TM. Centers for Disease Control and Prevention National Center on Birth Defects and Developmental Disabilities Division of Human Development and Disability.

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<ul><li> Slide 1 </li> <li> TM </li> <li> Slide 2 </li> <li> Centers for Disease Control and Prevention National Center on Birth Defects and Developmental Disabilities Division of Human Development and Disability Centers for Disease Control and Prevention National Center on Birth Defects and Developmental Disabilities Division of Human Development and Disability Military Audiology Association February 13, 2006 John Eichwald, Team Lead </li> <li> Slide 3 </li> <li> TM Incidence per 10,000 Congenital Defects/Diseases Incidence per 10,000 MACDP NCBDDD 2004 </li> <li> Slide 4 </li> <li> TM Conditions Screened in the Newborn Incidence per 10,000 NNSGRC 2003 </li> <li> Slide 5 </li> <li> TM Reading Comprehension Scores of Hearing and Deaf Students Age in Years Schildroth, A. N., &amp; Karchmer, M. A. (1986). Deaf children in America, San Diego: College Hill Press. Grade Equivalents </li> <li> Slide 6 </li> <li> TM Study of Early versus Late Identification 0.81.21.82.22.83.23.84.24.8 0 1 2 3 4 5 6 Identified 6 mos (n = 104) Age (yrs) Language Age (yrs) Moeller, M.P. (1997). Boys Town National Research Hospital 129 deaf and hard-of-hearing children assessed 2x each year. Assessments done by trained diagnostician as normal part of early intervention program. </li> <li> Slide 7 </li> <li> TM Universal Newborn Hearing Screening Endorsement American Academy of Audiology (AAA) American Academy of Pediatrics (AAP) American Speech-Language-Hearing Association (ASHA) Centers for Disease Control and Prevention (CDC) Joint Committee on Infant Hearing (JCIH) Maternal and Child Health Bureau (MCHB) National Association of the Deaf (NAD) National Institutes of Health (NIH) </li> <li> Slide 8 </li> <li> TM CDC EHDI Vision and Mission The vision of the Early Hearing Detection and Intervention (EHDI) program is to promote communication from birth for all children.The vision of the Early Hearing Detection and Intervention (EHDI) program is to promote communication from birth for all children. The mission of EHDI is for every state and territory to have a complete EHDI tracking and surveillance system that ensures children with hearing loss achieve communication and social skills commensurate with their cognitive abilities.The mission of EHDI is for every state and territory to have a complete EHDI tracking and surveillance system that ensures children with hearing loss achieve communication and social skills commensurate with their cognitive abilities. </li> <li> Slide 9 </li> <li> TM Childrens Health Act of 2000 Public Law 106310 DIVISION ACHILDRENS HEALTH TITLE VIIEARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING HEARING LOSS IN INFANTS The purposes of this title are to clarify the authority within the Public Health Service Act to authorize statewide newborn and infant hearing screening, evaluation and intervention programs and systems, technical assistance, a national applied research program, and interagency and private sector collaboration for policy development, in order to assist the States in making progress toward the following goals: </li> <li> Slide 10 </li> <li> TM Childrens Health Act of 2000 Public Law 106310 (1) All babies born in hospitals in the United States and its territories should have a hearing screening before leaving the birthing facility. (2) All babies who are not born in hospitals in the United States and its territories should have a hearing screening within the first 3 months of life. (3) Appropriate audiologic and medical evaluations should be conducted by 3 months for all newborns and infants suspected of having hearing loss to allow appropriate referral and provisions for audiologic rehabilitation, medical and early intervention before the age of 6 months. </li> <li> Slide 