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Need caption for photo of sleeping newborn baby Specialtry Care

Improvement Strategies


Confirm diagnostic audiology appointment at the first visit

Complete Parent Roadmap with families who have a child identified with a hearing loss

Complete the AZ EHDI Patient Checklist (English) or AZ EHDI Patient Checklist (Spanish)  with families who need further screening for hearing loss

Streamline authorization to eliminate delay of connection to specialty providers such as ORL, ENT and genetics

Offer a referral to Guide by your side  or Arizona Hands and Voices

Respond promptly to the Arizona Department of Health Services for follow-up information and plans

Specialty Care: Introduction

Best Practice Guidelines


Review sample policies, procedures and competency guidelines that align with JCIH Guidelines.

Tools for Improvement


Assure follow-up with a few key data-collection and communication tools.

Improvement in Action


See how the collaboratives used improvement tools to test steps of change within their organizations.

Closing the Follow-up Gap: Specialty Care

Specialty Care


All children identified with permanent hearing loss should receive the following specialty care evaluations:

  • Otolaryngology (ENT) Evaluation
    • The ENT physician should have expertise in childhood hearing loss.  The ENT physician is responsible for investigating the etiology of hearing loss and for determining whether medical or surgical intervention may be an appropriate option.  In addition, the ENT physician provides information about and participates in the assessment of the options for amplification, assistive listening devices, and cochlear implantation.  The ENT physician should participate in the long-term monitoring of the child's hearing in partnership with the primary care team.
  • Ophthalmologic Examination
    • Children with hearing loss often have vision problems.  The role of the ophthalmologist is to assess for the presence of syndromic visual loss associated with hearing loss, such as in Usher's syndrome.  Evaluation for more common types of visual impairment, including refractive error,  is essential for children who will likely be strong visual learners.
  • Genetic Evaluation and Counseling
    • Half of all hearing loss is genetic.  The purpose of the evaluation performed by a clinical geneticist is to determine the cause of hearing loss, identify other medical issues that are assosicated with hearing loss, and develop long-term medical management plans based on associated conditions.

Discussion Points

  • How do you find resources appropriate to this family's needs?
  • What could your practice do to increase access to your services?