From Colorado to Guam: Infant Diagnostic Audiological Evaluations by Telepractice

By Hayes, Deborah; Eclavea, Elaine et al. | The Volta Review, Winter 2012 | Go to article overview

From Colorado to Guam: Infant Diagnostic Audiological Evaluations by Telepractice


Hayes, Deborah, Eclavea, Elaine, Dreith, Susan, Habte, Bereket, The Volta Review


This manuscript describes a pilot project in which infants in Guam who refer on newborn hearing screening receive diagnostic audiological evaluation conducted by audiologists in Colorado over the Internet (telepractice). The evaluation is completed in real time using commercially-available software and personal computers to control the diagnostic audiological equipment remotely, and videoconferencing with support personnel and the family. Test results for 9 infants, all of whom received complete diagnostic assessment by auditory-evoked potentials and otoacoustic emissions, are described. Further elaboration is provided on steps to establishing the project and how regulatory, privacy and confidentiality, and professional practice issues in telepractice are addressed.

Introduction

Early hearing detection and intervention (EHDI) programs are systems of services that diagnose infants who are deaf and hard of hearing by 3 months of age and enroll identified infants in early intervention by 6 months of age (Centers for Disease Control [CDC], 2012; Healthy People 2020, 2012; Joint Committee on Infant Hearing [JCIH], 2007). Component steps include newborn hearing screening (NHS), diagnostic audiological evaluation (DAE), medicai/otologie assessment, and early intervention. NHS is wellestablished in the United States and its territories. Summary of 2009 CDC EHDI data (CDC, 2009) demonstrated that of 47 states and 3 territories responding, more than 97% of infants born in those states and territories were screened for hearing loss at birth. However, more than 45% of infants in this data set who referred for further testing are categorized as either lost to follow-up (LTF) or lost to documentation of follow-up. In total, more than 25,000 infants who referred on NHS either did not have diagnostic audiological evaluations or diagnostic results were not reported to the jurisdictional EHDI program.

LTF substantially hinders public health and public education efforts to improve language and academic outcomes for children who are deaf and hard of hearing. Delayed confirmation of hearing loss in infants who are deaf and hard of hearing increases their risk for delayed speech and language development (Yoshinaga-Itano, Sedey, Coulter, & Mehl, 1998). For some families, especially those in remote or rural areas, LTF occurs when infant DAE services are unavailable in close proximity. In these cases, travel costs, geographic or weather-related travel barriers, loss of work time, and /or other family commitments may prevent infants from receiving timely services (Shulman et al., 2010).

LTF became increasingly problematic for the Guam EHDI program between 2009 and 2011. Guam, a U.S. island territory in the western Pacific, has a robust NHS program for infants born in the island hospital or birthing center (infants born on the U.S. naval base are not reported in Guam EHDI program statistics). During the period of 2009-2011, 99% of infants born in these facilities received NHS. In addition, Guam EHDI introduced a two-stage NHS program where infants who referred on inpatient otoacoustic emission (OAE) screening received outpatient automated auditory brainstem response (ABR) screening after discharge. The two-stage screening process reduced the percentage of infants who referred for DAE from almost 15% (442/2953 infants) to less than 5% (125/2732 infants) in 2011. During this same period, however, LTF for infant DAE increased from 7% in 2009 to almost 35% in 2011.

Lack of an audiologist on-island to provide extensive infant DAE services was the principle reason for the increase in LTF. This compromised infant enrollment in early intervention services. Without a diagnosis from a licensed professional, infants could not be confirmed as eligible for Individuals with Disabilities Education Act (IDEA) Part C services and could not be enrolled in an early intervention program. Part C provides financial assistance to states and U. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

From Colorado to Guam: Infant Diagnostic Audiological Evaluations by Telepractice
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.