Early Hearing Detection and Intervention A roadmap to success
Outpatient screening: before one month
Introduction
Standardize communications (written and verbal) with parents about hearing screening results
Provide clear communication about next steps using the Patient Checklist for Primary Care Providers
Identify two points of contact for families of infants who did not pass such as a relative or friend
Offer a referral to Minnesota Hands and Voices
Schedule the follow-up appointment during the visit
Closing the follow-up gap: Outpatient screening
Role of Outpatient Screening Staff
Important Steps to Cover
Complete outpatient rescreening before 1 month of age
Educate parents about newborn hearing screening follow-up
Prepare quiet infant for screening
Screen both ears (ABR Tips, OAE Testing Steps & Do's and Don'ts, Clinic Quality Assurance Checklist)
If infant does NOT PASS, schedule appointment for diagnostic audiological evaluation (Hearing Screening Follow-up Process)
Document outpatient rescreening result in:
Baby's medical record
Hearing Screening log book (if completed by hospital nursery staff)
Communicate rescreening result to parents and primary care provider
Report outpatient results to MDH using appropriate forms for: Audiologists: Audiology Results Report Form
Have a plan if infant/family does not show for appointment
Materials marked with * are available to order free-of-charge on the Minnesota Newborn Screening Program website.
Tips for Improvement
Misconception: Abnormal OAE’s along with flat tympanograms (normal volume) confirms a conductive hearing loss
Clinical Fact: Diagnostic ABR including bone conduction testing is needed in combination with OAE’s and tympanograms for a complete diagnosis of type and degree of hearing loss in each ear
---------------
Misconception: Middle ear fluid prevents completion of diagnostic ABR
Clinical Fact: Underlying sensory loss can and should be ruled out as soon as possible through use of bone conduction ABR stimuli
Misconception: Babies need to be sedated to complete ABR testing
Clinical Fact: Babies younger than 3 months can typically be tested without need for sedation