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Need caption for photo of sleeping newborn baby Early Intervention: Before 6 Months

Improvement Strategies


Build family to family relationships

Standardize referral mechanisms (WE-TRAC to PPS)

Use a fax-back form to alert the Medical Home at the time of enrollment

Obtain a consent for release of information at first contact so that information can be shared with the state EHDI Program

Include communication outcomes in every IFSP

Confirm the hearing status of every child with a related condition

Identify every failed appointment as an opportunity to act and learn

Early Intervention: 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: Early Intervention

The Early Intervention Visit

Six Month Early Intervention Visit

The Lakeland County Birth to 3 Program received its first referral for a child with hearing loss through the WE-TRAC System. Daniel Jenson is a six-month old infant diagnosed with permanent, moderate sensorineural hearing loss who lives with his Mom and maternal grandmother. An intake evaluation was set up for three weeks after the referral was received.  Jane, the Lakeland County Birth to 3 Program Coordinator assigned to this case, conducted an eligibility assessment in the family’s home. It was noted and discussed with mom and grandmother that Daniel was meeting his developmental milestones in every area.  The mom was pleased and agreed that she had no concerns about Daniel’s development. Daniel’s grandmother, however, did express concern that her grandson could not hear her sing and was not calmed by her voice, the way her other grandchildren were.   Jane reassured the grandmother that although Daniel would not be found eligible for services at this time, they would reassess him in six months when she could begin to assess his speech and language development.  Jane provides the family with a copy of the Babies & Hearing Loss Notebook, as they did not receive one from their audiologist. Jane’s report indicates that the mother declined services at this time.

Twelve Month Early Intervention Visit

Jane returns to the home for Daniel’s six-month reevaluation.  An exasperated grandmother meets Jane at the door, with Daniel in one arm and his hearing aids in hand.  The grandmother explains that she is frustrated with the squealing sound the hearing aids make and is uncomfortable with putting them in his ears.  She also reports that Daniel’s mom is no longer living with them and she has primary responsibility for Daniel’s care.  Jane indicates that becoming more comfortable with using and caring for the hearing aids could be something that Birth to 3 could help with if Daniel was found eligible for services.  After Jane completed the assessment process, she and Daniel’s grandmother agree that he would be eligible for Birth to 3 and that they were in need of services.  They discussed the next steps, which would include goal setting as a part of the IFSP process, and gathered consent to share her contact information with other supportive programs such as the Guide By Your Side Program. The grandmother was relieved that she would receive support from Birth to 3 and seemed anxious to hear from her Parent Guide. 

Discussion Points

  • What might be unique considerations when serving families of children who are deaf or hard of hearing?
  • What could this program have done differently to expedite the enrollment process?
  • What improvement strategy could they implement to assure that families understand why early intervention is important?
  • How could the EI program have worked differently to engage partnerships with the medical community?
  • What developmental areas should have been discussed with the family?
  • Do you agree that this family should have declined services?
  • At the six-month visit, should this child have been found eligible for services?  Why?