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Referral information for infant hearing screening, cochlear implant program

Hearing loss is the No. 1 birth defect in America, yet only half of affected infants have a known risk factor, such as illness or family history. Because the detrimental effects of late-identified hearing loss are well documented, all 50 states screen for hearing loss at birth.

Early identification and intervention
Follow-up testing may confirm normal hearing or the need for additional testing. If hearing loss is eventually confirmed, families receive a care plan with recommended services to help develop speech and language skills.

It’s important to check an infant’s hearing screening results at the first well visit. Physicians should be notified by the hospital where the baby was tested within 2 days if a newborn failed the screening, with follow-up notification from the Ohio Department of Health.

Identification is crucial by age 3 months, so interventions can begin by 6 months. This gives babies the best chance at developing age-appropriate communication skills.

Making a referral for follow-up testing
Follow-up testing should occur between 4-6 weeks. To ensure appointments are scheduled in a timely manner after discharge from the birth hospital, send a prescription through Epic or by fax right away. The patient’s family should then call to schedule the follow-up testing.

Testing is offered in the Audiology Department and Ear, Nose and Throat Center.

The Family Child Learning Center (FCLC) Regional Infant Hearing Program provides free services to qualifying families with infants and toddlers who are hearing impaired. These services are offered in collaboration with Help Me Grow and other community resources.

Cochlear implants for severe hearing loss

For children identified with severe to profound hearing loss who receive limited benefit from hearing aids, the ENT Center offers a cochlear implant program.

“This includes those using binaural amplification who are unable to hear conversation at a low level or understand speech at an average conversational level,” said Marc Nelson, MD, “Infants should be referred as soon as severe to profound hearing loss is diagnosed, so they can be medically cleared for hearing aids.”

Our team will determine if a child is a good candidate for the procedure. The evaluation may take multiple appointments over an extended period of time to ensure the child can benefit from a cochlear implant and prepare the child and family for the intensive follow-up required for success.

“Having other special needs does not exclude a child from candidacy,” Dr. Nelson said.

The assessment includes:

  • Medical evaluation with an otolaryngologist, including a thorough medical history and imaging
  • Evaluation with an audiologist consisting of hearing tests, a hearing aid trial to assess the benefit and any additional testing as needed
  • Evaluation by a speech and language therapist specializing in children with hearing loss
  • Identification of additional referrals for services, including developmental-behavioral pediatrics, social work and other specialties, as indicated

Auditory-verbal therapy
Before and after cochlear implantation, children with hearing loss need to develop listening and spoken language skills. They will receive auditory-verbal therapy to promote the acquisition of spoken language and literacy skills through listening.

Parents and primary caregivers are crucial partners in the intervention process. They participate in each intervention or therapy session so they can learn strategies to use at home that reinforce listening and spoken language.

“Research shows that when children get their cochlear implants early, have good parental support and a lot of  encouragement at home, they can attain spoken language skills equal to their hearing peers,” Dr. Nelson said.

Children may be candidates for cochlear implants if they:

  • Have bilateral severe to profound sensorineural hearing loss
  • Are at least 12 months of age
  • Are struggling with hearing aid use, not making adequate speech progress or struggling in the classroom

Cochlear implant team:

  • Marc Nelson, MD, MS, FAAP
  • Shelley Duncan, AuD
  • Carrie Putka, AuD, CCC-A
  • K. Todd Houston, PhD, CCC-SLP, LSLS Cert. AVT
  • Denise Wray, PhD, CCC-SLP, LSLS Cert. AVT

Make a referral through Epic or by calling 330-543-4930.

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