11 </li> <li> TM Childrens Health Act of 2000 Public Law 106310 (4) All newborn and infant hearing screening programs and systems should include a component for audiologic rehabilitation, medical and early intervention options that ensures linkage to any new and existing state-wide systems of intervention and rehabilitative services for newborns and infants with hearing loss. (5) Public policy in regard to newborn and infant hearing screening and intervention should be based on applied research and the recognition that newborns, infants, toddlers, and children who are deaf or hard-of-hearing have unique language, learning, and communication needs, and should be the result of consultation with pertinent public and private sectors. </li> <li> Slide 12 </li> <li> TM Childrens Health Act of 2000 DIVISION A CHILDRENS HEALTH TITLE VII EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING HEARING LOSS IN INFANTS Health Resources and Services Administration (HRSA) shall: make awards of grants or cooperative agreements to develop statewide newborn and infant hearing screening, evaluation and intervention programs and systems </li> <li> Slide 13 </li> <li> TM Childrens Health Act of 2000 The Centers for Disease Control and Prevention shall: develop standardized procedures for data management provide technical assistance on data collection and management promote the sharing of data regarding early hearing loss with state-based birth defects and developmental disabilities monitoring programs </li> <li> Slide 14 </li> <li> TM Childrens Health Act of 2000 The Centers for Disease Control and Prevention (CDC) shall: develop standardized procedures for data management and program effectiveness and costs, such as to: ensure quality monitoring of newborn and infant hearing loss screening, evaluation, and intervention programs and systems; provide technical assistance on data collection and management; to study the costs and effectiveness of newborn and infant hearing screening, evaluation and intervention programs and systems conducted by State-based programs in order to answer issues of importance to State and national policymakers; </li> <li> Slide 15 </li> <li> TM Childrens Health Act of 2000 National Institutes of Health (NIH) shall: continue a program of research and development on the efficacy of new screening techniques and technology, including clinical studies of screening methods, studies on efficacy of intervention, and related research. </li> <li> Slide 16 </li> <li> TM WA 81% MT 97% OR 95% NV 99% CA 56% UT 98% AZ NM 92% CO 97% ID 83% WY 98% ND 95% SD 90% MN 93% IA NE 97% KS 97% TX 97% FL 86% MS 95% LA 94% GA 96% SC 98% NC 96% VA 96% ME 94% NY 92% WI 93% OK 96% MO 99% AR 92% TN 97% KY 99% IL 100% IN 99% MI* OH 40% WV 98% MD 91% DE 83% NJ 98% VT 93% RI 99% CT 97% NH 91% MA 99% AK 81% HI 99% PA 98% 87.2% Newborns Screened (2003) (n = 47) &gt;90% HP 2010 28-11 Target &gt;65% HP 2010 28-11 Baseline </li> <li> TM WA MT* OR 35% NV CA 80% UT 66% AZ NM CO 89% ID 100% WY 94% ND 43% SD 69% MN 53% IA NE 82% KS 77% TX FL MS 84% LA 65% AL GA 14% SC 65% NC* VA 70% ME NY 25% WI OK 32% MO 20% AR 47% TN 61% KY 14% IL 77% IN MI* OH 17% WV 66% MD 27% DE 100% NJ 53% VT 86% RI 95% CT 73% NH 9% MA 85% AK HI 74% PA 60% 55.9% Audiological Evaluation (2003) (n = 35) &gt;70% HP 2010 28-11 Target &gt;55% HP 2010 28-11 Baseline </li> <li> TM WA MT* OR 39% NV CA 87% UT 41% AZ NM 50% CO 45% ID 100% WY 100% ND SD 100% MN 100% IA NE 67% KS 84% TX FL MS 85% LA 53% AL GA SC* NC VA 63% ME NY 61% WI OK 91% MO 52% AR 64% TN 100% KY 100% IL 29% IN 67% MI* OH 28% WV 75% MD DE 100% NJ 75% VT 0% RI 100% CT 100% NH 64% MA 71% AK 0% HI 83% PA 64% 67.3% Intervention by 6 months (2003) (n = 34) &gt;90% HP 2010 28-11 Target &gt;65% HP 2010 28-11 Baseline </li> <li> TM Births: Combined US Military Forces Approximately 95,000 military families each year - more individual births than all but the 12 largest states Approximately 40% of