Screening Diagnosis Early Intervention
2/16/2018
Outline Effects of Early Hearing Detection and Intervention on Language Development in Children with Hearing Loss
• EHDI System in Wisconsin • Deafness Specific Early Intervention Support (CARES)
WI Speech‐Language Pathology and Audiology Association Convention, February 2018
• Language Outcomes at 14 and 30 months (AEIOu)
Christi Hess, PhD, CCC‐SLP‐ Waisman Center Elizabeth Seeliger, AuD ‐ Wisconsin Sound Beginnings Program
Screening
1
Diagnosis
3 Early Hearing Detection & Intervention
99% of babies born in Wisconsin screened by 1 month in 2016
6
Early Intervention
Percentage of Babies Diagnosed with Permanent Hearing Loss by 3 Months of Age
51%
47%
51%
50%
52%
2013
2014
2015
55%
36%
2010
2011
2012
2016
1
2/16/2018
Percentage of Babies with Permanent Hearing Loss Enrolled in EI by 6 Months of Age
1
99%
3
55%
6
Outline
✓• EHDI System in Wisconsin
37%
What is CARES? (Coordination Assistance Resource Evaluation Services)
✔
Referral
• Deafness Specific Early Intervention Support (CARES) • Language Outcomes at 14 and 30 months (AEIOu)
✔
IFSP Development
✔
Evaluation
✔
Annual IFSP Meetings
Intake
IFSP Implementation (on‐going visits)
✔
✔
✔
Eligibility Determination
✔
Transition
2
2/16/2018
Southern Region Enrollment
2016 Enrollment Data
Severe-Profound
49
100%
(6/6) Moderate-Mod Severe 30
27 19
20
18
Enrolled Referred
Slight-Mild
14 4
Southern Region
83%
(5/6) 57%
(4/7) 8
5
Unilateral HL (4/10)
Northern Region
Northeastern Southeastern Region Region
40%
Western Region
*The 4/10 children with UHL who enrolled had microtia/atresia (2) or additional disabilities (2)
AEIOu (Assessment of Early Intervention OUtcomes)
Outline
✓• EHDI System in Wisconsin
Eligibility criteria: Unilateral or bilateral hearing loss
✓• Deafness Specific Early Intervention Support (CARES) • Language Outcomes at 14 and 30 months (AEIOu)
Permanent conductive, sensorineural or mixed hearing loss Any degree of hearing loss from mild to profound Hearing loss only or hearing loss with additional disabilities English, Spanish or American Sign Language as their home language Enrolled in Part C Early Intervention (Birth to 3 Program)
AEIOu (Assessment of Early Intervention OUtcomes)
Phase 1: Meeting 3 month guideline 140
Phase 2
Mean (Range)
Mean (Range)
n size
n size
14.1 months (10‐18 mo.)
32.3 months (29‐45 mo.)
n=86, 44 females 3.4 months (0.5‐16 mo.) n=50
n=43, 22 females 2.9 months (0.5‐15 mo.) n=43
Age of Intervention
5.2 months (0.5‐17 mo.) n=51
5.7 months (0.5‐17 mo.) n=38
Age of Amplification
5.5 months (1‐15 mo.) n=83
5.6 months (1‐15 mo.) n=43
Maternal Education
15 years (8‐19 yr.) n=55
15.4 years (8‐19 yr.) n=36
PARTICIPANTS Age of Identification
120
Developmental Quotient
Phase 1
100 80 60 40 20 0 MN Expressive Language Q
MN Receptive Language Q
MN Social Emotional Q
Before 3 months n=50 (45*)
MN Cognitive Q
CDI Language Q
Greenspan SS
At or after 3 months n=35 (33*)
3
2/16/2018
Phase 1: Meeting 3 and 6 month guideline
140
140
120
120
100
100
Developmental Quotient
Developmental Quotient
Phase 1: Meeting 6 month guideline
80 60 40
80 60 40 20
20
0 0 MN Expressive Language Q
MN Receptive Language Q
MN Social Emotional Q Before 6 months
MN Cognitive Q
CDI Language Q
MN Expressive Language Q
Greenspan SS
MN Receptive Language Q
MN Social Emotional Q Meets 3‐6
At or after 6 months
n=51 (45*)
n=36 (31*)
MN Cognitive Q
CDI Language Q
Greenspan SS
Does not meet 3‐6 n=41 (39*)
n=26 (25*)
Phase 1: Additional Disabilities
Phase 1 vs. Phase 2
140 140 120
Developmental Quotient
Developmental Quotient
120 100 80 60 40 20
100 80 Phase 1 Phase 2
60 40 20
0
0 MN Expressive Language Q
MN Receptive Language Q
MN Social Emotional Q Deaf n=65 (63*)
MN Cognitive Q
Deaf Plus n=20 (14*)
CDI Language Q
Greenspan SS
MN Expressive Language Q
MN Receptive Language Q
MN Social Emotional Q
MN Cognitive Q
