OK 96
TN 97
AZ
AR 92
SC 98
NM 92
AL 96
GA 96
MS 95
LA 94
TX 97
AK 81
FL 86
gt90 HP 2010 28-11 Target gt65 HP 2010 28-11
Baseline lt65 Not Reported
HI 99
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55.9 Audiological Evaluation (2003)(n 35)
WA
ME
VT 86
ND 43
MT
MN 53
OR 35
NH 9
NY 25
WI
SD 69
ID 100
MA 85
MI
WY 94
RI 95
PA 60
CT 73
IA
NE 82
NV
OH 17
IN
NJ 53
IL 77
UT 66
DE 100
CO 89
WV 66
CA 80
VA 70
MD 27
MO 20
KS 77
KY 14
NC
OK 32
TN 61
AZ
AR 47
SC 65
NM
GA 14
AL
MS 84
LA 65
TX
AK
FL
gt70 HP 2010 28-11 Target gt55 HP 2010 28-11
Baseline lt55 Not Reported
HI 74
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67.3 Intervention by 6 months (2003)(n 34)
WA
ME
VT 0
ND
MT
MN 100
OR 39
NH 64
NY 61
SD 100
WI
ID 100
MA 71
MI
WY 100
RI 100
PA 64
CT 100
IA
NE 67
OH 28
NV
IN 67
NJ 75
IL 29
UT 41
DE 100
WV 75
CO 45
VA 63
MD
CA 87
MO 52
KS 84
KY 100
NC
OK 91
TN 100
AZ
NM 50
AR 64
SC
GA
AL
MS 85
LA 53
TX
AK 0
FL
gt90 HP 2010 28-11 Target gt65 HP 2010 28-11
Baseline lt65 Not Reported
HI 83
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Births Combined US Military Forces

• Approximately 95,000 military families each year
  - more individual births than all but the 12
  largest states
• Approximately 40 of these births occur at
  military facilities
• Military births take place in all 50 states and
  more than 20 foreign countries (8.5)
• More than 2,000 military births per year occur in
  each of 11 states
• CA, CO, FL, GA, HI, KY, MD, NC, TX, VA, and WA
• Non-US sites
• Germany and Japan (both gt 2,000)
• 3,700 in other sites

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Military Hospitals
Air ForceArmyNavy
Hawaii
Puerto Rico
Guam
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Recent CDC EHDI Activities

• DoD Birth and Infant Health Registry (BIHR)
• 05 Jan 06
• telephone call with LCDR Margaret Ryan, M.D.
  (Navy) Director, DoD Center for Deployment Health
  Research and Christina Spooner, M.S., coordinator
  for the BIHR
• Surveillance for birth defects in partnership
  with CDCs National Birth Defects Prevention
  Network

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DoD Birth and Infant Health Registry

• Preliminary BIHR results suggest a steady
  increase in the use of V72.1 (examination of ears
  and hearing) since 1998 with a large increase in
  the year 2000
• Increase in services or reporting?
• Approximately 1/3 of reported military births had
  this code associated with their obtained services
  in 2003
• BIHR will continue to explore codes in their data
  set

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11 Jan 06 Teleconference

• Army (Walter Reed) Donna MacNeil, M.A., FAAA
• Air Force CPT Alicia Burke, M.A.
• Navy CDR Leslie Sims, M.S., FAAA
• CDR Margaret Ryan, M.D.
• CDR Michelle Gasper, M.D.
• CPT Martin McCaffrey, M.D.
• LT Anne Jarrett, M.A. CCC-A
• Christina Spooner, M.S.
• BUMED (D.C.) CDR Khin Aungthein, RNC, MSN
• CDC John Eichwald, M.A., FAAA
• Craig Mason, Ph.D.

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Teleconference Issues Identified

• Most military programs are felt to be reporting
  data to their respective state EHDI program
• There is no uniform reporting of EHDI data or
  centralized database for military families
• Audiologists are generally responsible for
  follow-up newborns who fail the initial screen
• Primary Care Manager (PCM) responsible for
  follow-up when no audiologist is assigned to a
  facility
• Good early intervention support system available
  through Educational and Developmental
  Intervention Services (EDIS) both domestically
  and overseas
• EHDI services spread out in particular for non US
  sites

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CDC / NCBDDD / EHDI Briefing

• 06 Feb 06
• RADM José Cordero, MD, MPH, FAAP
• Director, CDC National Center on Birth Defects
  and Developmental Disabilities
• Assistant Surgeon General
• Peter Rzeszotarski, MA
• Acting Associate Director for Policy, Planning,
  and Evaluation

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Future Activities

• Continue communication among CDC-EHDI and all
  military branches
• Development of a new audiology survey for all
  branches (Dr. McCaffrey and Dr. Ryan expressed
  interest in collaborating on the survey)
• Teleconference with the EDIS Program Manager
• Possible EHDI Special Topics Teleconference
  concerning EHDI and the Military
• Offer of resources, materials and training

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(No Transcript)
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American Academy of Pediatrics PediaLink

• Web-based educational program for pediatric
  health care professionals
• Modules
• different types of hearing loss
• screening methods for hearing loss
• medical and genetic risk factors
• the importance of early recognition and ongoing
  surveillance
• the role of the medical home in hearing screening

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American Academy of Pediatrics PediaLink

• CDC-EHDI Free Scholarships for Continuing Medical
  Education
• (5 AMA PRA Category 1 credits)
• Contact
• John Eichwald jeichwald_at_cdc.gov
• Jill Ackermann JAckermann_at_aap.org
• or screening_at_aap.org

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Questions?
jeichwald_at_cdc.gov
The findings and conclusions in this presentation
have not been formally disseminated by the
Centers for Disease Control and Prevention and
should not be construed to represent any agency
determination or policy.