these births occur at military facilities Military births take place in all 50 states and more than 20 foreign countries (8.5%) More than 2,000 military births per year occur in each of 11 states: CA, CO, FL, GA, HI, KY, MD, NC, TX, VA, and WA Non-US sites: Germany and Japan (both &gt; 2,000) 3,700 in other sites </li> <li> Slide 20 </li> <li> TM Hawaii Puerto Rico Military Hospitals Guam Air Force Army Navy </li> <li> Slide 21 </li> <li> TM Recent CDC EHDI Activities DoD Birth and Infant Health Registry (BIHR)DoD Birth and Infant Health Registry (BIHR) 05 Jan 06 telephone call with LCDR Margaret Ryan, M.D. (Navy) Director, DoD Center for Deployment Health Research and Christina Spooner, M.S., coordinator for the BIHR Surveillance for birth defects in partnership with CDCs National Birth Defects Prevention Network </li> <li> Slide 22 </li> <li> TM DoD Birth and Infant Health Registry Preliminary BIHR results suggest a steady increase in the use of V72.1 (examination of ears and hearing) since 1998 with a large increase in the year 2000 Increase in services or reporting? Approximately 1/3 of reported military births had this code associated with their obtained services in 2003 BIHR will continue to explore codes in their data set </li> <li> Slide 23 </li> <li> TM 11 Jan 06 Teleconference Army Army (Walter Reed):Donna MacNeil, M.A., FAAA Air Force Air Force:CPT Alicia Burke, M.A. Navy Navy:CDR Leslie Sims, M.S., FAAA CDR Margaret Ryan, M.D. CDR Michelle Gasper, M.D. CPT Martin McCaffrey, M.D. LT Anne Jarrett, M.A. CCC-A Christina Spooner, M.S. BUMED BUMED (D.C.)CDR Khin Aungthein, RNC, MSN CDC CDC:John Eichwald, M.A., FAAA Craig Mason, Ph.D. </li> <li> Slide 24 </li> <li> TM Teleconference Issues Identified Most military programs are felt to be reporting data to their respective state EHDI program There is no uniform reporting of EHDI data or centralized database for military families Audiologists are generally responsible for follow-up newborns who fail the initial screen Primary Care Manager (PCM) responsible for follow-up when no audiologist is assigned to a facility Good early intervention support system available through Educational and Developmental Intervention Services (EDIS) both domestically and overseas EHDI services spread out in particular for non US sites </li> <li> Slide 25 </li> <li> TM CDC / NCBDDD / EHDI Briefing 06 Feb 06 RADM Jos Cordero, MD, MPH, FAAP Director, CDC National Center on Birth Defects and Developmental Disabilities Assistant Surgeon General Peter Rzeszotarski, MA Acting Associate Director for Policy, Planning, and Evaluation </li> <li> Slide 26 </li> <li> TM Future Activities Continue communication among CDC-EHDI and all military branches Development of a new audiology survey for all branches (Dr. McCaffrey and Dr. Ryan expressed interest in collaborating on the survey) Teleconference with the EDIS Program Manager Possible EHDI Special Topics Teleconference concerning EHDI and the Military Offer of resources, materials and training </li> <li> Slide 27 </li> <li> Slide 28 </li> <li> TM American Academy of Pediatrics PediaLink Web-based educational program for pediatric health care professionals Modules: different types of hearing loss screening methods for hearing loss medical and genetic risk factors the importance of early recognition and ongoing surveillance the role of the medical home in hearing screening </li> <li> Slide 29 </li> <li> TM American Academy of Pediatrics PediaLink CDC-EHDI Free Scholarships for Continuing Medical Education (5 AMA PRA Category 1 credits) Contact: jeichwald@cdc.go John Eichwald: jeichwald@cdc.gov JAckermann@aap.org Jill Ackermann: JAckermann@aap.org screening@aap.org or: screening@aap.org </li> <li> Slide 30 </li> <li> TM Questions? The findings and conclusions in this presentation have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy. jeichwald@cdc.gov </li> </ul>

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