CDI Language Q
= p
Outline Effects of Early Hearing Detection and Intervention on Language Development in Children with Hearing Loss
• EHDI System in Wisconsin • Deafness Specific Early Intervention Support (CARES)
WI Speech‐Language Pathology and Audiology Association Convention, February 2018
• Language Outcomes at 14 and 30 months (AEIOu)
Christi Hess, PhD, CCC‐SLP‐ Waisman Center Elizabeth Seeliger, AuD ‐ Wisconsin Sound Beginnings Program
Screening
1
Diagnosis
3 Early Hearing Detection & Intervention
99% of babies born in Wisconsin screened by 1 month in 2016
6
Early Intervention
Percentage of Babies Diagnosed with Permanent Hearing Loss by 3 Months of Age
51%
47%
51%
50%
52%
2013
2014
2015
55%
36%
2010
2011
2012
2016
1
2/16/2018
Percentage of Babies with Permanent Hearing Loss Enrolled in EI by 6 Months of Age
1
99%
3
55%
6
Outline
✓• EHDI System in Wisconsin
37%
What is CARES? (Coordination Assistance Resource Evaluation Services)
✔
Referral
• Deafness Specific Early Intervention Support (CARES) • Language Outcomes at 14 and 30 months (AEIOu)
✔
IFSP Development
✔
Evaluation
✔
Annual IFSP Meetings
Intake
IFSP Implementation (on‐going visits)
✔
✔
✔
Eligibility Determination
✔
Transition
2
2/16/2018
Southern Region Enrollment
2016 Enrollment Data
Severe-Profound
49
100%
(6/6) Moderate-Mod Severe 30
27 19
20
18
Enrolled Referred
Slight-Mild
14 4
Southern Region
83%
(5/6) 57%
(4/7) 8
5
Unilateral HL (4/10)
Northern Region
Northeastern Southeastern Region Region
40%
Western Region
*The 4/10 children with UHL who enrolled had microtia/atresia (2) or additional disabilities (2)
AEIOu (Assessment of Early Intervention OUtcomes)
Outline
✓• EHDI System in Wisconsin
Eligibility criteria: Unilateral or bilateral hearing loss
✓• Deafness Specific Early Intervention Support (CARES) • Language Outcomes at 14 and 30 months (AEIOu)
Permanent conductive, sensorineural or mixed hearing loss Any degree of hearing loss from mild to profound Hearing loss only or hearing loss with additional disabilities English, Spanish or American Sign Language as their home language Enrolled in Part C Early Intervention (Birth to 3 Program)
AEIOu (Assessment of Early Intervention OUtcomes)
Phase 1: Meeting 3 month guideline 140
Phase 2
Mean (Range)
Mean (Range)
n size
n size
14.1 months (10‐18 mo.)
32.3 months (29‐45 mo.)
n=86, 44 females 3.4 months (0.5‐16 mo.) n=50
n=43, 22 females 2.9 months (0.5‐15 mo.) n=43
Age of Intervention
5.2 months (0.5‐17 mo.) n=51
5.7 months (0.5‐17 mo.) n=38
Age of Amplification
5.5 months (1‐15 mo.) n=83
5.6 months (1‐15 mo.) n=43
Maternal Education
15 years (8‐19 yr.) n=55
15.4 years (8‐19 yr.) n=36
PARTICIPANTS Age of Identification
120
Developmental Quotient
Phase 1
100 80 60 40 20 0 MN Expressive Language Q
MN Receptive Language Q
MN Social Emotional Q
Before 3 months n=50 (45*)
MN Cognitive Q
CDI Language Q
Greenspan SS
At or after 3 months n=35 (33*)
3
2/16/2018
Phase 1: Meeting 3 and 6 month guideline
140
140
120
120
100
100
Developmental Quotient
Developmental Quotient
Phase 1: Meeting 6 month guideline
80 60 40
80 60 40 20
20
0 0 MN Expressive Language Q
MN Receptive Language Q
MN Social Emotional Q Before 6 months
MN Cognitive Q
CDI Language Q
MN Expressive Language Q
Greenspan SS
MN Receptive Language Q
MN Social Emotional Q Meets 3‐6
At or after 6 months
n=51 (45*)
n=36 (31*)
MN Cognitive Q
CDI Language Q
Greenspan SS
Does not meet 3‐6 n=41 (39*)
n=26 (25*)
Phase 1: Additional Disabilities
Phase 1 vs. Phase 2
140 140 120
Developmental Quotient
Developmental Quotient
120 100 80 60 40 20
100 80 Phase 1 Phase 2
60 40 20
0
0 MN Expressive Language Q
MN Receptive Language Q
MN Social Emotional Q Deaf n=65 (63*)
MN Cognitive Q
Deaf Plus n=20 (14*)
CDI Language Q
Greenspan SS
MN Expressive Language Q
MN Receptive Language Q
MN Social Emotional Q
MN Cognitive Q
CDI Language Q
= p
